Internal Medicine Service, Department of Medicine, Womack Army Medical Center, Fort Bragg, North Carolina.
Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, North Carolina, USA.
Metab Syndr Relat Disord. 2022 Apr;20(3):141-147. doi: 10.1089/met.2021.0111. Epub 2021 Dec 27.
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in the world. We evaluated vibration-controlled transient elastography (VCTE) data to determine the prevalence of two principle manifestations of NAFLD, hepatic steatosis and hepatic fibrosis. Data were sourced from the 2017 to 2018 National Health and Nutrition Examination Survey, which provides a representative cross-section of the noninstitutionalized U.S. population. Participants 18 years of age and older were examined using sera and VCTE. Sociodemographic and medical history information were gathered through self-report. Logistic regression models assessed relationships between steatosis, fibrosis, and variables of interest. Prevalence estimates are reported as weighted percentages with 95% Wald confidence intervals (CIs). A total of 4083 participants representing 187 million U.S. adults were included in our analysis. We estimate the prevalence of steatosis (controlled attenuation parameter ≥302 dB/m, ≥S1) at 27.3% (95% CI: 25.3-29.4) and significant fibrosis (liver stiffness ≥8.2 kPa, ≥F2) at 7.7% (95% CI: 6.1-9.6). Both were independently associated with age, gender, body mass index (BMI), and diabetes (all < 0.05). The greatest predictor of both steatosis and fibrosis was BMI. Steatosis was present in 3.6%, 18.7%, and 49.4% of those in the normal or underweight, overweight, or obese categories, respectively. Significant fibrosis was present in 2.1%, 3.2%, and 14.7% of those in the normal or underweight, overweight, or obese categories, respectively. Clinically significant steatosis and/or fibrosis are highly prevalent among the U.S. adult population. The greatest predictor of both steatosis and fibrosis is obesity.
非酒精性脂肪性肝病 (NAFLD) 是世界上最常见的肝脏疾病。我们评估了振动控制瞬态弹性成像 (VCTE) 数据，以确定 NAFLD 的两种主要表现，即肝脂肪变性和肝纤维化的患病率。数据来自 2017 年至 2018 年全国健康和营养调查，该调查提供了美国非机构化人口的代表性横断面。18 岁及以上的参与者接受了血清学和 VCTE 检查。通过自我报告收集了社会人口统计学和病史信息。逻辑回归模型评估了脂肪变性、纤维化与感兴趣变量之间的关系。患病率估计以加权百分比报告，并附有 95% Wald 置信区间 (CI)。共有 4083 名代表 1.87 亿美国成年人的参与者纳入我们的分析。我们估计脂肪变性的患病率（受控衰减参数≥302 dB/m，≥S1）为 27.3%（95%CI：25.3-29.4），显著纤维化（肝硬度≥8.2kPa，≥F2）的患病率为 7.7%（95%CI：6.1-9.6）。两者均与年龄、性别、体重指数 (BMI) 和糖尿病独立相关（均 < 0.05）。BMI 是两者的最大预测因素。在体重正常或体重不足、超重或肥胖的人群中，分别有 3.6%、18.7%和 49.4%存在脂肪变性。在体重正常或体重不足、超重或肥胖的人群中，分别有 2.1%、3.2%和 14.7%存在显著纤维化。在美国成年人群中，临床上显著的脂肪变性和/或纤维化的患病率很高。BMI 是脂肪变性和纤维化的最大预测因素。
