Nagaoki Yuko, Sugiyama Aya, Mino Megumi, Kodama Hiroomi, Abe Kanon, Imada Hirohito, Ouoba Serge, E Bunthen, Ko Ko, Akita Tomoyuki, Sako Toru, Kumada Takashi, Chayama Kazuaki, Tanaka Junko
Department of Gastroenterology, Mazda Hospital, Mazda Motor Corporation, Hiroshima, Japan.
Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Hepatol Res. 2022 Nov;52(11):908-918. doi: 10.1111/hepr.13821. Epub 2022 Aug 20.
Fatty liver is the most common liver disease. This study examined fatty liver and advanced fibrosis prevalence in a random sample of the Japanese general population.
A total of 6000 people randomly selected from two cities in Hiroshima Prefecture were invited to participate in this cross-sectional study originally carried out for hepatitis virus screening. Ultrasonography and FibroScan (controlled attenuation parameter [CAP] and liver stiffness measurement [LSM]) were provided as additional tests.
Of 6000 invited individuals, 1043 participated in hepatitis virus screening, of which 488 randomly selected individuals (median age, 56 years; interquartile range, 45-68 years; male participants, 49.8%) underwent ultrasonography, CAP, and LSM. Ultrasonography showed fatty liver in 24.6% and mild fatty liver in 32.8%. Controlled attenuation parameter showed severe steatosis in 27.5%, moderate steatosis in 12.5%, and mild steatosis in 11.1%. Overall, 62.1% were diagnosed with fatty liver based on ultrasonography or CAP. Nonalcoholic fatty liver disease (NAFLD) prevalence was 50.6%. Liver stiffness measurement found cirrhosis in 1.0% and severe fibrosis in 1.8%. Multivariate analysis of risk factors associated with ≥F2 or higher liver fibrosis showed that age ≥60 years and above (adjusted odds ratio [AOR], 3.2; 95% confidence interval [CI], 1.5-6.9; p = 0.0031), hepatitis C virus antibody positivity (AOR, 8.4; 95% CI, 1.0-68.4; p = 0.0467), and fatty liver (AOR, 2.3; 95% CI, 1.1-6.2; p = 0.0317) are independent risk factors.
In the general population, 62.1% had fatty liver, and NAFLD prevalence was twice as high as previously reported. Screening that is noninvasive, low-cost, and does not require special techniques or equipment is needed to detect advanced liver fibrosis.
脂肪肝是最常见的肝脏疾病。本研究调查了日本普通人群随机样本中的脂肪肝和晚期纤维化患病率。
从广岛县两个城市随机选取的6000人受邀参加这项最初为肝炎病毒筛查开展的横断面研究。提供超声检查和FibroScan（受控衰减参数[CAP]和肝脏硬度测量[LSM]）作为附加检查。
在6000名受邀者中，1043人参加了肝炎病毒筛查，其中488名随机选取的个体（年龄中位数为56岁；四分位间距为45 - 68岁；男性参与者占49.8%）接受了超声检查、CAP和LSM。超声检查显示24.6%有脂肪肝，32.8%有轻度脂肪肝。受控衰减参数显示27.5%为重度脂肪变性，12.5%为中度脂肪变性，11.1%为轻度脂肪变性。总体而言，基于超声检查或CAP诊断为脂肪肝的占62.1%。非酒精性脂肪性肝病（NAFLD）患病率为50.6%。肝脏硬度测量发现1.0%为肝硬化，1.8%为重度纤维化。对与≥F2或更高肝脏纤维化相关的危险因素进行多变量分析显示，年龄≥60岁及以上（调整优势比[AOR]为3.2；95%置信区间[CI]为1.5 - 6.9；p = 0.0031）、丙型肝炎病毒抗体阳性（AOR为8.4；95% CI为1.0 - 68.4；p = 0.0467）以及脂肪肝（AOR为2.3；95% CI为1.1 - 6.2；p = 0.0317）是独立危险因素。
在普通人群中，62.1%有脂肪肝，NAFLD患病率是先前报道的两倍。需要采用无创、低成本且不需要特殊技术或设备的筛查来检测晚期肝纤维化。
