Department of Gastroenterology, The Alfred Hospital, Melbourne, Victoria, Australia.
Central Clinical School, Monash University, Melbourne, Victoria, Australia.
J Gastroenterol Hepatol. 2022 Feb;37(2):395-403. doi: 10.1111/jgh.15723. Epub 2021 Nov 4.
Clinical and public health implications of the recent redefining of non-alcoholic fatty liver disease (NAFLD) to metabolic-associated fatty liver disease (MAFLD) remain unclear. We sought to determine the prevalence and compare MAFLD with NAFLD in a well-defined cohort.
A cross-sectional study was conducted in regional Victoria with participants from randomly selected households. Demographic and health-related clinical and laboratory data were obtained. Fatty liver was defined as a fatty liver index ≥ 60 with MAFLD defined according to recent international expert consensus.
A total of 722 participants were included. Mean age was 59.3 ± 16 years, and 55.3% were women with a median body mass index of 27.8 kg/m . Most (75.2%) participants were overweight or obese. MAFLD was present in 341 participants giving an unadjusted prevalence of 47.2% compared with a NAFLD prevalence of 38.7%. Fifty-nine (17.5%) participants met the criteria of MAFLD but not NAFLD. The increased prevalence of MAFLD in this cohort was primarily driven by dual etiology of fatty liver. All participants classified as NAFLD met the new definition of MAFLD. Compared with NAFLD subjects, participants with MAFLD had higher ALT (26.0 [14.0] U/L vs 30.0 [23] U/L, P = 0.024), but there were no differences in non-invasive markers for steatosis or fibrosis.
Metabolic-associated fatty liver disease is a highly prevalent condition within this large community cohort. Application of the MAFLD definition increased prevalence of fatty liver disease by including people with dual etiologies of liver disease.
最近将非酒精性脂肪性肝病（NAFLD）重新定义为代谢相关脂肪性肝病（MAFLD）的临床和公共卫生意义尚不清楚。我们旨在明确在一个明确界定的队列中 MAFLD 的患病率并与 NAFLD 进行比较。
在维多利亚州的一个地区进行了一项横断面研究，参与者来自随机抽取的家庭。获取了人口统计学和与健康相关的临床和实验室数据。脂肪肝定义为脂肪性肝指数≥60，MAFLD 根据最近的国际专家共识进行定义。
共纳入 722 名参与者。平均年龄为 59.3±16 岁，55.3%为女性，中位数体重指数为 27.8kg/m 。大多数（75.2%）参与者超重或肥胖。341 名参与者存在 MAFLD，未调整的患病率为 47.2%，而 NAFLD 的患病率为 38.7%。59 名（17.5%）参与者符合 MAFLD 但不符合 NAFLD 的标准。在该队列中 MAFLD 患病率的增加主要是由脂肪肝的双重病因驱动的。所有被归类为 NAFLD 的参与者均符合 MAFLD 的新定义。与 NAFLD 患者相比，MAFLD 患者的 ALT 更高（26.0[14.0]U/L 比 30.0[23]U/L，P=0.024），但非侵入性脂肪变性和纤维化标志物无差异。
代谢相关脂肪性肝病在这个大型社区队列中是一种高发疾病。应用 MAFLD 定义将包括具有双重肝病病因的人群在内，从而增加了脂肪肝疾病的患病率。
