Aralik 2021
Biyopsi tanili nonalkolik steatohepatit hastalarinda fibrozis evrelerine göre metabolik sendrom komponentlerinin sikliklarinin karsilastirilmasi: Metabolik bozukluk sayisindaki artis fibrozis progresyonunda etkili mi?
Comparison of the frequencies of metabolic syndrome components according to fibrosis stages in biopsy-proven nonalcoholic steatohepatitis patients: Does increased number of metabolic dysregulation have an effect on fibrosis progression?
- Ana Sayfa
- Sayılar
- Aralik 2021
- Biyopsi tanili nonalkolik steatohepatit hastalarinda fibrozis evrelerine göre metabolik sendrom komponentlerinin sikliklarinin karsilastirilmasi: Meta...
Özet
Giris ve Amaç: Fibrozis evresi, nonalkolik steatohepatitte karacigeriliskili komplikasyonlar ve mortalite ile iliskisi en kuvvetli olan histolojikparametredir. Nonalkolik steatohepatit hastalarinda fibrozisin patogenezi halen tam olarak ortaya konulamamistir ve eslik eden tip 2 diyabet, obezite, hipertansiyon ve dislipideminin fibrozis progresyonundakirolleri net degildir. Bununla beraber, eslik eden metabolik bozukluklarinsayisiyla fibrozis evresi arasinda bir iliski olmasi mümkündür. Gereç veYöntem: Bu çalisma tek merkezli, kesitsel bir çalisma olup bu çalismadaOcak 2020-Ocak 2021 tarihleri arasinda karaciger biyopsisi yapilaraknonalkolik steatohepatit tanisi konulan 56 hastanin metabolik özellikleri, Ulusal Kolesterol Egitim Programi/3. Eriskin Tedavi Paneli metabolik sendrom kriterleri temel alinarak degerlendirilmistir. NonalkolikSteatohepatit-Klinik Arastirma agina göre yapilan fibrozis evrelemesisonrasinda, hastalar evre 2 ve üzeri fibrozisi ( ? F2) olanlar ve ? F1fibrozisi olanlar seklinde iki gruba ayrilmistir. Bu iki grup arasinda tip 2diyabet, hipertansiyon, dislipidemi ve metabolik sendrom varligi, vücutkitle indeksi, bel çevresi, kalça çevresi, bel çevresi/kalça çevresi orani veolusturulan toplam metabolik sendromu puani açisindan karsilastirmayapilmistir. Bulgular: Fibrozis evrelemesi sonucunda ? F1 grubunda 23hasta, ? F2 grubunda 33 hasta mevcuttur. Gruplar arasinda tip 2 diyabet, hipertansiyon ve dislipidemi varligi ile vücut kitle indeksi, bel çevresi, kalça çevresi, bel çevresi/kalça çevresi orani açisindan anlamli birfark saptanmazken, metabolik sendrom varligi açisindan anlamli bir farkmevcuttur ( ? F2 grubunda %84.8 ve ? F1 grubunda %47.8; p = 0.001).Toplam metabolik sendrom puani ? F2 grubunda anlamli olarak dahayüksek olup bu gruptaki hastalarin %60.6’sinda 4 puan ve üzerindedir(p < 0.001). Korelasyon analizinde fibrozis evresi ile toplam metaboliksendrom puani arasinda istatistiksel açidan anlamli, orta derecede korelasyon saptanmistir (r = 0.48, p < 0.001). Sonuç: Toplam metaboliksendrom puani kolay hesaplanabilir bir yöntem olup nonalkolik steatohepatit hastalarinda fibrozis progresyonu riskinin degerlendirilmesindekullanilabilir
Abstract
Background and Aims: Fibrosis stage is the histologic parameter thathas the strongest association with liver-related complications and mortality in nonalcoholic steatohepatitis. The pathogenesis of fibrosis innonalcoholic steatohepatitis patients has still not been fully elucidated,and the roles of concomitant type 2 diabetes, obesity, hypertensionand dyslipidemia in the progression of fibrosis are unclear. However,there may be an association between the number of accompanyingmetabolic dysregulations and fibrosis stage in a number-dependentmanner. Materials and Methods: In this single-center, cross-sectionalstudy, 56 patients with the diagnosis of biopsy-proven nonalcoholic steatohepatitis were enrolled between January 2020 and January 2021,and the metabolic characteristics of these patients were evaluated onthe basis of National Cholesterol Education Program/Adult TreatmentPanel III metabolic syndrome criteria. After fibrosis staging according toNonalcoholic Steatohepatitis Clinical Research Network, patients weredivided into two groups as those with fibrosis stage ? F2, and thosewith fibrosis stage ? F1. Comparison between these two groups interms of the presence of type 2 diabetes, hypertension, dyslipidemiaand metabolic syndrome, total metabolic syndrome score, body massindex, waist circumference, hip circumference and waist circumference/hip circumference ratio has been made. Results: After grouping of patients according to fibrosis stages, there were 23 patients in ? F1 groupand 33 patients in ? F2 group. While there was no significant differencebetween the groups in terms of presence of type 2 diabetes, hypertension and dyslipidemia, body mass index, waist circumference, hipcircumference and waist circumference/hip circumference ratio, therewas a significant difference for the presence of metabolic syndrome(84.8% in ? F2 group and 47.8% in ? F1 group; p = 0.001). The totalmetabolic syndrome score was significantly higher in ? F2 group and itwas 4 points or more in 60.6% of the patients in this group. In the correlation analysis, a statistically significant and moderate correlation wasfound between the fibrosis stage and total metabolic syndrome score(r = 0.48, p < 0.001). Conclusion: Total metabolic syndrome score is aneasily calculated method and can be used to evaluate the risk of fibrosisprogression in nonalcoholic steatohepatitis patients
