脂肪性肝病(SLD)包括代谢功能障碍相关的脂肪性肝病(MASLD)和酒精相关的肝病(AALD),以及称为MASLD的重叠组,其酒精摄入量增加(Met-ALD)。建议使用酒精性肝病/非酒精性脂肪性肝病指数(ANI)来区分ALD与非酒精性脂肪性肝病(NAFLD)。我们分析了ANI在SLD频谱中的区分性能。
■在三级护理中心的一项横断面研究中,纳入202名通过磁共振成像-质子密度脂肪分数>6.4%前瞻性诊断为SLD的成年人(>18岁)。根据显着的AC阈值记录酒精消耗(AC):女性为140-350g/周(或20-50g/天),男性为210-420g/周(或30-60g/天)。计算了ANI,并生成受试者工作特征曲线下面积(AUROC)。
■202名患者(47岁[四分位距,IQR,38至55],23.75%的女性,77%肥胖,42.1%糖尿病,38.1%高血压,28.7%的他汀类药物使用),40.5%是饮酒消费者;120(59%),50(24.7%),32例(15.8%)为MASLD(ANI,-3.7[IQR,-7至-1.6];Met-ALD,-1.45[IQR,-2.4至0.28];和AALD,0.71[IQR,-1.3to4.8],分别为;全部P<0.05)。MASLD和AALD的ANI的AUROC为0.79(0.72至0.84;截止值<-3.5)和0.80(0.74至0.86;截止值>-1.49),分别。ANI优于天冬氨酸转氨酶/丙氨酸转氨酶(AST/ALT)比率(AUROC=0.75[0.69至0.81])和γ谷氨酰转肽酶(GGT)(AUROC=0.74[0.67至0.80])。添加GGT并没有改善模型性能(AUCdiff=0.004;P=0.33)。
■AC在MASLD中是常见的。ANI区分了MASLD和AALD,中间区内的各个截止值指示Met-ALD。ANI也优于AST/ALT比率或GGT。
UNASSIGNED: Steatotic liver disease (SLD) encompasses metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (AALD) at extremes as well as an overlap group termed MASLD with increased alcohol intake (Met-ALD). The Alcoholic Liver Disease/Non-Alcoholic Fatty Liver Disease Index (ANI) was proposed to differentiate ALD from non-alcoholic fatty liver disease (NAFLD). We analysed the performance of the ANI in differentiating within the SLD spectrum.
UNASSIGNED: In a cross-sectional study at a tertiary care center, 202 adults (>18 years) who were prospectively diagnosed with SLD defined by magnetic resonance imaging-proton density fat fraction >6.4% were enrolled. Alcohol consumption (AC) was recorded according to thresholds for significant AC: 140-350 g/week (or 20-50 g/day) for females and 210-420 g/week (or 30-60 g/day) for males. The ANI was calculated, and area under the receiver operating characteristic curve (AUROC) was generated.
UNASSIGNED: Of 202 patients (47 years [interquartile range, IQR, 38 to 55], 23.75% females, 77% obese, 42.1% diabetic, 38.1% hypertensive, 28.7% statin use), 40.5% were ever-alcohol consumers; 120 (59%), 50 (24.7%), and 32 (15.8%) were MASLD (ANI, -3.7 [IQR, -7 to -1.6]; Met-ALD, - 1.45 [IQR, -2.4 to 0.28]; and AALD, 0.71 [IQR, -1.3 to 4.8], respectively; P<0.05 for all). The AUROC of the ANI for MASLD and AALD was 0.79 (0.72 to 0.84; cut-off <-3.5) and 0.80 (0.74 to 0.86; cut-off >-1.49), respectively. The ANI outperformed aspartate transaminase/alanine transaminase (AST/ALT) ratio (AUROC=0.75 [0.69 to 0.81]) and gamma glutamyl transpeptidase (GGT) (AUROC=0.74 [0.67 to 0.80]). Addition of GGT did not improve model performance (AUCdiff=0.004; P=0.33).
UNASSIGNED: AC is common in MASLD. The ANI distinguishes MASLD and AALD, with individual cut-offs within the intermediate zone indicating Met-ALD. ANI also outperforms AST/ALT ratio or GGT.