目前对脂肪椰性肝病的认识成都.ppt

目前对脂肪性肝病的认识 上海交通大学医学院附属 仁济医院消化科 上海市消化疾病研究所 范 竹 萍 内容提要 NAFLD的流行现状 NAFLD的危害 NAFLD患者更易患进展性肝病 NAFLD患者更易患CVD NAFLD患者是一群异质性人群 NAFLD治疗策略 选取2007年10月在仁济医院体检中心进行常规体检的年龄≥18岁的普通人群共2374人。所有患者均经签署知情同意书后入选 NAFLD患者不同年龄段的性别分布 年龄组 男性 女性 男 : 女 (岁) 例数 ( %) 例数 (%) 20 1 (0.25) 0 1:0 20～ 68(17.5) 4 (3.5) 17.0:1 30～ 97 (25.0) 13(11.4) 7.46:1 40～ 88 (22.7) 29(25.4) 3.03:1 50～ 81 (20.9) 30(26.3) 2.70:1 60～ 53 (13.7) 38(33.3) 1.39:1 合计 388 (100) 114 (100) 1.34:1 各代谢相关因素所占比例 内容提要 NAFLD的流行现状 NAFLD的危害 NAFLD患者更易患进展性肝病 NAFLD患者更易患CVD NAFLD患者是一群异质性人群 NAFLD治疗策略 Visceral fat: A key mediator of steatohepatitis in metabolic liver disease a cross-sectional, proof of concept study in 38 consecutive adults with NAFLD at a tertiary liver clinic All subjects had a complete physical examination, anthropometric assessment, and fasting blood tests on the day of liver biopsy Abdominal fat volumes were assessed by magnetic resonance imaging within 2 weeks of liver biopsy Result The extent of hepatic inflammation and fibrosis augmented incrementally with increases in visceral fat (P 0.01) each 1% increase in visceral fat, the odds ratio for increasing liver inflammation and fibrosis was 2.4 (confidence interval [CI]: 1.3-4.2) and 3.5 (CI: 1.7-7.1), respectively. Visceral fat remained an independent predictor of advanced steatohepatitis (odds ratio [OR] 2.1, CI: 1.1-4.2, P = 0.05) and fibrosis (OR 2.9, CI: 1.4-6.3, P = 0.006) Conclusion Visceral fat should therefore be a central target for future interventions in nonalcoholic steatohepatitis and indeed all metabolic disease 内容提要 NAFLD的流行现状 NA