Hepatocellular carcinoma is the most common liver-related complication in patients with histopathologically-confirmed NAFLD in Japan.
Hepatocellular carcinoma is the most common liver-related complication in patients with histopathologically-confirmed NAFLD in Japan.
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DOI：
10.1186/s12876-018-0900-1
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发表时间：
2018-11-06
影响因子：
2.4
通讯作者：
Kumada H
中科院分区：
文献类型：
--
作者：
Akuta N;Kawamura Y;Arase Y;Saitoh S;Fujiyama S;Sezaki H;Hosaka T;Kobayashi M;Kobayashi M;Suzuki Y;Suzuki F;Ikeda K;Kumada H
经组织病理学证实的NAFLD患者的肝脏相关事件、心血管事件和2型糖尿病的发生率仍不清楚。我们对402例经组织病理学证实的日本NAFLD患者的肝脏事件、心血管事件、恶性肿瘤和2型糖尿病的发生率进行了回顾性调查，平均随访时间为4.2年。我们还调查了这些患者发生肝细胞癌和2型糖尿病的预测因素。每1000人年肝脏相关事件的发生率为4.17(肝细胞癌3.67例；肝性脑病1.60例；食道胃底静脉曲张2.43例；腹水0.80例；黄疸0.40例)。心血管事件和2型糖尿病的发生率分别为5.73和9.95。在没有既往或当前恶性肿瘤的患者中，总死亡率为3.33(与肝脏相关的事件，1.25；心血管事件，0.42；除肝细胞癌以外的其他恶性肿瘤，0.83)。多变量分析发现，高龄(≥70岁)和晚期纤维化4期是这些患者发生肝细胞癌的重要决定因素，肝细胞脂肪变性(>； 33%)、女性和血清铁蛋白(≤80μg/L)是这些患者发生2型糖尿病的重要决定因素。我们的研究结果强调了日本NAFLD患者心血管和肝脏相关事件的重要性。肝细胞癌是最常见的肝相关事件，其发生率占心血管事件的一半以上。
The incidence of liver-related events, cardiovascular events and type 2 diabetes mellitus in patients with histopathologically confirmed NAFLD remains unclear. We retrospectively investigated the incidence of liver events, cardiovascular events, malignancy, and type 2 diabetes mellitus in 402 Japanese patients with histopathologically confirmed NAFLD for a median follow-up of 4.2 years. We also investigated predictors of the development of hepatocellular carcinoma and type 2 diabetes mellitus in these patients. The rate of liver-related events per 1000 person years was 4.17 (hepatocellular carcinoma, 3.67; hepatic encephalopathy, 1.60; esophago-gastric varices, 2.43; ascites, 0.80; and jaundice, 0.40). The rate of cardiovascular events and type 2 diabetes mellitus was 5.73 and 9.95, respectively. Overall mortality was 3.33 (liver-related events, 1.25; cardiovascular events, 0.42; and malignancies other than hepatocellular carcinoma, 0.83), in patients free of previous or current malignancies. Multivariate analyses identified old age (≥70 years) and advanced fibrosis stage 4 as significant determinants of hepatocellular carcinoma development, and hepatocyte steatosis (> 33%), female sex, and serum ferritin (≤80 μg/l) as significant determinants of type 2 diabetes mellitus development in these patients. Our results highlighted the importance of cardiovascular and liver-related events in Japanese patients with histopathologically-confirmed NAFLD. Hepatocellular carcinoma was the most common liver-related event, and the incidence of hepatocellular carcinoma was more than half of that of cardiovascular events.
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DOI：
10.1056/nejmoa0907929
发表时间：
2010-05-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Sanyal AJ;Chalasani N;Kowdley KV;McCullough A;Diehl AM;Bass NM;Neuschwander-Tetri BA;Lavine JE;Tonascia J;Unalp A;Van Natta M;Clark J;Brunt EM;Kleiner DE;Hoofnagle JH;Robuck PR;NASH CRN
通讯作者：
NASH CRN
影响因子：
3.1
作者：
Lonardo, Amedeo;Sookoian, Silvia;Targher, Giovanni
通讯作者：
Targher, Giovanni
影响因子：
29.4
作者：
Angulo P;Kleiner DE;Dam-Larsen S;Adams LA;Bjornsson ES;Charatcharoenwitthaya P;Mills PR;Keach JC;Lafferty HD;Stahler A;Haflidadottir S;Bendtsen F
通讯作者：
Bendtsen F
影响因子：
13.5
作者：
Williams, Roger
通讯作者：
Williams, Roger
影响因子：
9.8
作者：
Brunt, EM;Janney, CG;Bacon, BR
通讯作者：
Bacon, BR