背景:为了克服术语“非酒精性脂肪性肝病”(NAFLD)的局限性,引入术语代谢相关脂肪变性肝病(MASLD).虽然已经对MASLD进行了流行病学研究,关于其相关性别和种族差异的证据有限。
目的:这项研究评估了不同性别和种族-种族患病率的差异,MASLD患者的相关危险因素和不良结局。
方法:分析了从1999年至2018年的国家健康和营养检查调查中检索的数据。患病率,临床特征,并根据性别和种族种族评估结局.使用多变量分析对不良结果和死亡事件进行分析。
结果:包括40,166个人,37.63%有MASLD。从1999年到2018年,墨西哥裔美国人的MASLD患病率显着增加(年度百分比变化[APC]+1.889%,p<0.001),其他西班牙裔(APC+1.661%,p=0.013),NH白色(APC+1.084%,p=0.018),NH黑人(APC+1.108%,p=0.007),和女性(APC+0.879%,p=0.030),但不是男性。MASLD患者的全因风险较低(HR:0.766,95CI0.711至0.825,p<0.001),心血管疾病相关(CVD)(SHR:0.802,95%CI0.698~0.922,p=0.002)和癌症相关死亡率(SHR:0.760,95%CI0.662~0.873,p<0.001)。重要的是,NH黑人的全因和CVD相关死亡率风险最高,其次是NH白人,然后是墨西哥裔美国人。
结论:随着时间的推移,大多数种族的患病率都在增加。虽然定义的变化表明在NAFLD中发现的先前关联没有显着差异,NH白人相对于墨西哥裔美国人的死亡率增加还有待探索。
BACKGROUND: To overcome the limitations of the term \"non-alcoholic fatty liver disease\" (NAFLD), the term metabolic-associated steatotic liver disease (MASLD) was introduced. While epidemiologic studies have been conducted on MASLD, there is limited evidence on its associated
sex and ethnic variations.
OBJECTIVE: This study assesses the differences across
sex and race-ethnicity on the prevalence, associated risk factors and adverse outcomes in individuals with MASLD.
METHODS: Data retrieved from the National Health and Nutrition Examination Survey between 1999 to 2018 was analyzed. Prevalence, clinical characteristics, and outcomes were evaluated according to
sex and race-ethnicity. Adverse outcomes and mortality events were analyzed using multivariate analyses.
RESULTS: Of 40,166 individuals included, 37.63% had MASLD. There was a significant increase in MASLD prevalence from 1999 to 2018 among Mexican Americans (Annual Percentage Change [APC] + 1.889%, p < 0.001), other Hispanics (APC + 1.661%, p = 0.013), NH Whites (APC + 1.084%, p = 0.018), NH Blacks (APC + 1.108%, p = 0.007), and females (APC + 0.879%, p = 0.030), but not males. Females with MASLD were at lower risk of all-cause (HR: 0.766, 95%CI 0.711 to 0.825, p < 0.001), cardiovascular disease-related (CVD) (SHR: 0.802, 95% CI 0.698 to 0.922, p = 0.002) and cancer-related mortality (SHR: 0.760, 95% CI 0.662 to 0.873, p < 0.001). Significantly, NH Blacks have the highest risk of all-cause and CVD-related mortality followed by NH Whites then Mexican Americans.
CONCLUSIONS: There has been an increase in prevalence in most race-ethnicities over time. While the change in definition shows no significant differences in previous associations found in NAFLD, the increased mortality in NH Whites relative to Mexican Americans remains to be explored.