Tình trạng xơ hóa gan và nhiễm mỡ gan ở bệnh nhân thừa cân, béo phì mắc bệnh gan nhiễm mỡ liên quan chuyển hóa

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Tác giả: Đức Tiến Đào, Thanh Duy Đào, Thị Khánh Tường Trần, Thị Ái Phương Trương

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2024

Mô tả vật lý: tr.22

Bộ sưu tập: Báo, Tạp chí

ID: 286057

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Đặt vấn đề: Thừa cân, béo phì là nhóm bệnh nhân nguy cơ cao phát triển bệnh gan nhiễm mỡ liên quan chuyển hóa (Metabolic Associated Fatty Liver Disease - MAFLD) với odds ratios (OR): 5,5. MAFLD là nguyên nhân phổ biến thứ hai của bệnh nhân ung thư biểu mô tế bào gan. Nghiên cứu của Zysk và Gopalakriskna cho thấy có mối tương quan tuyến tính giữa giá trị độ nhiễm mỡ gan, độ cứng của gan và chỉ số khối cơ thể tương ứng r = 0,7, r = 0,3. Tại Việt Nam ung thư gan đứng ở vị trí thứ hai chiếm 11,7% năm 2022. Do đó, chúng tôi thực hiện đề tài này nhằm xác định mối tương quan giữa mức độ nhiễm mỡ và xơ hóa gan với chỉ số khối cơ thể và các yếu tố nguy cơ xơ hóa gan đáng kể ở bệnh nhân thừa cân, béo phì mắc MAFLD góp phần cho việc quản lý tốt hơn nhóm bệnh nhân này. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang trên bệnh nhân thừa cân, béo phì từ 18 tuổi trở lên đến khám tại phòng khám của bệnh viện Nhân dân 115 trong thời gian tháng 3/2024 đến tháng 6/2024 Kết quả: 140 bệnh nhân thừa cân, béo phì mắc MAFLD được đưa vào nghiên cứu. Trong bệnh nhân thừa cân, béo phì mắc MAFLD, có mối tương quan tuyến tính giữa BMI và LSM cũng như BMI và CAP tương ứng r = 0,5, r = 0,8. Khi phân tích đa biến chỉ có BMI ≥ 25 kg/m² (OR:4,17), MAFLD đồng mắc (OR: 4,74) là yếu tố nguy cơ của xơ hóa đáng kể. Kết luận: Trong bệnh nhân thừa cân, béo phì mắc MAFLD, có mối tương quan tuyến tính giữa LSM và BMI với r = 0,5 cũng như CAP và BMI với r = 0,8. MAFLD đồng mắc và BMI ≥ 25 kg/m² là yếu tố nguy cơ của xơ hóa gan đáng kể ở bệnh nhân thừa cân, béo phì mắc MAFLD. Abstract Background: Overweight and obesity are high-risk factors for the development of metabolic associated fatty liver disease (MAFLD), with an odds ratio (OR) of 5,5. MAFLD is the second most common cause of hepatocellular carcinoma. Zysk and Gopalakriskna’s study showed a linear correlation between liver steatosis, liver stiffness, and body mass index, with corresponding correlation coefficients of r = 0,7 and r = 0,3. In Vietnam, liver cancer ranks as the second leading cause of cancer, comprising 11,7% in 2022. Therefore, this study aims to determine the correlation between the degree of liver steatosis and liver fibrosis with BMI and identify risk factors for significant liver fibrosis in overweight and obese patients with MAFLD, facilitating better management of MAFLD in the population group. Methods: A descriptive and cross-sectional study on overweight and obese patients aged 18 and older who visited the outpatient clinic of People’s Hospital 115 from March 2024 to June 2024. Results: A total of 140 overweight and obese patients with MAFLD were included in the study. In overweight or obese patients with MAFLD, there were a linear correlation between BMI and LSM as well as BMI and CAP, with corresponding correlation coefficients of r = 0,5 and r = 0,8. Multivariate analysis revealed that only a BMI ≥ 25 kg/m² (OR: 4,2) and comorbid MAFLD (OR: 4,7) were independent significant risk factors for significant fibrosis. Conclusions: In overweight and obese patients with MAFLD, there were a linear correlation between CAP and BMI with r = 0,8, as well as between LSM and BMI with r = 0,5. Comorbid MAFLD and BMI ≥ 25 kg/m² were risk factors for significant liver fibrosis in these patients. DOI: 10.59715/pntjmp.3.4.3

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