肝硬化患者血清学维生素 A 受到抑制与肝功能受损和临床恶

StephenW

肝硬化患者血清学维生素 A 受到抑制与肝功能受损和临床恶化有关

内格尔，米凯拉，b，c；拉本兹，克里斯蒂安娜，b；多伯曼，亨里克德； Czauderna，卡罗琳；沃尔沙伊德，妮娜·卡贝萨斯； Schattenberg, Jörn M.a,b; Wörns，马库斯·AC；加勒，彼得 R.a,b；马夸特，延斯大学
作者信息
欧洲胃肠病学和肝病学杂志：2022 年 10 月 - 第 34 卷 - 第 10 期 - 第 1053-1059 页
doi: 10.1097/MEG.0000000000002418

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抽象的
背景

肝脏对于代谢和免疫调节特性的稳态以及维生素，尤其是维生素 A 的储存至关重要。在这项前瞻性分析中，血清维生素 A 缺乏症的发生率以及与疾病严重程度以及临床并发症对肝硬化患者进行了调查。
方法

从 2017 年 5 月至 2018 年 5 月，前瞻性招募了 159 名主要与酒精相关和非酒精性脂肪性肝炎 (NASH) 相关的既往肝硬化患者，并收集了维生素 A 状态。在 1 年的随访期内，对临床并发症和感染进行了跟踪和记录。选定的研究结果在 44 名患者的独立队列中得到验证。
结果

在研究纳入时，77% 的患者显示血清维生素 A 降低。抑制维生素 A 在酒精性肝硬化（52% 对 8%）和 NASH 相关肝硬化（16% 对 9%）中比在病毒相关肝硬化中更常见。 MELD 评分和 Child-Pugh 评分与抑制维生素 A 显着相关（P < 0.001）。单变量和多变量回归分析证实了维生素 A 抑制程度与肝功能之间的关联。随访1年，57例死亡，21例接受肝移植。此外，在严重腹水（P = 0.001）、肝性脑病（P = 0.002）和肝肾综合征（P = 0.008）的患者中更常见的是低维生素A水平。此外，维生素A减少的患者感染发生率增加（P = 0.02），尤其是呼吸道感染（P = 0.04）。
结论：

抑制血清学维生素 A 在肝硬化患者中很常见，并且与肝功能有关。肝硬化和维生素 A 抑制患者的临床并发症和感染更为常见。

StephenW

Suppressed serological vitamin A in patients with liver cirrhosis is associated with impaired liver function and clinical detoriation

Nagel, Michaela,b,c; Labenz, Christiana,b; Dobbermann, Henriked; Czauderna, Carolind; Wallscheid, Nina Cabezase; Schattenberg, Jörn M.a,b; Wörns, Marcus A.c; Galle, Peter R.a,b; Marquardt, Jens U.d
Author Information
European Journal of Gastroenterology & Hepatology: October 2022 - Volume 34 - Issue 10 - p 1053-1059
doi: 10.1097/MEG.0000000000002418

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Abstract
Background

The liver is of critical importance for the homeostasis of metabolic and immunomodulatory properties as well as the storage of vitamins, especially vitamin A. In this prospective analysis, the incidence of serological vitamin A deficiency and the association with disease severity as well as clinical complications in patients with liver cirrhosis were investigated.
Method

From May 2017 to May 2018, 159 patients with primarily alcohol-associated and non-alcoholic steatohepatitis (NASH)-associated preexisting liver cirrhosis were prospectively enrolled and vitamin A status was collected. Clinical complications and infections were followed and recorded over a period of 1-year follow-up. Selected findings were validated in an independent cohort of 44 patients.
Results

At study inclusion, 77% of patients showed decreased serological vitamin A. Suppressed vitamin A was more common in alcoholic (52 vs. 8%) and NASH-associated liver cirrhosis (16 vs. 9%) than in viral-associated liver cirrhosis. MELD score as well as Child-Pugh score were significantly associated with suppressed vitamin A (P < 0.001). The association between the degree of vitamin A suppression and liver function was confirmed in univariate and multivariate regression analysis. After 1 year of follow-up, 57 patients died and 21 patients received a liver transplant. In addition, low vitamin A levels were more commonly observed in patients with severe ascites (P = 0.001), hepatic encephalopathy (P = 0.002) and hepatorenal syndromes (P = 0.008). In addition, patients with reduced vitamin A showed an increased incidence of infections (P = 0.02), especially respiratory infections (P = 0.04).
Conclusion:

Suppressed serological Vitamin A is common in patients with liver cirrhosis and is associated with liver function. Clinical complications and infections are more frequent in patients with liver cirrhosis and vitamin A suppression.

StephenW

https://journals.lww.com/eurojgh ... tients_with.42.aspx

小牡丹

拜读

小牡丹

俗话说，胡萝卜是小人槮。现代研究认为，胡萝卜与油脂一起吃，维生素容易吸收。最近我把胡萝卜当水果吃，感觉有人参的作用。建议大家当饭后甜点，看看怎么样。提醒一下，必须咀嚼充分，细嚼慢咽。