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非酒精性脂肪性肝病与心外膜脂肪组织关系的Meta分析
Association between nonalcoholic fatty liver disease and epicardial adipose tissue: A Meta-analysis
文章发布日期:2020年06月01日  来源:  作者:王向红,马葆华,邹秀兰,等  点击次数:175次  下载次数:33次

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【摘要】:目的 评价非酒精性脂肪性肝病(NAFLD)与心外膜脂肪组织(EAT)的相关性。方法 计算机检索PubMed、Embase、Web of Science、万方、中国知网等数据库,检索时间为 自建库起至2019年1月1日,收集关于EAT厚度或体积与NAFLD相关性文献。采用Stata12.0软件计算标准化均数差(SMD)及95%可信区间(95%CI),I2检验评估研究间的异质性,采用敏感性分析和亚组分析来探讨异质性来源。采用漏斗图、Begg’s检验和Egger’s检验评价发表偏倚。结果 共纳入13篇文献,共包含4672例受试者,其中正常对照组2586例,NAFLD组2086例。NAFLD组较正常对照组EAT明显增加(SMD=0.58,95%CI:0.39~0.77,P<0.001)。NAFLD组与正常对照组在EAT厚度和EAT体积方面均存在差异(EAT厚度: SMD=0.61,95%CI:0.40~0.83,P<0.001;EAT体积:SMD=0.47,95%CI:0.17~0.76,P=0.002)。亚洲人群NAFLD与正常对照组比较,EAT增加,差异有统计学意义(SMD=0.37,95%CI: 0.06~0.68,P=0.018);欧洲/美国人群NAFLD患者与正常对照组比较,EAT明显增加,差异有统计学意义(SMD=0.66,95%CI: 0.40~0.92,P<0.001)。年龄≥50岁NAFLD组与对照组比较EAT增加,差异有统计学意义(SMD=0.46, 95%CI: 0.31~0.62, P<0.001);而年龄<50岁NAFLD组与对照组比较EAT差异也有统计学意义(SMD=0.72, 95%CI: 0.37~1.06,P<0.001)。BMI≥30 kg/m2的NAFLD患者比正常对照组EAT更厚(SMD=0.79, 95%CI: 0.43~1.15,P<0.001),而BMI<30 kg/m2的NAFLD患者EAT也较对照组厚(SMD=0.42,95%CI: 0.21~0.62,P<0.001)。影像学检查的NAFLD组与对照组比较EAT增加,差异有统计学意义(SMD=0.44,95%CI: 0.26~0.63,P<0.001);肝活检的NAFLD组与对照组比较EAT明显增加,差异有统计学意义(SMD=1.05, 95%CI: 0.82~1.29,P<0.001)。采用漏斗图(对称)、Begg’s检验(P=0.583)和Egger’s检验(P=0.126)进行发表偏倚的检验结果均显示可信度较高。结论 NAFLD与EAT心血管疾病风险因子显著相关,将有助于NAFLD患者建立有效的心血管事件防控策略。
【Abstract】:Objective To investigate the association between nonalcoholic fatty liver disease (NAFLD) and epicardial adipose tissue (EAT). Methods Databases including PubMed, Embase, Web of Science, Wanfang Data, and CNKI were searched for the articles on the association of thickness and volume of EAT with NAFLD published up to January 1, 2019. Stata12.0 was used to calculate standardized mean difference (SMD) and 95% confidence interval (CI); the I2 test was used to evaluate heterogeneity between studies, and sensitivity analysis and subgroup analysis were used to explore the source of heterogeneity. Results A total of 13 articles were included, with 4672 subjects in total (2586 subjects in the normal control group and 2086 subjects in the NAFLD group). The NAFLD group had a significant increase in EAT compared with the normal control group (SMD=0.58, 95% CI: 0.39-0.77, P<0.001). There were significant differences between the NAFLD group and the normal control group in the thickness and volume of EAT (thickness: SMD=0.61, 95% CI: 0.40-0.83, P<0.001; volume: SMD=0.47, 95% CI: 0.17-0.76, P=0.002). As for the Asian population, compared with the normal control group, the NAFLD group had a significant increase in EAT (SMD=0.37, 95% CI: 0.06-0.68, P=0.018); as for the European/American population, compared with the normal control group, the NAFLD group had a significant increase in EAT (SMD=0.66, 95% CI: 0.40-0.92, P<0.001). Compared with the normal control group, the NAFLD patients aged ≥50 years had a significant increase in EAT (SMD=0.46, 95% CI: 0.31-0.62, P<0.001); there was a significant difference in EAT between the NAFLD patients aged <50 years and the normal control group (SMD=0.72, 95% CI: 0.37-1.06, P<0.001). The NAFLD patients with a body mass index (BMI) of ≥30 kg/m2 had significantly thicker EAT than the normal control group (SMD=0.79, 95% CI: 0.43-1.15, P<0.001); the NAFLD patients with a BMI of <30 kg/m2 also had significantly thicker EAT than the normal control group (SMD=0.42, 95% CI: 0.21-0.62, P<0.001). Compared with the normal control group, the NAFLD patients undergoing radiological examination had a significant increase in EAT (SMD=0.44, 95% CI: 0.26-0.63, P<0.001); compared with the normal control group, the NAFLD patients undergoing liver biopsy also had a significant increase in EAT (SMD=1.05, 95% CI: 0.82-1.29, P<0.001). Publication bias was assessed by funnel plots (symmetric), Begg’s test (P=0.583), and the Egger’s test (P=0.126), and the results showed high reliability. Conclusion NAFLD is significantly associated with EAT cardiovascular risk factors, which will help NAFLD patients to establish effective strategies for the prevention and control of cardiovascular events.
【关键字】:非酒精性脂肪性肝病; 心包; Meta分析(主题)
【Key words】:non-alcoholic fatty liver disease; pericardium; Meta-analysis as topic
【引证本文】:WANG XH, MA BH, ZOU XL, et al. Association between nonalcoholic fatty liver disease and epicardial adipose tissue: A Meta-analysis[J]. J Clin Hepatol, 2020, 36(6): 1304-1309. (in Chinese)
王向红, 马葆华, 邹秀兰, 等. 非酒精性脂肪性肝病与心外膜脂肪组织关系的Meta分析[J]. 临床肝胆病杂志, 2020, 36(5): 1304-1309.

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