Background: Due to the increasing global prevalence of non-alcoholic fatty liver disease (NAFLD), which is closely linked to metabolic disorders, there has been a rise in the number of patients with NAFLD undergoing hepatectomy. The metabolic disorders, as well as NAFLD, increase venous thrombotic risk. NAFLD was recently updated to a new concept of hepatic steatosis: metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to investigate the impact of MASLD on post-hepatectomy portal vein thrombosis (PH-PVT).Methods: A total of 106 patients who underwent hepatectomy for liver cancer were included. Steatotic liver disease (SLD) was diagnosed using a CT L/S ratio of <1.1. SLD was classified as follows: MASLD, SLD associated with metabolic factors without alcohol consumption; MetALD, SLD with metabolic factors and moderate alcohol consumption; Other SLD, alcohol or other specific etiology of SLD; and No SLD, no hepatic steatosis.Results: PH-PVT was detected in 12/106 patients (11.3%); MASLD, 7/20 (35%); MetALD, 1/5 (20%); Other SLD, 1/13 (8%); and No SLD, 3/68 (4.4%). Multivariate analysis showed that the MASLD group (including MASLD and MetALD) (odds ratio [OR], 9.27) and left lateral sectionectomy (OR, 6.22) were significant independent risk factors for PH-PVT. Additionally, the incidence of PH-PVT was significantly higher in patients with MASLD than in those without SLD, along with metabolic factors, excluding alcohol consumption.Conclusions: MASLD and MetALD were identified as independent and significant risk factors for PH-PVT. Consideration was given to the idea that hepatic steatosis and metabolic dysfunction play synergistic roles in PH-PVT development.
背景：随着全球非酒精性脂肪性肝病（NAFLD）患病率不断上升，且该疾病与代谢紊乱密切相关，接受肝切除术的NAFLD患者数量也随之增加。代谢紊乱及NAFLD均会增加静脉血栓风险。近期NAFLD已更新为肝脏脂肪变性的新概念——代谢功能障碍相关脂肪性肝病（MASLD）。本研究旨在探讨MASLD对肝切除术后门静脉血栓形成（PH-PVT）的影响。 方法：共纳入106例因肝癌接受肝切除术的患者。采用CT L/S比值<1.1诊断脂肪性肝病（SLD）。SLD分类如下：MASLD（伴代谢因素但不饮酒的SLD）、MetALD（伴代谢因素且中度饮酒的SLD）、其他SLD（酒精或其他特定病因所致SLD）以及无SLD（无肝脏脂肪变性）。 结果：106例患者中12例（11.3%）检出PH-PVT，其中MASLD组7/20例（35%）、MetALD组1/5例（20%）、其他SLD组1/13例（8%）、无SLD组3/68例（4.4%）。多变量分析显示，MASLD组（包括MASLD和MetALD）（比值比[OR]为9.27）和左外叶切除术（OR为6.22）是PH-PVT的显著独立危险因素。此外，在排除饮酒因素后，伴代谢因素的MASLD患者PH-PVT发生率显著高于无SLD患者。 结论：MASLD和MetALD被确定为PH-PVT的独立且显著的危险因素。研究认为肝脏脂肪变性与代谢功能障碍在PH-PVT发生发展中具有协同作用。
Impact of MASLD on Portal Vein Thrombosis Following Hepatectomy for Liver Cancer
肿瘤(癌症)患者之家