背景:最近,一组肝病学家建议将非酒精性脂肪性肝病(NAFLD)重命名为代谢相关脂肪性肝病(MAFLD),并修改了诊断标准.重要的是要注意,然而,用于NAFLD和MAFLD的诊断标准之间存在一些差异。由于MAFLD的研究才刚刚开始,然而,关于其在普通人群和特定亚群中的发病率和患病率的证据仍然有限。
目的:评估新定义脂肪肝的流行病学,并比较MAFLD和NAFLD。探讨MAFLD个体的危险因素。
方法:这是一个回顾性研究,横断面研究。2017-2022年从中国健康管理数据库中筛选出85242名成年人。一般资料的数据,实验室指标,获得生活方式管理和心理状况。MAFLD被诊断为脂肪肝的超声诊断和这三种情况之间的至少一种:超重/肥胖,2型糖尿病(T2DM)或代谢失调。NAFLD诊断标准中未考虑代谢因素。采用描述性统计学方法分析MAFLD和NAFLD的临床特征。正态分布的连续变量表示为平均值±SD。分类变量表示为频率和比例。采用二元Logistic回归分析确定MAFLD的危险因素。
结果:MAFLD和NAFLD的患病率分别为40.5%和31.0%,分别。MAFLD或NAFLD人群更可能年龄较大(M:47.19±10.82vs43.43±11.96;N:47.72±11.17vs43.71±11.66),男性(M:77.21%vs44.43%;N:67.90%vs53.12%)和高体重指数(M:26.79±2.69vs22.44±2.48;N:26.29±2.84vs23.29±3.12)。在多变量分析中,一般信息(例如,≥2代谢异常OR=3.38,(95CI:2.99-3.81),P<0.001;舒张压OR=1.01,(95CI:1.00-1.01),P=0.002),实验室结果[例如,总胆红素(TBIL)OR=0.98,(95CI:0.98-0.99),P<0.001;血清尿酸(SUA)OR=1.01,(95CI:1.01-1.01),P<0.001],和生活方式因素[例如,饮料OR=0.32,(95CI:0.17-0.63),P=0.001是MAFLD的影响因素。我们的研究结果提供了与脂肪肝疾病相关的潜在危险因素的新见解,包括SUA,TBIL和肌酐,所有这些都与慢性肾脏疾病(CKD)有关。
结论:MAFLD比NAFLD更普遍,五分之二的人符合诊断标准。MAFLD和NAFLD人群具有不同的临床特征。CKD可能与MAFLD有关。
BACKGROUND: Recently, a group of hepatologists proposed to rename non-alcoholic fatty liver disease (NAFLD) as metabolic associated fatty liver disease (MAFLD) with modified diagnostic criteria. It is important to note, however, that there are some differences between the diagnostic criteria used for NAFLD and MAFLD. Since the research on MAFLD is just beginning, however, evidence on its incidence and prevalence in the general population and in specific subpopulations remains limited.
OBJECTIVE: To assess epidemiology of fatty liver in new definition and compare MAFLD with NAFLD. Exploring risk factors of MAFLD individuals.
METHODS: This was a retrospective, cross-sectional study. A total of 85242 adults were selected from the Chinese health management database in 2017-2022. The data of general information, laboratory indicators, lifestyle management and psychological status were obtained. MAFLD was diagnosed as ultrasound diagnosis of fatty liver and at least one between these three conditions: Overweight/obesity, type 2 diabetes mellitus (T2DM) or metabolic dysregulation. Metabolic factors were not considered in NAFLD diagnosis standard. The clinical characteristics of MAFLD and NAFLD were analysed using descriptive statistics. Continuous variables normally distributed were expressed as means ± SD. Categorical variables were expressed as frequencies and proportions. Binary logistic regression was used to determine risk factors of the MAFLD.
RESULTS: The prevalence of MAFLD and NAFLD was 40.5% and 31.0%, respectively. The MAFLD or NAFLD population is more likely to be older (M: 47.19 ± 10.82 vs 43.43 ± 11.96; N: 47.72 ± 11.17 vs 43.71 ± 11.66), male (M: 77.21% vs 44.43%; N: 67.90% vs 53.12%) and high body mass index (M: 26.79 ± 2.69 vs 22.44 ± 2.48; N: 26.29 ± 2.84 vs 23.29 ± 3.12) than the non-MAFLD or non-MAFLD population. In multivariate analysis, general information (e.g., ≥ 2 metabolic abnormalities OR = 3.38, (95%CI: 2.99-3.81), P < 0.001; diastolic blood pressure OR = 1.01, (95%CI: 1.00-1.01), P = 0.002), laboratory results [e.g.,total bilirubin (TBIL) OR = 0.98, (95%CI: 0.98-0.99), P < 0.001; serum uric acid(SUA) OR = 1.01, (95%CI: 1.01-1.01), P < 0.001], and lifestyle factors [e.g., drink beverage OR = 0.32, (95%CI: 0.17-0.63), P = 0.001] were influence factors for MAFLD. Our study results offer new insight into potential risk factors associated with fatty liver disease, including SUA, TBIL and creatinine, all of which are related to chronic renal disease (CKD).
CONCLUSIONS: MAFLD is more prevalent than NAFLD, with two-fifths of individuals meeting the diagnosis criteria. MAFLD and NAFLD populations have different clinical characteristics. CKD may be related with MAFLD.