Peripheral Artery Disease and Risk of Fibrosis Deterioration in Nonalcoholic Fatty Liver Disease:A Prospective Investigation  

作　　者：ZHU Wen DENG Chan Juan XUAN Li Ping DAI Hua Jie ZHAO Zhi Yun WANG Tian Ge LI Mian LU Jie Li XU Yu CHEN Yu Hong WANG Wei Qing BI Yu Fang XU Min 

机构地区：[1]State Key Laboratory of Medical Genomics,Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases,Collaborative Innovation Center of Systems Biomedicine,Shanghai Institute of Endocrine and Metabolic Diseases,Department of Endocrine and Metabolic Diseases,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China

出　　处：《Biomedical and Environmental Sciences》2020年第4期217-226,共10页生物医学与环境科学（英文版）

基　　金：Grants from the Ministry of Science and Technology of China[2018YFC1311705,2016YFC1305600,and 2016YFC1304904];the National Natural Science Foundation of China[81770842,81941017,and 81870604];the Shanghai Science and Technology Commission[YDZX20173100004881];the Shanghai Shen-Kang Hospital Development Center[SHDC12016202]。

摘　　要：Objective Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease(NAFLD).Peripheral artery disease(PAD)and liver fibrosis share many common metabolic dysfunctions.We aimed to explore the association between PAD and risk of fibrosis deterioration in NAFLD patients.Methods The study recruited 1,610 NAFLD patients aged≥40 years from a well-defined community at baseline in 2010 and followed up between August 2014 and May 2015.Fibrosis deterioration was defined as the NAFLD fibrosis score(NFS)status increased to a higher category at the follow-up visit.PAD was defined as an ankle-brachial index of<0.90 or>1.40.Results During an average of 4.3 years’follow-up,618 patients progressed to a higher NFS category.PAD was associated with 92%increased risk of fibrosis deterioration[multivariable-adjusted odds ratio(OR):1.92,95%confidence interval(CI):1.24,2.98].When stratified by baseline NFS status,the OR for progression from low to intermediate or high NFS was 1.74(95%CI:1.02,3.00),and progression from intermediate to high NFS was 2.24(95%CI:1.05,4.80).There was a significant interaction between PAD and insulin resistance(IR)on fibrosis deterioration(P for interaction=0.03).As compared with non-PAD and non-IR,the coexistence of PAD and IR was associated with a 3.85-fold(95%CI:2.06,7.18)increased risk of fibrosis deterioration.Conclusion PAD is associated with an increased risk of fibrosis deterioration in NAFLD patients,especially in those with IR.The coexistence of PAD and IR may impose an interactive effect on the risk of fibrosis deterioration.

关 键 词：Ankle-brachial index Nonalcoholic fatty liver disease Fibrosis deterioration NAFLD fibrosis score Insulin resistance 

分 类 号：R575.5[医药卫生—消化系统]