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中国当代城市健康成年人中 NAFLD 和 MAFLD 诊断标准的比较:一项横断面研究。

A comparison of NAFLD and MAFLD diagnostic criteria in contemporary urban healthy adults in China: a cross-sectional study.

机构信息

Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China.

Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China.

出版信息

BMC Gastroenterol. 2022 Nov 19;22(1):471. doi: 10.1186/s12876-022-02576-4.

Abstract

BACKGROUND

A recently proposed diagnostic criteria of metabolic dysfunction-associated fatty liver disease (MAFLD) is more available for various clinical situations than nonalcoholic fatty liver disease (NAFLD), but understanding about differences between NAFLD and MAFLD in clinical practice remains limited in the general adult urban population in China.

METHODS

A total of 795 subjects were recruited from Wu Song Branch of Zhongshan Hospital who participated in the general health assessment. Examination results was obtained through analysis of blood samples and abdominal ultrasonography. Participants were divided into four subgroups according to whether they had NAFLD or MAFLD (NAFLD- MAFLD-, NAFLD + MAFLD-, NAFLD- MAFLD + and NAFLD + MAFLD+).

RESULTS

Among the urban healthy adults investigated, 345 people (43.4%) were diagnosed with NAFLD and 356 people (44.8%) with MAFLD. No significant differences in the prevalence, age, fasting blood glucose, glycosylated hemoglobin, liver enzyme examination, percentage of overweight, hypertension or dyslipidaemia were found between NAFLD and MAFLD patients. Patients with MAFLD had worse metabolic disorders than NAFLD + MAFLD- patients. The NAFLD fibrosis score (NFS) of the NAFLD- MAFLD + group was higher than that of the NAFLD + MAFLD- group. Higher proportion of patients in the NAFLD- MAFLD + group have NFS ≥-1.455.

CONCLUSION

MAFLD criteria have similar prevalence and patient characteristics compared with previous NAFLD but help to identify a group of patients with high risks of metabolic disorders and liver fibrosis who have been missed with NAFLD, and has superior utility.

摘要

背景

与非酒精性脂肪性肝病(NAFLD)相比,代谢相关脂肪性肝病(MAFLD)的新诊断标准在各种临床情况下更具优势,但在中国一般城市成年人群中,对 MAFLD 与 NAFLD 之间差异的了解仍有限。

方法

共招募 795 名来自中山医院吴淞分院参加一般健康评估的受试者。通过分析血样和腹部超声检查获得检查结果。根据是否患有 NAFLD 或 MAFLD(NAFLD-MAFLD-、NAFLD+MAFLD-、NAFLD+MAFLD+和 NAFLD+MAFLD+)将参与者分为四个亚组。

结果

在所调查的城市健康成年人中,345 人(43.4%)被诊断为 NAFLD,356 人(44.8%)被诊断为 MAFLD。NAFLD 和 MAFLD 患者的患病率、年龄、空腹血糖、糖化血红蛋白、肝酶检查、超重百分比、高血压或血脂异常无显著差异。与 NAFLD+MAFLD-患者相比,MAFLD 患者的代谢紊乱更严重。NAFLD- MAFLD+组的 NAFLD 纤维化评分(NFS)高于 NAFLD+MAFLD-组。NAFLD- MAFLD+组中 NFS≥-1.455 的患者比例更高。

结论

与以前的 NAFLD 相比,MAFLD 标准具有相似的患病率和患者特征,但有助于识别一组已被 NAFLD 漏诊的代谢紊乱和肝纤维化风险较高的患者,且具有更好的应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/812c/9675196/f6a31238bad5/12876_2022_2576_Fig1_HTML.jpg

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