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代谢相关脂肪性肝病与颈动脉粥样硬化斑块及狭窄的关联分析OA北大核心CSTPCD

Association of metabolic associated fatty liver disease with carotid atherosclerotic plaque and stenosis

中文摘要英文摘要

目的 分析代谢相关脂肪性肝病(MAFLD)与颈动脉粥样硬化斑块的相关性.方法 随机纳入2014年7月—2022年12月在昆明医科大学第二附属医院住院期间同时完善腹部超声、头颈动脉CT血管成像的1 107例患者.收集基线资料、临床诊断,根据病史、临床检验及影像学指标分为MAFLD组(n=499)和非MAFLD组(n=608).颈动脉斑块根据CT值分为钙化斑块、非钙化斑块及混合斑块.根据北美症状性颈动脉内膜剥脱试验(NASCET)标准,颈动脉狭窄分为:正常血管、轻微狭窄、轻度狭窄、中度狭窄、重度狭窄及闭塞.符合正态分布的计量资料两组间比较采用成组t检验;不符合正态分布的计量资料两组间比较采用Mann-Whitney U秩和检验;计数资料两组间比较采用χ2检验.采用单因素和多因素Logistic回归分析颈动脉粥样硬化的影响因素.结果 MAFLD组患者钙化斑块、非钙化斑块、混合斑块的比例均高于非MAFLD组(74.3%vs 63.3%、27.1%vs 17.1%、27.3%vs 20.7%),差异均有统计学意义(P值均<0.05);MAFLD组患者颈动脉轻度狭窄、中度狭窄、重度狭窄及闭塞的比例均高于非MAFLD组(50.9%vs 44.9%、14.6%vs 8.4%、6.6%vs 3.5%),差异均有统计学意义(P值均<0.05).单因素Logistic回归分析结果显示,MAFLD是颈动脉钙化斑块、非钙化斑块和混合斑块的危险因素,也是颈动脉轻度、中度、重度狭窄及闭塞的危险因素(P值均<0.05).校正混杂因素后,多因素Logistic回归分析结果显示MAFLD仍是颈动脉钙化斑块、非钙化斑块、混合斑块以及颈动脉中度狭窄的独立危险因素(P值均<0.05).结论 MAFLD是颈动脉中度狭窄,颈动脉钙化斑块、非钙化斑块及混合斑块的独立危险因素.

Objective To investigate the association between metabolic associated fatty liver disease(MAFLD)and carotid atherosclerotic plaque.Methods A total of 1 107 patients who were hospitalized in The Second Affiliated Hospital of Kunming Medical University from July,2014 to December,2022 were enrolled,and all patients underwent abdominal ultrasound and CT angiography of the head and neck arteries.Baseline data and clinical diagnosis were collected,and the patients were divided into MAFLD group with 499 patients and non-MAFLD group with 608 patients based on medical history,clinical tests,and imaging findings.According to the CT value,carotid plaques were classified into calcified plaques,non-calcified plaques,and mixed plaques.According to the NASCET criteria,carotid stenosis was categorized as normal vessel,slight stenosis,mild stenosis,moderate stenosis,and severe stenosis/occlusion.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups.Univariate and multivariate Logistic regression analyses were used to investigate the influencing factors for carotid atherosclerosis.Results Compared with the non-MAFLD group,the MAFLD group had a significantly higher proportion of patients with calcified plaques(74.3%vs 63.3%,P<0.05),non-calcified plaques(27.1%vs 17.1%,P<0.05),or mixed plaques(27.3%vs 20.7%,P<0.05),as well as a significantly higher proportion of patients with mild stenosis(50.9%vs 44.9%,P<0.05),moderate stenosis(14.6%vs 8.4%,P<0.05),or severe stenosis/occlusion(6.6%vs 3.5%,P<0.05).The univariate logistic regression analysis showed that MAFLD was a risk factor for calcified carotid plaques,non-calcified plaques,and mixed plaques,and it was also a risk factor for mild stenosis,moderate stenosis,and severe stenosis/occlusion of the carotid artery(all P<0.05).After adjustment for confounding factors,the multivariate Logistic regression analysis showed that MAFLD was an independent risk factor for calcified plaque,non-calcified plaque,mixed plaque,and moderate stenosis of the carotid arteries(all P<0.05).Conclusion MAFLD is an independent risk factor for moderate stenosis,calcified plaques,non-calcified plaques,and mixed plaques of the carotid arteries.

朱英嵽;张志娇;张桂林;高云堃;郑梦瑶;黄华;赵公芳

昆明医科大学第二附属医院消化内科,昆明 650000

代谢相关脂肪性肝病动脉粥样硬化颈动脉斑块危险因素

Metabolic Associated Fatty Liver DiseaseAtherosclerosisCarotid PlaqueRisk Factors

《临床肝胆病杂志》 2024 (008)

1591-1597 / 7

云南省"万人计划"名医人才专项(YNWR-MY-2019-074) Yunnan Province"Ten Thousand Talents Plan"Famous Medical Talents Project(YNWR-MY-2019-074)

10.12449/JCH240814

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