Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Two Democracy Plaza, Room 6009, 6707 Democracy Blvd., Bethesda, MD, 20892-5458, USA.
Social & Scientific Systems, Inc., a DLH Holdings Corp Company, 8757 Georgia Avenue, 12th Floor, Silver Spring, MD, 20910, USA.
Dig Dis Sci. 2023 Apr;68(4):1237-1252. doi: 10.1007/s10620-022-07707-1. Epub 2022 Sep 29.
Fatty liver disease is a growing public health burden. We estimated prepandemic fatty liver disease prevalence determined by transient elastography-assessed hepatic steatosis and fibrosis, and examined associations with lifestyle and other factors in a United States population sample.
Liver stiffness and controlled attenuation parameter (CAP) were assessed on 7923 non-Hispanic white, non-Hispanic black, non-Hispanic Asian, and Hispanic men and women aged 20 years and over in the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 prepandemic data.
The prevalence of fatty liver disease (CAP > 300 dB/m) was 28.8% and of fibrosis (liver stiffness > 8 kPa) was 10.4%. Only 7.2% of participants with fatty liver disease and 10.9% with fibrosis reported being told by a health care provider that they had liver disease. In addition to known risk factors such as metabolic factors and ALT, persons with fatty liver disease were less likely to meet physical activity guidelines, more likely to be sedentary for ≥ 12 h a day, and reported a less healthy diet. Persons with fibrosis were less likely to have a college degree and reported a less healthy diet.
In the U.S. population, most persons with fatty liver disease are unaware of their condition. Physical activity and dietary modifications might reduce the fatty liver disease burden. There is an urgent need for fatty liver disease management in high-risk individuals using transient elastography or other noninvasive methods to intervene in disease progression.
脂肪肝疾病是一个日益严重的公共健康负担。我们评估了通过瞬时弹性成像评估的肝脂肪变性和纤维化的大流行前脂肪肝疾病的患病率，并在美国人群样本中检查了与生活方式和其他因素的关联。
在 2017 年至 2020 年大流行前的 NHANES 数据中，对 7923 名年龄在 20 岁及以上的非西班牙裔白人、非西班牙裔黑人、非西班牙裔亚洲人和西班牙裔男性和女性进行了肝脏硬度和受控衰减参数（CAP）评估。
脂肪肝疾病（CAP>300dB/m）的患病率为 28.8%，纤维化（肝脏硬度>8kPa）的患病率为 10.4%。只有 7.2%的脂肪肝疾病患者和 10.9%的纤维化患者报告称他们的肝脏疾病曾被医疗保健提供者告知。除了代谢因素和丙氨酸氨基转移酶等已知的风险因素外，患有脂肪肝疾病的人更不可能符合体育活动指南，更有可能每天久坐超过 12 小时，并且报告的饮食更不健康。患有纤维化的人更不可能拥有大学学位，并且报告的饮食更不健康。
在美国人群中，大多数脂肪肝疾病患者都不知道自己的病情。体育活动和饮食的改变可能会减轻脂肪肝疾病的负担。迫切需要使用瞬时弹性成像或其他非侵入性方法对高危人群进行脂肪肝疾病管理，以干预疾病进展。
