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Aliment Pharmacol Ther:肥胖和二型糖尿病是先前未确诊的肝硬化患者的重要危险因素

2017-12-08 MedSci MedSci原创

经诊断的肝硬化新病例的数量清楚地表明,现有估计的患病率可能是严重低估。肥胖是酗酒者和糖尿病患者肝硬化的一个重要危险因素。

英国肝硬化发病率和死亡率的上升主要归因于过量饮酒。然而,代谢危险因素-2型糖尿病和肥胖可能也是重要的危险因素。针对未检测到的肝硬化患者,使用瞬态弹性成像技术对高危人群进行筛查,并研究这些病例背后的危险因素。

这项研究在2012年2月至2014年9月间进行了4次常规筛查(成人患者人口20868)。从一般的电子记录中识别出慢性肝病(危险的酒精使用和/或2型糖尿病)高危患者,并邀请这些患者进行瞬时弹性成像。肝硬度增高被定义为≥8 kPa。肝硬化通过组织学、放射学和生化方法得到证实。

本研究共有2368例患者被邀请进行瞬时弹性成像,899/919(97.8%)的患者有有效的测量。230例患者(25.6%),肝硬度增高,27例患者(2.9%)存在肝硬化。新诊断出肝硬化的患者的危险因素为肥胖和2型糖尿病(16例患者,59.3%),酒精(3例患者,11.1%),酒精和肥胖/糖尿病(8例患者,29.6%)。相比非肥胖患者,患有2型糖尿病或过量饮酒的肥胖患者,肝硬化出现显著增高(优势比 9.4 [95% CI 2.2-40.9]和5.6 [95% CI 1.6-19.7] )。

诊断的肝硬化新病例的数量清楚地表明,现有估计的患病率可能是严重低估。肥胖是酗酒者和糖尿病患者肝硬化的一个重要危险因素。

原始出处

Harman DJ, Ryder SD, James MW, et al. Obesity and type 2 diabetes are important risk factors underlying previously undiagnosed cirrhosis in general practice: a cross-sectional study using transient elastography.Aliment Pharmacol Ther, 2017, Dec 6. doi: 10.1111/apt.14463

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    2018-09-19 jj000001
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    2018-05-20 yb6560

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