Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Department of Thyroid and Breast Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China.
BMC Gastroenterol. 2021 May 10;21(1):212. doi: 10.1186/s12876-021-01782-w.
Metabolic associated fatty liver disease (MAFLD) is a new definition for liver disease associated with known metabolic dysfunction. Based on new diagnostic criteria, we aimed to investigate its prevalence and risk factors in Chinese population.
We conducted this study in a health examination population who underwent abdominal ultrasonography in China. The diagnosis of MAFLD was based on the new diagnostic criteria. The characteristics of the MAFLD population, as well as the associations between MAFLD and metabolic abnormalities, were explored. Mann-Whitney U test and chi-square test were performed to compare different variables. Binary logistic regression was used to determine the risk factors for MAFLD.
Among 139,170 subjects, the prevalence of MAFLD was 26.1% (males: 35.4%; females: 14.1%). The prevalence based on female menopausal status, that is, premenopausal, perimenopausal, and postmenopausal, was 6.1%, 16.8%, and 30.2%, respectively. In different BMI groups (underweight, normal, overweight and obese), the prevalence was 0.1%, 4.0%, 27.4% and 59.8%, respectively. The proportions of abnormal metabolic features in the MAFLD group were significantly higher than those in the non-MAFLD group, as was the proportion of elevated alanine aminotransferase (ALT) (42.5% vs. 11%, P < 0.001). In nonobese individuals with MAFLD, the proportions of abnormal metabolic features were also all significantly higher than those in nonobese individuals without MAFLD. The prevalence of metabolic syndrome (MS), dyslipidaemia, and hyperuricaemia, respectively, in the MAFLD group (53.2%, 80.0%, and 45.0%) was significantly higher than that in the non-MAFLD group (10.1%, 41.7%, and 16.8%). Logistic regression revealed that age, BMI, waist circumference, ALT, triglycerides, fasting glucose, uric acid and platelet count were associated with MAFLD.
MAFLD is prevalent in China and varies considerably among different age, sex, BMI, and female menopausal status groups. MAFLD is related to metabolic disorders, especially obesity, while metabolic disorders also play important roles in the occurrence of MAFLD in nonobese individuals. MAFLD patients exhibit a high prevalence of MS, dyslipidaemia, hyperuricaemia, and elevated liver enzymes. MAFLD tends to coexist with systemic metabolic disorders, and a deep inner relationship may exist between MAFLD and MS. Metabolic disorders should be considered to improve the management of MAFLD.
代谢相关脂肪性肝病（MAFLD）是一种与已知代谢功能障碍相关的肝病的新定义。基于新的诊断标准，我们旨在研究其在中国人群中的患病率和危险因素。
我们在中国进行了这项健康体检人群的研究，这些人接受了腹部超声检查。MAFLD 的诊断基于新的诊断标准。探讨了 MAFLD 人群的特征，以及 MAFLD 与代谢异常之间的关联。采用 Mann-Whitney U 检验和卡方检验比较不同变量。采用二项逻辑回归确定 MAFLD 的危险因素。
在 139170 名受试者中，MAFLD 的患病率为 26.1%（男性：35.4%；女性：14.1%）。基于女性绝经状态（绝经前、围绝经期和绝经后），患病率分别为 6.1%、16.8%和 30.2%。在不同 BMI 组（体重不足、正常、超重和肥胖）中，患病率分别为 0.1%、4.0%、27.4%和 59.8%。MAFLD 组异常代谢特征的比例明显高于非 MAFLD 组，丙氨酸氨基转移酶（ALT）升高的比例也明显高于非 MAFLD 组（42.5% vs. 11%，P<0.001）。在非肥胖的 MAFLD 患者中，异常代谢特征的比例也明显高于非肥胖的非 MAFLD 患者。MAFLD 组代谢综合征（MS）、血脂异常和高尿酸血症的患病率分别为 53.2%、80.0%和 45.0%，明显高于非 MAFLD 组（10.1%、41.7%和 16.8%）。Logistic 回归显示，年龄、BMI、腰围、ALT、甘油三酯、空腹血糖、尿酸和血小板计数与 MAFLD 相关。
MAFLD 在我国患病率较高，且在不同年龄、性别、BMI 和女性绝经状态组之间差异较大。MAFLD 与代谢紊乱有关，尤其是肥胖，而代谢紊乱在非肥胖个体中发生 MAFLD 中也起着重要作用。MAFLD 患者 MS、血脂异常、高尿酸血症和肝酶升高的患病率较高。MAFLD 倾向于与全身代谢紊乱共存，MAFLD 和 MS 之间可能存在内在的密切关系。应考虑代谢紊乱以改善 MAFLD 的管理。
