Yu Cheng, Wang Minzhen, Zheng Shan, Xia Miao, Yang Hongyan, Zhang Desheng, Yin Chun, Cheng Ning, Bai Yana
Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
Workers' Hospital of Jinchuan Group Co, Ltd, Jinchang, Gansu, China.
J Clin Transl Hepatol. 2022 Feb 28;10(1):6-16. doi: 10.14218/JCTH.2021.00089. Epub 2021 Jul 1.
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new concept, proposed in 2020; however, its applicability in Asia populations has yet to be evaluated. Therefore, we aimed to compare the difference in epidemiological and clinical characteristics between MAFLD and non-alcoholic fatty liver disease (NAFLD) among Asian populations.
Based on the Jinchang cohort, 30,633 participants were collected. The prevalence and incidence of MAFLD and NAFLD were used to analyze the epidemic characteristics and its overlapping effects. In addition, the corresponding clinical characteristics of the two diagnostic criteria populations were compared.
The prevalence rates of MAFLD and NAFLD were 21.03% and 18.83%, respectively. After an average 2.28-year follow-up, the incidence densities of MAFLD and NAFLD were 41.58 per 1,000 person-years and 37.69 per 1,000 person-years, respectively. With the increase of baseline age, body mass index (BMI), and waist circumference (WC) levels, the prevalence and incidence of MAFLD and NAFLD were on the rise (all <0.05). Among the total patients diagnosed at baseline or follow-up, most patients had both MAFLD and NAFLD, accounting for 78.84% and 82.88%, respectively. Compared with NAFLD, MAFLD patients had greater proportions of males and metabolic diseases (diabetes, dyslipidemia), and had higher BMI, WC, liver enzymes, blood glucose, and lipid levels in the baseline diagnosis patients (<0.05). Additionally, lean MAFLD patients had higher metabolic disorders than lean NAFLD patients (<0.05).
Compared with NAFLD, the newly proposed definition of MAFLD is more practical and accurate, and it can help identify more fatty liver patients with high-risk diseases.
代谢功能障碍相关脂肪性肝病（MAFLD）是2020年提出的一个新概念；然而，其在亚洲人群中的适用性尚未得到评估。因此，我们旨在比较亚洲人群中MAFLD和非酒精性脂肪性肝病（NAFLD）在流行病学和临床特征方面的差异。
基于金昌队列，收集了30633名参与者。采用MAFLD和NAFLD的患病率和发病率来分析流行特征及其重叠效应。此外，还比较了两种诊断标准人群的相应临床特征。
MAFLD和NAFLD的患病率分别为21.03%和18.83%。经过平均2.28年的随访，MAFLD和NAFLD的发病密度分别为每1000人年41.58例和每1000人年37.69例。随着基线年龄、体重指数（BMI）和腰围（WC）水平的增加，MAFLD和NAFLD的患病率和发病率均呈上升趋势（均P<0.05）。在基线或随访时诊断出的所有患者中，大多数患者同时患有MAFLD和NAFLD，分别占78.84%和82.88%。与NAFLD相比，MAFLD患者中男性和代谢性疾病（糖尿病、血脂异常）的比例更高，并且在基线诊断患者中BMI、WC、肝酶、血糖和血脂水平更高（P<0.05）。此外，瘦型MAFLD患者比瘦型NAFLD患者有更高的代谢紊乱（P<0.05）。
与NAFLD相比，新提出的MAFLD定义更实用、准确，有助于识别更多患有高危疾病的脂肪肝患者。
