Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, No 1, Xue Yuan Road, Fuzhou, 350108, Fujian, China.
Department of Ultrasonography, Fuqing Hospital, Fuqing, China.
Lipids Health Dis. 2023 Oct 28;22(1):185. doi: 10.1186/s12944-023-01947-4.
Variations in the prevalence and systemic inflammatory (SI) status between non-alcoholic fatty liver disease (NAFLD) and newly defined metabolic dysfunction-associated fatty liver disease (MAFLD) have only been reported by few studies. Hence, this study aimed to compile data on the prevalence and the systemic inflammation levels of MAFLD and NAFLD in a general population from Southeast China was summarized to explore the potential effect of the transformation of disease definition.
A total of 6718 general population participants aged 35-75 were enrolled. Logistic regression and restricted cubic spline (RCS) models were used to examine the relationship between 15 SI indicators and NAFLD and MAFLD. The predicted values of MAFLD and NAFLD were analyzed using the receiver operating characteristic (ROC) curve.
The prevalence of MAFLD and NAFLD was 34.7% and 32.4%, respectively. Their overlapping rate was 89.7%, while only 8.3% and 1.9% of participants were MAFLD-only and NAFLD-only. Among three FLD groups, the MAFLD-only group had the highest levels of 8 SI indicators, including CRP, WBC, LYMPH, NEUT, MONO, ALB, NLR, and SIRI. The non-FLD group had the lower levels of all 15 SI indicators compared with all FLD subgroups. The odds ratios (ORs) of 10 SI indicators were significant in both multivariable-adjusted logistic regression and RCS analyses of MAFLD or NAFLD, including CRP, WBC, LYMPH, NEUT, MONO, ALB, PLR, LMR, ALI and CA. ROC analysis showed that the AUC values of all SI were lower than 0.7 in both MAFLD and NAFLD.
MAFLD could cover more FLD than NAFLD, and the MAFLD-only group had a more severe inflammation status, whereas the NAFLD-only exhibited lower levels. Moreover, there was not a high AUC and a high sensitivity of SI indicators, suggesting that SI indicators are not good indicators to diagnose NAFLD/MAFLD.
非酒精性脂肪性肝病（NAFLD）和新定义的代谢功能相关脂肪性肝病（MAFLD）之间的患病率和系统性炎症（SI）状态的差异仅被少数研究报道。因此，本研究旨在汇总中国东南部一般人群中 MAFLD 和 NAFLD 的患病率和系统炎症水平数据，以探讨疾病定义转变的潜在影响。
共纳入 6718 名年龄在 35-75 岁的一般人群。使用逻辑回归和限制立方样条（RCS）模型来研究 15 个 SI 指标与 NAFLD 和 MAFLD 的关系。使用受试者工作特征（ROC）曲线分析 MAFLD 和 NAFLD 的预测值。
MAFLD 和 NAFLD 的患病率分别为 34.7%和 32.4%，重叠率为 89.7%，而只有 8.3%和 1.9%的参与者为 MAFLD 仅有和 NAFLD 仅有。在三个 FLD 组中，MAFLD 仅有组的 8 个 SI 指标水平最高，包括 CRP、WBC、LYMPH、NEUT、MONO、ALB、NLR 和 SIRI。非 FLD 组的所有 15 个 SI 指标水平均低于所有 FLD 亚组。多变量调整后的逻辑回归和 RCS 分析显示，MAFLD 或 NAFLD 中 10 个 SI 指标的比值比（OR）均有统计学意义，包括 CRP、WBC、LYMPH、NEUT、MONO、ALB、PLR、LMR、ALI 和 CA。ROC 分析显示，MAFLD 和 NAFLD 中所有 SI 的 AUC 值均低于 0.7。
MAFLD 比 NAFLD 能涵盖更多的 FLD，MAFLD 仅有组的炎症状态更严重，而 NAFLD 仅有组的水平较低。此外，SI 指标的 AUC 值不高，灵敏度也不高，提示 SI 指标不是诊断 NAFLD/MAFLD 的良好指标。
