Fan Jiahua, Luo Shiyun, Ye Yongxin, Ju Jingmeng, Zhang Zhuoyu, Liu Ludi, Yang Jialu, Xia Min
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangdong Engineering Technology Research Center of Nutrition Translation, Department of Nutrition, School of Public Health, Sun Yat-Sen University (Northern Campus), Guangzhou, Guangdong Province, People's Republic of China.
Nutr Metab (Lond). 2021 Sep 8;18(1):82. doi: 10.1186/s12986-021-00611-x.
As a newly proposed diagnosis, data on the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is rare. We aimed to assess the prevalence and risk factors of MAFLD using new definition in the contemporary South China population.
In this population based, cross sectional study, a total of 5377 participants aged 30-79 years old were recruited from the South China between 2018 and 2019. MAFLD was diagnosed in subjects who have both hepatic steatosis and metabolic disorders according to the newly international expert consensus. The total prevalence of MAFLD and prevalence by sex and age was estimated. Demographic characteristics, history of disease, and lifestyle were recorded by participants on a questionnaire. Abdominal ultrasonography was performed and evaluated by experienced sonographers. Multivariable logistic regression was used to calculate the odds ratios (ORs) of MAFLD.
Overall prevalence of MAFLD was 29.2% (95% confidence interval [CI] 28.0% to 30.5%). Prevalence was higher in women (31.7%) than in men (25.5%; p < 0.001 for sex difference) and in subjects aged 50 years or older (30.7%) than in those aged 30-49 years (19.8%; p < 0.001 for age difference). In participants diagnosed with MAFLD, the prevalence of overweight/obesity was up to 90.5%, type 2 diabetes (T2DM) and metabolic dysregulation were 25.0% and 62.2%, respectively. Risk factors for MAFLD included overweight/obesity (OR = 4.67; 95% CI, 3.76-5.83), T2DM (OR = 2.41, 95% CI, 1.68-3.47), hypertriglyceridemia (OR = 2.42, 95% CI, 2.03-2.87), high school education (OR = 1.50, 95% CI, 1.23-1.82), high income (OR = 1.22, 95% CI, 1.05-1.42). A lower risk of MAFLD was associated with high physical activity equivalent (OR = 0.71, 95% CI, 0.60-0.85). A U-shaped association of frequency of soups and ORs of MAFLD was found, the adjusted ORs (95% CI) of lower and higher frequency of soups were 1.58 (1.32-1.89) and 1.36 (1.13-1.63), respectively.
Our results showed a high prevalence of MAFLD in the general adult population in South China. Obesity has the greatest impact on MAFLD, physical activity and moderate consumption of soups might be the potential protective factors of MAFLD.
作为一种新提出的诊断，关于代谢功能障碍相关脂肪性肝病（MAFLD）患病率的数据很少。我们旨在使用新定义评估当代华南人群中MAFLD的患病率及危险因素。
在这项基于人群的横断面研究中，2018年至2019年期间从华南地区招募了共5377名年龄在30 - 79岁的参与者。根据新的国际专家共识，在同时患有肝脂肪变性和代谢紊乱的受试者中诊断MAFLD。估计MAFLD的总患病率以及按性别和年龄分层的患病率。参与者通过问卷记录人口统计学特征、疾病史和生活方式。由经验丰富的超声医师进行腹部超声检查并评估。采用多变量逻辑回归计算MAFLD的比值比（OR）。
MAFLD的总体患病率为29.2%（95%置信区间[CI] 28.0%至30.5%）。女性患病率（31.7%）高于男性（25.5%；性别差异p < 0.001），50岁及以上受试者的患病率（30.7%）高于30 - 49岁受试者（19.8%；年龄差异p < 0.001）。在诊断为MAFLD的参与者中，超重/肥胖的患病率高达90.5%，2型糖尿病（T2DM）和代谢失调的患病率分别为25.0%和62.2%。MAFLD的危险因素包括超重/肥胖（OR = 4.67；95% CI，3.76 - 5.83）、T2DM（OR = 2.41，95% CI，1.68 - 3.47）、高甘油三酯血症（OR = 2.42，95% CI，2.03 - 2.87）、高中教育程度（OR = 1.50，95% CI，1.23 - 1.82）、高收入（OR = 1.22，95% CI，1.05 - 1.42）。较高的体力活动当量与较低的MAFLD风险相关（OR = 0.71，95% CI，0.60 - 0.85）。发现汤的摄入频率与MAFLD的OR呈U形关联，汤摄入频率较低和较高时调整后的OR（95% CI）分别为1.58（1.32 - 1.89）和1.36（1.13 - 1.63）。
我们的结果显示MAFLD在华南地区普通成年人群中患病率较高。肥胖对MAFLD的影响最大，体力活动和适量饮用汤可能是MAFLD的潜在保护因素。
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