PDF(Pubmed)
Abstract：
Fatty liver disease (FLD) affects approximately 25% of global adult population. Metabolic-associated fatty liver disease (MAFLD) is a term used to emphasize components of metabolic syndrome in FLD. MAFLD does not exclude coexistence of other liver disease, but impact of coexisting MAFLD is unclear. We investigated prevalence and characteristics of MAFLD in patients with biopsy-proven autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), or toxic liver disease. Liver histopathology and clinical data from Helsinki University Hospital district (1.7 million inhabitants) between 2009 and 2019 were collected from patients with AIH, PBC, PSC, or toxic liver disease at the time of diagnosis. MAFLD was diagnosed as macrovesicular steatosis ≥5% together with obesity, type-2 diabetes, or signs of metabolic dysregulation. Of 648 patients included, steatosis was observed in 15.6% (n = 101), of which 94.1% (n = 95) was due to MAFLD. Prevalence of coexisting MAFLD in the four liver diseases varied between 12.4 and 18.2% (P = 0.483). Fibrosis was more severe in MAFLD among patients with toxic liver disease (P = 0.01). Histopathological characteristics otherwise showed similar distribution among MAFLD and non-FLD controls. Alcohol consumption was higher in MAFLD group among patients with AIH or PBC (P < 0.05 for both). In AIH, smoking was more common in patients with coexisting MAFLD (P = 0.034). Prevalence of coexisting MAFLD in other primary liver diseases is lower than reported in general population. Histopathology of MAFLD patients did not clearly differ from non-FLD ones. Alcohol and smoking were associated with MAFLD in AIH.
摘要：
脂肪肝（FLD）影响全球约25％的成年人。代谢相关脂肪性肝病（MAFLD）是用于强调FLD中代谢综合征成分的术语。MAFLD不排除其他肝病的共存，但共存MAFLD的影响尚不清楚。我们调查了活检证实的自身免疫性肝炎（AIH）患者MAFLD的患病率和特征，原发性胆汁性胆管炎(PBC),原发性硬化性胆管炎（PSC），或中毒性肝病。2009年至2019年赫尔辛基大学医院区（170万居民）的肝脏组织病理学和临床数据收集自AIH患者，PBC,PSC,或诊断时的中毒性肝病。MAFLD被诊断为大泡性脂肪变性≥5%并伴有肥胖，2型糖尿病,或是代谢失调的迹象.在648名患者中，在15.6%（n=101）观察到脂肪变性，其中94.1%(n=95)是由于MAFLD。四种肝病中共存MAFLD的患病率在12.4％至18.2％之间（P=0.483）。MAFLD中毒性肝病患者的纤维化更为严重（P=0.01）。组织病理学特征在MAFLD和非FLD对照中显示出相似的分布。在AIH或PBC患者中，MAFLD组的饮酒量较高（均P<0.05）。在AIH，吸烟在合并MAFLD的患者中更为常见(P=0.034).其他原发性肝病中共存MAFLD的患病率低于一般人群。MAFLD患者的组织病理学与非FLD患者没有明显差异。酒精和吸烟与AIH的MAFLD相关。
