Fatty infiltration of liver in hyperlipidemic patients
Fatty infiltration of liver in hyperlipidemic patients
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DOI：
10.1023/a:1005661516165
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发表时间：
2000-10-01
影响因子：
3.1
通讯作者：
Minuk, G
中科院分区：
文献类型：
--
作者：
Assy, N;Kaita, K;Minuk, G
高脂血症是肝脏脂肪浸润的已知危险因素，这种情况可发展为肝硬化和肝功能衰竭。本研究的目的是记录高脂血症患者肝脏脂肪浸润的患病率，并确定与该疾病相关的预测变量。在18个月的招募期内，以横断面方式对95名到城市医院血脂诊所评估和管理高脂血症的成年患者进行临床、生化和放射学评估。患者的平均（+/- sd）年龄为55 +/- 13岁。48例（51%）为男性。52例（55%）患有高胆固醇血症，25例（26%）患有重度高甘油三酯血症，14例（15%）患有混合性高脂血症，4例（4%）患有中度高甘油三酯血症。肥胖和糖尿病分别占36例（38%）和12例（12%）。共有61例（64%）患者肝酶检测升高。最常见的酶异常是45例（47%）患者血清ALT升高，43例（45%）患者血清GGT升高。超声表现为弥漫性脂肪肝47例（50%），其中轻度21例（22%），中度18例（19%），重度8例（9%）。大多数高胆固醇血症患者[35/52(67%)]超声检查正常，而重度高甘油三酯血症和混合性高脂血症往往与脂肪肝的影像学证据相关（优势比分别为5.9和5.1,P < 0.01）。脂肪肝的独立预测因子是；AST （P = 0.001）、高血糖（P = 0.02）和年龄（P = 0.04）。在一个纳入已知脂肪肝危险因素的模型中，糖尿病是除高甘油三酯血症外唯一与脂肪浸润显著相关的危险因素。年龄、性别、肥胖或饮酒没有这种影响。总之，本研究结果表明，在大约50%的高脂血症患者中，肝脏脂肪浸润的超声证据是明显的。高甘油三酯血症是最常与此病相关的血脂。血清AST值、高血糖和年龄独立预测脂肪浸润的存在，而高甘油三酯血症和糖尿病是唯一显著增加高脂血症患者脂肪浸润风险的危险因素。
Hyperlipidemia is a known risk factor for fatty infiltration of the liver, a condition that can progress to cirrhosis and liver failure. The objectives of this study were to document the prevalence of fatty infiltration in the livers of hyperlipidemic patients and to identify the predictor variables associated with this condition. Over an 18-month recruitment period, clinical, biochemical, and radiologic assessments were performed in a cross-sectional manner in 95 adult patients referred to an urban hospital-based lipid clinic for evaluation and management of hyperlipidemia. The mean (+/-SD) age of the patients was 55 +/- 13 years. Forty-eight (51%) were male. Fifty-two patients (55%) had hypercholesterolemia, 25 (26%) severe hypertriglyceridemia, 14 (15%) mixed hyperlipidemia, and 4 (4%) moderate hypertriglyceridemia. Obesity and diabetes were present in 36 (38%) and 12 (12%) of cases, respectively. A total of 61 (64%) patients had elevated liver enzyme tests. The most common enzyme abnormalities were an elevated serum ALT in 45 (47%) and GGT in 43 (45%) of patients. Ultrasound findings revealed diffuse fatty liver in 47 patients (50%), of which 21 cases (22%) were mild, 18 (19%) moderate, and 8 (9%) severe. The majority of patients with hypercholesterolemia [35/52 (67%)] had normal ultrasounds, whereas severe hypertriglyceridemia and mixed hyperlipidemia were frequently associated with radiologic evidence of fatty liver (odds ratios 5.9 and 5.1 respectively, P < 0.01). Independent predictors of fatty liver were; AST (P = 0.001), hyperglycemia (P = 0.02), and age (P = 0.04). In a model incorporating known risk factors for fatty liver, diabetes was the only risk factor other than hypertriglyceridemia that was significantly associated with fatty infiltration. No such effect was seen with age, gender, obesity, or alcohol consumption. In conclusions, the results of this study indicate that ultrasonographic evidence of fatty infiltration of the liver is evident in approximately 50% of patients with hyperlipidemia. Hypertriglyceridemia is the lipid profile most often associated with this condition. Serum AST values, hyperglycemia, and age independently predict the presence of fatty infiltration, while hypertriglyceridemia and diabetes are the only risk factors that significantly increase the risk of fatty infiltration in hyperlipidemic patients.