Teeratorn Nicha, Piyachaturawat Panida, Thanapirom Kessarin, Chaiteerakij Roongruedee, Sonsiri Kanokwan, Komolmit Piyawat, Tangkijvanich Pisit, Rerknimitr Rungsun, Adams Leon, Treeprasertsuk Sombat
Department of Medicine, Division of Gastroenterology, Faculty of Medicine Chulalongkorn University Bangkok Thailand.
Thai Red Cross Society Bangkok Thailand.
JGH Open. 2019 Sep 4;4(2):245-250. doi: 10.1002/jgh3.12252. eCollection 2020 Apr.
BACKGROUND/AIM: The global problems of chronic liver disease and non-alcoholic fatty liver disease (NAFLD) are increasing. We examined the prevalence of NAFLD and significant liver stiffness in an asymptomatic population and identified the predictors of significant fibrosis in NAFLD.
We prospectively enrolled Thai subjects, aged 18-80 years, from four regions (Bangkok, Central, North, South) of Thailand from March 2013 to November 2016. All participants underwent controlled attenuation parameter (CAP) measurement for liver fat quantification and transient elastography (TE) for liver stiffness measurement (LSM). NAFLD was defined as liver fat ≥10% (CAP ≥ 306 dB/m). Of 1145 participants, 782 (68.3%) were eligible for analysis.
The mean age ± standard deviation (SD) was 53.1 ± 4.6 years, and 71.6% were female. The mean ± SD values of CAP and LSM of the overall cohort were 241.9 ± 61.4 dB/m and 5.5 ± 3.8 kPa, respectively. The prevalence of NAFLD was 18.0%, whereas 5.4% of the cohort had nonobese NAFLD (BMI < 25 kg/m), and 2.8% had lean NAFLD (BMI < 23 kg/m). The prevalence of significant liver fibrosis (≥F2) in NAFLD subjects was 18.4%. On multivariate analysis, the degree of significant fibrosis in NAFLD was significantly associated with male gender and a history of dyslipidemia.
NAFLD with significant fibrosis (≥F2) is prevalent in asymptomatic populations. The predictors of significant fibrosis in NAFLD were male gender and dyslipidemia. Screening for NAFLD using CAP/TE in asymptomatic populations should be considered in hospitals with available facilities.
背景/目的：慢性肝病和非酒精性脂肪性肝病（NAFLD）的全球性问题日益增加。我们调查了无症状人群中NAFLD的患病率和显著肝硬度，并确定了NAFLD中显著纤维化的预测因素。
2013年3月至2016年11月，我们前瞻性地招募了来自泰国四个地区（曼谷、中部、北部、南部）年龄在18 - 80岁的泰国受试者。所有参与者均接受了用于肝脏脂肪定量的受控衰减参数（CAP）测量和用于肝脏硬度测量（LSM）的瞬时弹性成像（TE）。NAFLD定义为肝脏脂肪≥10%（CAP≥306dB/m）。在1145名参与者中，782名（68.3%）符合分析条件。
平均年龄±标准差（SD）为53.1±4.6岁，女性占71.6%。整个队列的CAP和LSM的平均值±SD分别为241.9±61.4dB/m和5.5±3.8kPa。NAFLD的患病率为18.0%，而该队列中有5.4%患有非肥胖型NAFLD（BMI<25kg/m²），2.8%患有瘦型NAFLD（BMI<23kg/m²）。NAFLD受试者中显著肝纤维化（≥F2）的患病率为18.4%。多因素分析显示，NAFLD中显著纤维化的程度与男性性别和血脂异常病史显著相关。
伴有显著纤维化（≥F2）的NAFLD在无症状人群中普遍存在。NAFLD中显著纤维化的预测因素为男性性别和血脂异常。在有可用设备的医院，应考虑对无症状人群使用CAP/TE进行NAFLD筛查。
