Abnormal glucose tolerance is a predictor of steatohepatitis and fibrosis in patients with non-alcoholic fatty liver disease
Abnormal glucose tolerance is a predictor of steatohepatitis and fibrosis in patients with non-alcoholic fatty liver disease
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DOI：
10.1080/00365520500264953
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发表时间：
2005-12-01
影响因子：
1.9
通讯作者：
Bjoro, K
中科院分区：
文献类型：
--
作者：
Haukeland, JW;Konopski, Z;Bjoro, K
目标。大多数非酒精性脂肪性肝病(NAFLD)患者都有单纯性脂肪变性。然而，少数人患有非酒精性脂肪性肝炎(NASH)，这是一种可能导致晚期纤维化和肝硬变的疾病。NAFLD和持续肝功能升高(LFT)患者中NASH和纤维化的频率尚不确定。我们的目标是估计这些频率。我们描述了患有NAFLD的人群的特征，特别强调胰岛素抵抗和代谢综合征，并研究了疾病不同阶段的可能预测因素。材料和方法。在2002年6月至2004年12月期间，所有转诊的LFT持续升高、有放射学证据或临床怀疑有脂肪肝、且无其他肝病的患者均被邀请参加我们的研究。结果。在129名符合纳入标准的患者中，88人接受了肝活检。其中83例确诊为非酒精性脂肪肝。在这些患者中，59例(71%)有代谢综合征，41例(49%)有NASH，36例(43%)有纤维化。糖耐量异常(T2 DM或糖耐量减低)是NASH的唯一独立危险因素(OR：3.14；95%CI：1.20~8.23)。糖耐量异常(OR：3.83；95%CI：1.29-11.40)和体重指数(OR：1.20；95%CI：1.06-1.36)/kg/m(2)是纤维化的独立预测因素。结论。NASH和纤维化在NAFLD和LFT持续升高的患者中经常出现。随着糖耐量异常的存在，NAFLD的这些潜在进展期的概率增加。
Objective. The majority of patients with non- alcoholic fatty liver disease ( NAFLD) have simple steatosis. A minority, however, present with non- alcoholic steatohepatitis ( NASH), a condition that can lead to advanced fibrosis and cirrhosis. The frequencies of NASH and fibrosis among patients with NAFLD and sustained elevation of liver function tests ( LFT) are uncertain. Our aim was to estimate these frequencies. We characterize a population with NAFLD, with special emphasis on insulin resistance and the metabolic syndrome, and study possible predictors for different stages of the disease. Material and methods. All referred patients with sustained elevation of LFT, radiological evidence or clinical suspicion of fatty liver, and absence of other liver disease, were invited to participate in our study in the period June 2002 to December 2004. Results. Of 129 patients who met the inclusion criteria, 88 underwent liver biopsy. NAFLD was verified in 83 of them. Among these patients, 59 ( 71%) had the metabolic syndrome, 41 ( 49%) had NASH and 36 ( 43%) had fibrosis. Abnormal glucose tolerance ( T2DM or impaired glucose tolerance) was the only independent risk factor for NASH ( OR: 3.14; 95% CI: 1.20 - 8.23). Independent predictors for fibrosis were abnormal glucose tolerance ( OR: 3.83; 95% CI: 1.29 - 11.40) and body mass index ( OR: 1.20; 95% CI: 1.06 - 1.36) per kg/m(2). Conclusions. Both NASH and fibrosis are frequently present among patients with NAFLD and sustained elevation of LFT. The probability of these potentially progressive stages of NAFLD increases with the presence of abnormal glucose tolerance.