Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Oberndorf, Salzburg, Austria.
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
J Clin Endocrinol Metab. 2021 Aug 18;106(9):2670-2677. doi: 10.1210/clinem/dgab339.
Recently, the novel metabolic dysfunction-associated fatty liver disease (MAFLD) definition has been introduced.
To assess the relevance of MAFLD for mortality.
Single-center cohort-study using colorectal cancer screening program involving 4718 subjects aged 45 to 80 who were grouped according to their body mass index (BMI) and the presence or absence of MAFLD. Mortality was compared among these groups by performing a systematic read-out of the national health insurance system, fatty liver (FL) was diagnosed using ultrasound.
Overall prevalence of FL was 47.9%: 1200 (25.4%) patients were lean (BMI < 25 kg/m2) and did not have MAFLD, 73 (1.5%) patients were lean and had nonalcoholic fatty liver disease but did not fulfill criteria for MAFLD, and 221 (4.7%) patients were lean and fulfilled criteria for MAFLD. Additionally, 1043 (22.1%) and 925 (19.6%) subjects had MAFLD with overweight (BMI 25-30 kg/m2) and obesity (BMI ≥ 30 kg/m2), respectively, while 1041 (22.1%) and 215 (4.6%) had overweight and obesity, respectively, without FL. During a median follow-up of 7.5 (interquartile range: 4.0-9.6) years, 278 deaths (5.9%) occurred. Of these, 98 (2.1%) were cancer-related, 65 (1.4%) were cardiovascular, and 17 (0.4%) were liver-related. Overall survival was similar between patient strata (after 5 years: 93.9%-98.2%) with lean MAFLD having the numerically worst survival. Although lean and overweight patients with MAFLD had a numerically worse outcome compared to their non-MAFLD counterparts, this association was driven by age and metabolic comorbidities (predominantly diabetes) rather than the presence of MAFLD.
Presence of MAFLD does not increase mortality in a cohort of individuals aged 45 to 80 years.
最近，新型代谢相关性脂肪性肝病（MAFLD）定义被引入。
评估 MAFLD 与死亡率的相关性。
采用单中心队列研究，纳入了 4718 名年龄在 45 至 80 岁的结直肠癌筛查计划参与者，根据体重指数（BMI）和是否存在 MAFLD 进行分组。通过系统读取国家健康保险系统来比较这些组之间的死亡率，使用超声诊断脂肪肝（FL）。
总体 FL 患病率为 47.9%：1200 名（25.4%）患者为消瘦（BMI<25kg/m2）且无 MAFLD，73 名（1.5%）患者为消瘦且患有非酒精性脂肪性肝病但不符合 MAFLD 标准，221 名（4.7%）患者为消瘦且符合 MAFLD 标准。此外，1043 名（22.1%）和 925 名（19.6%）超重（BMI25-30kg/m2）和肥胖（BMI≥30kg/m2）患者分别患有 MAFLD，同时，1041 名（22.1%）和 215 名（4.6%）患者超重且无 FL。在中位随访 7.5 年（四分位距：4.0-9.6）期间，278 例死亡（5.9%）发生。其中，98 例（2.1%）与癌症相关，65 例（1.4%）与心血管疾病相关，17 例（0.4%）与肝脏相关。各患者分层之间的总体生存率相似（5 年后：93.9%-98.2%），消瘦 MAFLD 患者的生存率略差。尽管 MAFLD 消瘦和超重患者与非 MAFLD 患者相比，结局略差，但这种关联是由年龄和代谢合并症（主要是糖尿病）驱动的，而不是 MAFLD 的存在。
在 45 至 80 岁人群中，MAFLD 的存在不会增加死亡率。
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