炎症在代谢功能障碍相关脂肪性肝病肝纤维化与亚临床动脉粥样硬化间的中介效应分析

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【中图分类号】R575.5 【文献标志码】A

Inflammationas a mediator between fibrosis in metabolic dysfunctionassociated steatotic liver disease and subclinical atherosclerosis

Mei Jia，Wang Lihua，Xie Yuncai，Jin Yudi，Chen Ying

（Health Medicine Center，The SecondAfliated Hospital ofChongqing Medical University 【Abstract】Objective：Toanalyzetherelationshipsofinflammation，metabolicdysfunction-asociatedsteatoticliverdisease （MASLD），andsubclinicalatherosclerosis（SCA），andtoexploretheroleof inflammationintheimpactofliverfibrosisonSCA. Methods：Atotalof9791patients whomettheiclusionandexclusioncriteria wereconseutivelyenrolledfromtheHealthExaminationCenterattheJiangnanCampusofTeSecondAflitedHospitalofChongqingMedicalUniversityetweenOctober31，3nd November 1，2024 .Patient information wascollcted from electronic medicalrecords.Results：Afteradjusting for traditional cardiovasculariskfactors，uiaratelostegresionalyssodsigiiantssociatiosofithpatelettlmeti （20 （1.00，P =0.01）and monocyte-to-high-densitylipoproteincholesterolratio（1.21，P<0.001）.TheoccurrenceofSCAwassignificantly related to aspartate aminotransferase-to-platelet ratio index（1.43， P =0.036），lymphocyte-to-monocyteratio（ 0.96，P =0.019），and systemic inflammation response index（0.71， P =0.018）.Mediationanalysis indicated that fibrosis-4index exerted partial mediating effects ontheoccurrence ofSCA through inflammatory markers monocyte-to-high-density lipoproteincholesterolratio（ 95% CI=0.005 to 0.032），systemicimmune-inflammationindex（95%CI：-0068to-.02），ndstemicinflmmationresponseindex（95%CI= -0.011to-0o）hilespartateamnotransferasetoplateletratiindexthrougheutrophltomphocteratio95%I.02t -0.002），platelet-to-lymphocyte ratio（ 95% CI=0.055 to 0.175），lymphocyte-to-monocyte ratio（ 95% CI=0.011 to 0.001），and systemic inflammation response index（ 95% CI=-0.042 to-O.Oo2）.Conclusion：Liver fibrosis in MASLD has a direct effect on the occurrence of SCAandalsoinfluencesitthroughinflammatorymarkers.Thesefindingshighlighttheimportanceofearlyscreeningforcadiovascular disease risk in MASLD patientsand suggest that anti-inflammatory therapy may play a significant role in the future management of MASLD.

【Keywords】metabolic dysfunction-associated steatotic liver disease;liverfibrosis;subclinicalatherosclerosis;inflammation

非酒精性脂肪肝病的发病率在全球已达 30% 左右。（剩余18400字）