Abstract：
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) was renamed metabolic dysfunction associated with fatty liver disease (MAFLD) recently. We aimed to explore the risk of all-cause deaths in MAFLD participants and compare it with NAFLD in Chinese adults.
METHODS: We enrolled 152,139 participants with abdominal ultrasonography in the Kailuan Cohort from 2006 to 2012. We categorized the participants into MAFLD and non-MAFLD, NAFLD and non-NAFLD, and four groups of Neither-FLD, MAFLD-only, NAFLD-only, and MAFLD-NAFLD, respectively. We used Cox regression models to estimate the hazard ratios and 95% confidence interval (CI) of death.
RESULTS: The prevalence of MAFLD and NAFLD was 31.5% and 27.3%, respectively. After a median follow-up of 12.7 years, MAFLD and NAFLD were both associated with increased mortality, especially in men aged <40, with HR (95% CI) of 1.51(1.19-1.93) and 1.37(1.06-1.78), respectively. The MAFLD-only group had higher mortality than the NAFLD-only in males aged ≥ 60 (adjusted HR=1.43; 95% CI, 1.00-2.03) and lower risk in males aged 40-59 (adjusted HR=0.65; 95% CI,0.48-0.90). MAFLD with overweight/obesity-only decreased, but those with diabetes and/or metabolic dysregulation increased the risk of death. MAFLD with positive HBsAg and/or excessive alcohol consumption further increased the risk of death, especially in men aged <40 years (HR, 9.86; 95% CI, 2.44-39.98).
CONCLUSIONS: MAFLD was associated with increased all-cause mortality among the Chinese population, which was different by the status of overweight/obesity, diabetes, other metabolic indicators, and second causes. MAFLD patients should be managed by metabolic indicators and second causes to fulfill precise treatment and management.
METHODS: We enrolled 152,139 participants with abdominal ultrasonography in the Kailuan Cohort from 2006 to 2012. We categorized the participants into MAFLD and non-MAFLD, NAFLD and non-NAFLD, and four groups of Neither-FLD, MAFLD-only, NAFLD-only, and MAFLD-NAFLD, respectively. We used Cox regression models to estimate the hazard ratios and 95% confidence interval (CI) of death.
RESULTS: The prevalence of MAFLD and NAFLD was 31.5% and 27.3%, respectively. After a median follow-up of 12.7 years, MAFLD and NAFLD were both associated with increased mortality, especially in men aged <40, with HR (95% CI) of 1.51(1.19-1.93) and 1.37(1.06-1.78), respectively. The MAFLD-only group had higher mortality than the NAFLD-only in males aged ≥ 60 (adjusted HR=1.43; 95% CI, 1.00-2.03) and lower risk in males aged 40-59 (adjusted HR=0.65; 95% CI,0.48-0.90). MAFLD with overweight/obesity-only decreased, but those with diabetes and/or metabolic dysregulation increased the risk of death. MAFLD with positive HBsAg and/or excessive alcohol consumption further increased the risk of death, especially in men aged <40 years (HR, 9.86; 95% CI, 2.44-39.98).
CONCLUSIONS: MAFLD was associated with increased all-cause mortality among the Chinese population, which was different by the status of overweight/obesity, diabetes, other metabolic indicators, and second causes. MAFLD patients should be managed by metabolic indicators and second causes to fulfill precise treatment and management.
摘要：
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