PDF(Pubmed)
Abstract：
Patients with metabolic dysfunction-associated fatty liver disease (MAFLD) often present with concomitant metabolic dysregulation and alcohol consumption, potentially leading to distinct clinical outcomes. We analyzed data from 8043 participants with MAFLD in the Thai National Health Examination Survey with linked mortality records. According to the MAFLD criteria, 1432 individuals (17.2%) were categorized as having the diabetes phenotype, 5894 (71.0%) as the overweight/obesity phenotype, and 978 (11.8%) as the lean metabolic phenotype. Over 71,145 person-years, 916 participants died. Using Cox proportional hazard models adjusting for physiological, lifestyle, and comorbid factors, both diabetes (adjusted hazards ratio [aHR] 1.59, 95% CI 1.18-2.13) and lean metabolic phenotypes (aHR 1.28, 95% CI 1.01-1.64) exhibited significantly higher mortality risk compared to the overweight/obesity phenotype. A J-shaped relationship was observed between daily alcohol consumption and the risk of all-cause mortality. Daily alcohol intake exceeding 50 g for women and 60 g for men increased the all-cause mortality risk among MAFLD individuals with the lean metabolic phenotype (aHR 3.39, 95% CI 1.02-11.29). Our study found that metabolic phenotype and alcohol consumption have interactive effects on the risk of all-cause mortality in patients with MAFLD, indicating that evaluating both factors is crucial for determining prognostic outcomes and management strategies.
摘要：
代谢功能障碍相关脂肪性肝病（MAFLD）患者常伴有代谢失调和饮酒，可能导致不同的临床结果。我们分析了来自泰国国家健康检查调查中的8043名MAFLD参与者的数据以及相关的死亡率记录。根据MAFLD标准,1432人（17.2%）被归类为患有糖尿病表型，5894（71.0%）为超重/肥胖表型，和978（11.8%）为瘦代谢表型。超过71,145人年，916名参与者死亡。使用Cox比例风险模型调整生理，生活方式,和合并症因素，与超重/肥胖表型相比,糖尿病(校正风险比[aHR]1.59,95%CI1.18-2.13)和瘦代谢表型(aHR1.28,95%CI1.01-1.64)均表现出显著更高的死亡风险.观察到每日饮酒与全因死亡风险之间存在J形关系。女性每日酒精摄入量超过50g，男性每日酒精摄入量超过60g会增加具有瘦代谢表型的MAFLD个体的全因死亡风险(aHR3.39,95%CI1.02-11.29)。我们的研究发现，代谢表型和饮酒对MAFLD患者全因死亡的风险有相互作用的影响，这表明评估这两个因素对于确定预后结果和管理策略至关重要。
