摘要
目的:了解代谢相关脂肪性肝病(MAFLD)患者临床特征及数字疗法对MAFLD的干预效果。方法:选取2020年5月至2020年12月在重庆市第五人民医院体检中心通过肝脏瞬时弹性成像技术检测的体检人群。回顾性分析了2020年5月至2022年9月在本院脂肪肝门诊就诊的患者,分为生活方式干预组和数字疗法组。数字疗法是利用应用程序(APP)管理平台对MAFLD患者在节制饮食和适度运动基础上进行干预前、干预中及干预后闭环式健康管理。分析体检人群和MAFLD患者性别、年龄、血压、体质量指数(BMI)、体脂率、腰围、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)、总胆固醇(TC)、甘油三酯(TG)、尿酸(UA)、空腹血糖(FBG)和肝脏受控衰减参数(CAP)等情况。结果:在1330例体检人群中,男性占72.9%(969/1330),平均年龄(55.0±13.9)岁,超重及肥胖人群占61%(811/1330),MAFLD患者占69.4%(923/1330),中重度MAFLD患者占MAFLD患者的80.8%(746/923),超重及肥胖人群中MAFLD患者高达82.6%(670/811)。不同程度BMI患者的性别、年龄、是否患高血压、ALT、AST、TG、UA、FBG和CAP等比较,差异均有统计学意义(P<0.05)。不同程度MAFLD患者的年龄、BMI、是否患高血压、ALT、AST、TC、TG、UA、FBG等比较,差异均有统计学意义(P<0.05)。205例MAFLD患者数字疗法治疗26周后BMI、体脂率、腰围、ALT、AST、GGT、TC、TG、UA、FBG和CAP的数值与治疗前比较,差异均有统计学意义(P<0.05);数字疗法治疗26周前后MAFLD患者的BMI、体脂率、腰围、FBG和CAP的差值与生活方式干预治疗26周前后的差值比较,差异均有统计学意义(P<0.05)。结论:体检人群中男性超重和肥胖的比例较高,超重和肥胖患者容易患MAFLD,MAFLD患者发生高胆固醇、高甘油三酯、高尿酸和高血糖的风险更大。数字疗法可有效改善MAFLD患者的临床预后,减少体质量和体脂含量,缩小腰围,降低血糖水平和减轻肝脏脂肪变性。
Objective:To investigate the clinical characteristics of patients with metabolic dysfunction-associated fatty liver disease(MAFLD)and the effect of digital therapy on MAFLD.Methods:The physical examination population analyzed in the study who were evaluated by liver instantaneous elastic imaging in the physical examination center of the Fifth People′s Hospital of Chongqing from May 2020 to December 2020.The patients who visited the fatty liver clinic of our hospital from May 2020 to September 2022 were retrospectively analyzed and divided into the lifestyle intervention group and the digital therapy group.Digital therapy is a closed-loop health management for MAFLD patients before,during,and after intervention on the basis of moderate diet and moderate exercise using an application program(APP)management platform.The gender,age,blood pressure,body mass index(BMI),body fat rate,waist circumference,alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT),total cholesterol(TC),triglyceride(TG),uric acid(UA),fasting blood glucose(FBG)and liver controlled attenuation parameter(CAP)were analyzed in the physical examination population and MAFLD patients.Results:Among 1330 cases,72.9%were males(969/1330),the average age was 55±13.9 years old,61%were overweight and obese(811/1330),69.4%were fatty liver(923/1330).The patients with moderate and severe fatty liver accounted for 80.8%(746/923)of the patients with fatty liver,and the patients with fatty liver were as high as 82.6%(670/811)of the overweight and obese people.There were statistically significant differences,respectively,in gender,age,hypertension,ALT,AST,TG,UA,FBG,and CAP among different BMI(P<0.05).There were statistically significant differences,respectively,in age,BMI,hypertension,ALT,AST,TG,TC,UA and FBG among patients with different degrees of MAFLD(P<0.05).After 26 weeks of digital therapy,the outcomes were improvements in BMI,body fat percentage,waist circumference,ALT,AST,GGT、TG,TC,UA,FBG,and CAP compared with those of 205 patients with MAFLD before treatment,with statistical significance,respectively(P<0.05).The differences in differentials of BMI,body fat rate,waist circumference,FBG,and CAP before and after 26 weeks of digital therapy were statistically significant,respectively,compared with those of MAFLD patients before and after 26 weeks of lifestyle intervention(P<0.05).Conclusion:The proportion of overweight and obesity is higher in men in the physical examination population.Overweight and obese patients are more likely to suffer from MAFLD,and the risk of high TC,high TG,high UA,and high FBG is higher in patients with MAFLD.Digital therapy can effectively improve the clinical prognosis of MAFLD patients,reduce body weight and body fat contents,and reduce waist circumference,reduce blood glucose level and liver steatosis.
作者
黄光明
刘钦
陈萍
HUANG Guang-ming;LIU Qin;CHENn Ping(Department of gastroenterology,The Fifth People′s Hospital of Chongqing,Chongqing,400062,China)
出处
《中西医结合肝病杂志》
2025年第7期817-822,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
国家重点研发计划“智能传感器”重点专项(No.2022YFB3203700)
南岸区科卫联合课题(No.2021-28)。
关键词
代谢相关脂肪性肝病
体质量指数
数字疗法
健康生活方式
metabolic dysfunction-associated fatty liver disease
body mass index
digital therapy
health lifestyle
作者简介
通讯作者:黄光明,E-mail:gmhuangcq@163.com。
