孕妇群体或需关注“代谢功能障碍相关的脂肪肝”
创作:Epi汪 审核:Epi汪 2021年12月10日
  • 纳入1744名孕妇,其中10%的孕妇存在代谢功能障碍相关的脂肪肝(MAFLD),而在有肝脏脂肪变性的妇女中,代谢功能障碍的发病率高达81%;
  • MAFLD孕妇发生不良妊娠结局(定义为妊娠糖尿病或妊娠相关高血压或早产或胎儿生长异常)的风险高于无代谢功能障碍的非酒精性脂肪肝(非MD-NAFLD)人群;
  • 而非MD-NAFLD人群与酒精性脂肪肝(NAFLD)女性相比,不良妊娠结局发生风险无差异;
  • MAFLD或许是不良妊娠结局发生的危险因素。
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Epi汪
非酒精性脂肪肝是人们常常关注的肝脏疾病,其与妊娠结局之间的关联研究较多。但是“代谢功能障碍相关的脂肪肝”是一个较新的概念,根据最新的共识,其诊断基于肝活检组织学或影像学甚至血液生物标志物检查提示存在脂肪肝,同时满足以下三项条件之一,即超重/肥胖、2型糖尿病、代谢功能障碍。本研究提示,有MAFLD的女性未来发生不良妊娠结局的风险增高,尤其是比代谢功能正常但有脂肪肝的女性风险更高。这提示了代谢功能检查在孕检中的重要作用。
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Metabolic dysfunction-associated fatty liver disease and subsequent development of adverse pregnancy outcomes

代谢功能障碍相关的脂肪肝和不良妊娠结局的后续发展

10.1016/j.cgh.2021.11.007

2021-11-16, Article

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Background & Aims: Recently, metabolic dysfunction-associated fatty liver disease (MAFLD), rather than nonalcoholic fatty liver disease (NAFLD), was proposed to better describe liver disease associated with metabolic dysfunction (MD). In this study, we attempted to investigate the impact of MAFLD on pregnancy complications.
Methods: The current study is a secondary analysis of a multicenter prospective cohort designed to examine the risk of NAFLD during pregnancy. In the first trimester, enrolled pregnant women were evaluated for hepatic steatosis by liver ultrasonography, and blood samples were collected for biochemical measurements. The study population was divided into three groups: no NAFLD, hepatic steatosis but without metabolic dysfunction (non-MD NAFLD), and MAFLD. The primary outcome was the subsequent development of adverse pregnancy outcomes, including gestational diabetes mellitus, pregnancy-associated hypertension, preterm birth, and fetal growth abnormalities.
Results: The study population consisted of 1,744 pregnant women, including 1,523 with no NAFLD, 43 with non-MD NAFLD, and 178 with MAFLD. The risk of subsequent development of adverse pregnancy outcomes was higher in MAFLD than in non-MD NAFLD (adjusted odds ratio, 4.03; 95% CI, 1.68-9.67), whereas the risk was not significantly different between no NAFLD and non-MD NAFLD. 3) Among women with no NAFLD, the presence of MD increased the risk of adverse pregnancy outcomes. However, women with MAFLD were at higher risk for adverse pregnancy outcomes than women with no NAFLD without MD or those with no NAFLD with MD.
Conclusions: In pregnant women, MAFLD may be associated with an increased risk of subsequent adverse pregnancy outcomes.

First Authors:
Seung Mi Lee

Correspondence Authors:
Won Kim,Joong Shin Park

All Authors:
Seung Mi Lee,Young Mi Jung,Eun Saem Choi,Soo Heon Kwak,Ja Nam Koo,Ig Hwan Oh,Byoung Jae Kim,Sun Min Kim,Sang Youn Kim,Gyoung Min Kim,Sae Kyung Joo,Bo Kyung Koo,Sue Shin,Errol R Norwitz,Chan-Wook Park,Jong Kwan Jun,Won Kim,Joong Shin Park

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