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Gastroenterology:生活方式干预对非酒精性脂肪肝儿童患者病情进展的影响

2020-11-29 MedSci原创 MedSci原创

生活方式干预可降低儿童非酒精性脂肪肝患者病情进展风险,1/3不干预对照组患儿在2年内出现进展的组织学特征,其风险特征包括肥胖、血清转氨酶水平升高和葡萄糖稳态丧失

非酒精性脂肪肝(NAFLD)是最常见的儿科慢性肝病,近日研究人员考察了非酒精性脂肪肝患儿进行生活方式干预对其病情进展的影响。
 
2005-15年间,NASH临床网络研究中,122名NAFLD患儿参与,其中男童占74%,白种人占64%,西班牙裔占71%,平均年龄13岁,患儿随机接受标准生活方式护理及对照,对组间患儿肝组织样本较基线及纵向变化进行比较。
 
基线时31%的患儿为确诊NASH,47%为边界NASH,21%为单纯脂肪肝非NASH。在平均1.6年后,29%的边界或确诊NASH患儿缓解,但18%的脂肪肝及边界NASH患儿进展而确诊NASH,34%的患儿纤维化程度改善,23%的患儿加重。确诊NASH和或纤维化进展与基线时年龄、高腰围、丙氨酸或天冬氨酸转氨酶水平、总胆固醇和低密度脂蛋白胆固醇,以及随访期间丙氨酸转氨酶、血红蛋白A1C、谷氨酰转移酶和II型糖尿病相关。
 
研究证实,生活方式干预可降低儿童非酒精性脂肪肝患者病情进展风险,1/3不干预对照组患儿在2年内出现进展的组织学特征,其风险特征包括肥胖、血清转氨酶水平升高和葡萄糖稳态丧失。
 
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createdBy=d18c27357544, createdName=Tommy1958, createdTime=Thu Jan 07 18:00:05 CST 2021, time=2021-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1673635, encodeId=22a216e3635f7, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Mon Jun 21 20:00:05 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073178, encodeId=43ed20e317850, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, 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objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Jan 28 08:00:05 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765127, encodeId=7c061e6512709, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Aug 30 19:00:05 CST 2021, time=2021-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505138, 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Nov 30 14:01:04 CST 2020, time=2020-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903282, encodeId=f9499032821c, content=想学习想学习想学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/9iaAb4Jw2bbQql9icNGa5FjbmPicfSE7biaQIwz1AApCvib4HUmz3W6DibibX6BAgp4atWt9Qkox88aPJQY6GkvckxdfQ/132, createdBy=448e5312462, createdName=陈小凤, createdTime=Sun Nov 29 14:37:56 CST 2020, time=2020-11-29, status=1, ipAttribution=)]
    2021-03-12 许安
  5. [GetPortalCommentsPageByObjectIdResponse(id=1980573, encodeId=a1ef19805e3aa, content=<a href='/topic/show?id=099f9548ed7' target=_blank style='color:#2F92EE;'>#酒精性脂肪肝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95487, encryptionId=099f9548ed7, topicName=酒精性脂肪肝)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=26a9200, createdName=yangshch, createdTime=Sat Oct 09 00:00:05 CST 2021, time=2021-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676609, encodeId=137c16e6609cf, content=<a href='/topic/show?id=397299e19c7' target=_blank style='color:#2F92EE;'>#非酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99719, encryptionId=397299e19c7, topicName=非酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, 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objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Thu Jan 28 08:00:05 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765127, encodeId=7c061e6512709, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Aug 30 19:00:05 CST 2021, time=2021-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505138, 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Nov 30 14:01:04 CST 2020, time=2020-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903282, encodeId=f9499032821c, content=想学习想学习想学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/9iaAb4Jw2bbQql9icNGa5FjbmPicfSE7biaQIwz1AApCvib4HUmz3W6DibibX6BAgp4atWt9Qkox88aPJQY6GkvckxdfQ/132, createdBy=448e5312462, createdName=陈小凤, createdTime=Sun Nov 29 14:37:56 CST 2020, time=2020-11-29, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1980573, encodeId=a1ef19805e3aa, content=<a href='/topic/show?id=099f9548ed7' target=_blank style='color:#2F92EE;'>#酒精性脂肪肝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95487, encryptionId=099f9548ed7, topicName=酒精性脂肪肝)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=26a9200, createdName=yangshch, createdTime=Sat Oct 09 00:00:05 CST 2021, time=2021-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676609, encodeId=137c16e6609cf, content=<a href='/topic/show?id=397299e19c7' target=_blank style='color:#2F92EE;'>#非酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99719, encryptionId=397299e19c7, topicName=非酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, 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  7. 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  8. 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  9. 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encodeId=8ace1505138db, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Dec 01 05:00:05 CST 2020, time=2020-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903546, encodeId=c73e903546c4, content=生活方式干预是有效的,问题是如何干预是标准化干预?, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200901/629d1ce7d6f64d17a642c37c90dea72c/202f9333a3ea4b23a9b07ede3364e86b.jpg, createdBy=1a335163906, createdName=Sunny orchard, createdTime=Mon Nov 30 14:01:04 CST 2020, time=2020-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=903282, encodeId=f9499032821c, content=想学习想学习想学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/9iaAb4Jw2bbQql9icNGa5FjbmPicfSE7biaQIwz1AApCvib4HUmz3W6DibibX6BAgp4atWt9Qkox88aPJQY6GkvckxdfQ/132, createdBy=448e5312462, createdName=陈小凤, createdTime=Sun Nov 29 14:37:56 CST 2020, time=2020-11-29, status=1, ipAttribution=)]
    2020-11-30 Sunny orchard

    生活方式干预是有效的,问题是如何干预是标准化干预?

    0

  10. 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    2020-11-29 陈小凤

    想学习想学习想学习

    0

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肠道源性免疫原如脂多糖(LPS)对先天免疫的激活可能在非酒精性脂肪肝疾病(NAFLD)的发病机理中起重要作用。与NAFLD相关的脂质紊乱和多不饱和脂肪酸(PUFA)代谢是否特别有助于增强先天免疫力。

Cell Rep:灵芝衍生物或有望帮助治疗非酒精性脂肪肝!

研究报道了灵芝杂萜衍生物(GMD)的抗非酒精性脂肪性肝病的效应,研究者表示,GMD能增加拟杆菌属细菌的丰度从而激活拟杆菌属-叶酸-肝脏通路,进而减缓非酒精性脂肪肝患者的症状。

Nat Commun:非肥胖性非酒精性脂肪肝中肠道微生物组与肝纤维化显著相关

非酒精性脂肪肝病(NAFLD)的特征表现为代谢紊乱,包括单纯性脂肪变性和非酒精性脂肪肝炎(NASH),最终会导致晚期肝纤维化和肝硬化。在大多数流行病学研究中,NAFLD的全球患病率约为24%至30%,

AP&T: 患有非酒精性脂肪肝的肥胖和非肥胖受试者的脂质组学的改变

非酒精性脂肪肝疾病(NAFLD)是由肝甘油三酸酯(TGs)的异常积累引起的,这被称为单纯脂肪变性,有时可能会发展为非酒精性脂肪性肝炎(NASH)。

Medicine:研究发现幽门螺杆菌感染会促进亚洲人群非酒精性脂肪肝的进展

目前尚未清楚幽门螺杆菌感染是否能促进非酒精性脂肪肝(NAFLD)的发生和发展。本研究旨在通过整合所有现有数据,评估幽门螺杆菌感染与非酒精性脂肪肝之间的确切关系,研究结果已在线发表于。

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