Lin Su, Huang Jiaofeng, Wang Mingfang, Kumar Rahul, Liu Yuxiu, Liu Shiying, Wu Yinlian, Wang Xiaozhong, Zhu Yueyong
Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Department of Gastroenterology and Hepatology, Duke-NUS academic Medical Centre, Changi General Hospital, Singapore, Singapore.
Liver Int. 2020 Sep;40(9):2082-2089. doi: 10.1111/liv.14548. Epub 2020 Jul 26.
Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020, the utility of which has not been tested and validated in real world. We aimed to compare the characteristics of MAFLD and non-alcoholic fatty liver disease (NAFLD).
The data was retrieved from the third National Health and Nutrition Examination Surveys of the United States, which is an unbiased survey dataset and frequently used for the study of fatty liver disease.
A total of 13 083 cases with completed ultrasonography and laboratory data were identified from the NHANES III database. MAFLD was diagnosed in 4087/13 083 (31.24%) participants, while NAFLD in 4347/13 083 (33.23%) amongst the overall population and 4347/12 045 (36.09%) in patients without alcohol intake and other liver diseases. Compared with NAFLD, MAFLD patients were significantly older, had higher BMI level, higher proportions of metabolic comorbidities (diabetes, hypertension) and higher HOMA-IR, lipid and liver enzymes. MAFLD patients with alcohol consumption were younger than those without, and more likely to be male. They had less metabolic disorder but higher liver enzymes. There were more cases with advance fibrosis in MAFLD patients with alcohol consumption.
MAFLD definition is more practical for identifying patients with fatty liver disease with high risk of disease progression.
代谢相关脂肪性肝病（MAFLD）是2020年提出的一个新概念，其效用尚未在现实世界中得到检验和验证。我们旨在比较MAFLD和非酒精性脂肪性肝病（NAFLD）的特征。
数据取自美国第三次国家健康与营养检查调查，这是一个无偏倚的调查数据集，常用于脂肪肝疾病的研究。
从NHANES III数据库中识别出13083例有完整超声检查和实验室数据的病例。在总体人群中，4087/13083（31.24%）的参与者被诊断为MAFLD，而4347/13083（33.23%）被诊断为NAFLD；在无酒精摄入和其他肝脏疾病的患者中，4347/12045（36.09%）被诊断为NAFLD。与NAFLD相比，MAFLD患者年龄显著更大，BMI水平更高，代谢合并症（糖尿病、高血压）比例更高，HOMA-IR、血脂和肝酶水平更高。饮酒的MAFLD患者比不饮酒的患者更年轻，更可能为男性。他们的代谢紊乱较少，但肝酶水平较高。饮酒的MAFLD患者中进展性纤维化的病例更多。
MAFLD定义对于识别具有疾病进展高风险的脂肪肝患者更具实用性。
