■脂肪性肝病(SLD)患病率在全球范围内呈上升趋势,与胰岛素抵抗和肥胖有关。即使在体重正常的人群中,SLD的患病率也可以超过10%。在老挝人民民主共和国(老挝人民民主共和国),其中OV吸虫感染和2型糖尿病(T2DM)很常见,感染相关的肝脏发病率,如胆管癌(CCA)高,但缺乏有关SLD患病率的数据。这项研究的目的是估算老挝南部农村地区瘦弱和非瘦弱人群的SLD患病率并探讨其决定因素。
■一项基于社区的横断面研究使用腹部超声(US)评估了SLD的患病率。通过访谈确定了与SLD相关的因素,血清学测试(乙型肝炎表面抗原(HBsAg);脂质和HbA1c),人体测量,和寄生虫学评估(OV感染)。分别对瘦(体重指数(BMI)<23.0kg/m2)和非瘦(BMI≥23.0kg/m2)参与者进行以SLD为终点的单变量和多变量逻辑回归分析。
■包括2,826名参与者。SLD患病率为27.1%(95%置信区间(95%CI)24.0%-30.4%),非瘦人(39.8%)高于瘦人(17.4%)。患有OV感染的瘦弱个体与SLD的较低几率具有统计学上的显着关联(调整后的优势比(aOR)0.49,95%CI0.33-0.73)。2型糖尿病在瘦个体(aOR3.58,95%CI2.28-5.63)和非瘦个体(aOR3.31,95%CI2.31-4.74)中均显示与SLD显著正相关,而血脂异常仅在非瘦个体中显著相关(aOR1.83,95%CI1.09-3.07)。女性参与者在精益(aOR1.43,95%CI1.02-2.01)和非精益SLD(aOR1.50,95%CI1.12-2.01)中均表现出SLD的几率升高。
■农村地区的老挝成年人的SLD患病率很高,特别是在女性和非瘦个体中。OV感染的瘦弱个体表现出较低的SLD患病率。SLD在T2DM患者中更为普遍,与BMI无关。SLD增加了老挝人民民主共和国感染相关肝脏发病率的负担。
Steatotic liver disease (SLD) prevalence is rising worldwide, linked to insulin resistance and obesity. SLD prevalence can surpass 10% even among those with normal weight. In Lao People\'s Democratic Republic (Lao PDR), where Opisthorchis viverrini (OV) trematode infection and type 2 diabetes mellitus (T2DM) are common, infection related liver morbidity such as cholangiocarcinoma (CCA) is high, but data on SLD prevalence is lacking. The objective of this
study was to estimate the prevalence and explore determinants of SLD in rural southern Lao PDR for lean and non-lean populations.
A cross-sectional community-based
study assessed SLD prevalence using abdominal ultrasonography (US). Factors investigated for association with SLD were identified by interview, serological tests (Hepatitis B surface antigen (HBsAg); lipids and HbA1c), anthropometrical measurements, and parasitological assessments (OV infection). Uni- and multivariable logistic regression analyses with SLD as endpoint were conducted separately for lean (body mass index (BMI) <23.0 kg/m2) and non-lean (BMI ≥ 23.0 kg/m2) participants.
2,826 participants were included. SLD prevalence was 27.1% (95% confidence interval (95% CI) 24.0%-30.4%), higher among non-lean (39.8%) than lean individuals (17.4%). Lean individuals with OV infection had a statistically significant association with lower odds of SLD (adjusted odds ratio (aOR) 0.49, 95% CI 0.33 - 0.73). T2DM showed a significant positive association with SLD in both lean (aOR 3.58, 95% CI 2.28 - 5.63) and non-lean individuals (aOR 3.31, 95% CI 2.31 - 4.74) while dyslipidemia was significantly associated only in the non-lean group (aOR 1.83, 95% CI 1.09 - 3.07). Females participants exhibited elevated odds of SLD in both lean (aOR 1.43, 95% CI 1.02 - 2.01) and non-lean SLD (aOR 1.50, 95% CI 1.12 - 2.01).
SLD prevalence is notably high among Laotian adults in rural areas, particularly in females and in non-lean individuals. Lean individuals with OV infection exhibited lower SLD prevalence. SLD was more prevalent in individuals with T2DM, independent of BMI. SLD adds to the burden of infection-related liver morbidity in Lao PDR.