高血压与2型糖尿病对代谢功能障碍相关脂肪性肝病肝纤维化的交互作用分析

摘要/Abstract

摘要： 目的了解高血压与2型糖尿病(T2DM)的交互作用对代谢功能障碍相关脂肪性肝病(MASLD)肝纤维化风险的影响。方法收集2018年1月至2024年6月新疆医科大学附属中医医院肝病科733例住院患者的临床资料。根据是否合并肝纤维化,将患者分为单纯MASLD组、MASLD合并肝纤维化组,比较两组的基线资料。二元logistic回归模型分析高血压、T2DM对MASLD肝纤维化患病风险的影响。相乘和相加模型分析高血压、T2DM的交互作用。计算相对超额危险度(RERI)、交互作用归因比(API)、交互作用指数(SI)。结果与MASLD组相比,MASLD伴肝纤维化组高血压、高尿酸血症、T2DM占比较高,分别为43.4%、72.5%、25.5%;TG、CAP水平较高,分别为1.91(1.36,2.74)mmol/L、(278.73±31.78)dB/m。高血压病合并T2DM人群患MASLD肝纤维化的风险是无高血压病且无T2DM人群的24.43倍(OR=24.35,95%CI:4.82~122.95,P<0.05)。高血压与T2DM存在相加交互作用(RERI=13.07,95%CI:2.42~60.29;SI=8.06,95%CI:6.26~16.07;API=0.82,95%CI:0.62~0.92)。结论高血压与T2DM可能存在相加交互作用,将血压和血糖控制在正常水平可能会协同预防或延缓MASLD发生肝纤维化。

关键词: 高血压病, 2型糖尿病, 代谢功能障碍性脂肪性肝病, 肝纤维化, 交互作用

Abstract: Objective To investigate the effect of interaction between hypertension and type 2 diabetes mellitus (T2DM) on the risk of liver fibrosis in MASLD, and to provide reference for scientific and reasonable prevention or delay of liver fibrosis in MASLD. Methods The clinical data of 733 inpatients in the Department of Hepatology, Xinjiang Medical University affiliated Traditional Chinese Medicine from January 2018 to June 2024 were collected. The patients were divided into MASLD group and MASLD with liver fibrosis group according to whether they were complicated with liver fibrosis. The baseline data of the two groups were compared. The effects of hypertension and type 2 diabetes on the risk of liver fibrosis in MASLD were analysed by binary logistic regression model. The interaction between hypertension and type 2 diabetes was analysed using a multiplicative and additive model. The relative excess risk (RERI), interaction attribution ratio (API) and interaction index (SI) were calculated. Results Compared with the MASLD group, the MASLD with liver fibrosis group had a higher proportion of hypertension, hyperuricemia and T2DM, which were 43.4%, 72.5% and 25.5% respectively. The levels of TG and CAP were also higher, at 1.91 (1.36, 2.74) mmol/L and (278.73±31.78) dB/m, respectively.The risk of MASLD-related liver fibrosis in patients with hypertension and T2DM was 24.43 times higher than that of those without hypertension and T2DM (OR=24.35, 95%CI:4.82~122.95, P<0.05). There was an additive interaction between hypertension and T2DM(RERI=13.07,95%CI:2.42~60.29,SI=8.06,95%CI:6.26~16.07,API=0.82,95%CI:0.62~0.92). Conclusion There may be an additive interaction between hypertension and T2DM. Maintaining blood pressure and blood glucose at normal levels may collaboratively prevent or delay liver fibrosis in MASLD.

Key words: Hypertension, Type 2 diabetes, Metabolic dysfunction-associated steatotic liver disease, Hepatic fibrosis, Interaction

刘云霄, 张荣, 王晓忠. 高血压与2型糖尿病对代谢功能障碍相关脂肪性肝病肝纤维化的交互作用分析[J]. 肝脏, 2026, 31(5): 673-677.

LIU Yun-xiao, ZHANG Rong , WANG Xiao-zhong. The interaction of hypertension, type 2 diabetes on metabolic dysfunction-associated steatotic liver disease with hepatic fibrosis[J]. Chinese Hepatolgy, 2026, 31(5): 673-677.

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