Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.
Abdom Radiol (NY). 2024 Sep;49(9):3036-3044. doi: 10.1007/s00261-024-04285-w. Epub 2024 Apr 8.
PURPOSE: International expert panels proposed new nomenclatures, metabolic dysfunction-associated fatty liver disease (MAFLD) in 2020 and metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023, along with revised diagnostic criteria to replace non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the differences in NAFLD, MAFLD, and MASLD prevalence with changing nomenclature in a health check-up using magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) to assess hepatic steatosis. We also examined the prevalence of the sub-classifications of steatotic liver disease (SLD) and the differences in characteristics among the sub-categories. METHODS: We included 844 participants who underwent liver MRI-PDFF at our health check-up clinic between January 2020 and November 2022. Hepatic steatosis was defined as MRI-PDFF ≥ 5%. Participants were categorized according to NAFLD, MAFLD, MASLD, and sub-classifications of SLD. RESULTS: The prevalence rates of NAFLD, MAFLD, and MASLD were 25.9%, 29.5%, and 25.2%, respectively. 30.5% of the participants was categorized as SLD. The prevalence rates of the SLD sub-categories were 25.2% for MASLD, 3.7% for MASLD and alcohol-associated liver disease (MetALD), 0.1% for alcohol-associated liver disease, 1.3% for specific etiology SLD, and 0.1% for cryptogenic SLD. Compared with patients in the MASLD group, those in the MetALD group were younger, predominantly male, and exhibited higher levels of serum aspartate aminotransferase, gamma-glutamyl transpeptidase, and triglycerides. CONCLUSION: The prevalences of NAFLD and MASLD assessed using MRI-PDFF were similar, with MASLD accounting for 97.3% of the patients with NAFLD. The separate MetALD sub-category may have clinical characteristics that differ from those of MASLD.
目的:国际专家小组分别于 2020 年和 2023 年提出了新的命名法,即代谢相关脂肪性肝病(MAFLD)和代谢相关脂肪性肝疾病(MASLD),并修订了诊断标准以取代非酒精性脂肪性肝病(NAFLD)。我们旨在通过磁共振成像衍生的质子密度脂肪分数(MRI-PDFF)评估肝脂肪变性,用其来进行健康检查,以此来研究使用不同命名法时,NAFLD、MAFLD 和 MASLD 的患病率差异。我们还检查了脂肪性肝病(SLD)亚类别的患病率以及各亚类别的特征差异。
方法:我们纳入了 2020 年 1 月至 2022 年 11 月期间在我们的健康检查诊所接受肝脏 MRI-PDFF 的 844 名参与者。肝脂肪变性定义为 MRI-PDFF≥5%。参与者根据 NAFLD、MAFLD、MASLD 和 SLD 的亚类进行分类。
结果:NAFLD、MAFLD 和 MASLD 的患病率分别为 25.9%、29.5%和 25.2%。30.5%的参与者被归类为 SLD。SLD 亚类的患病率分别为 MASLD 为 25.2%、MASLD 和酒精相关肝病(MetALD)为 3.7%、酒精相关肝病为 0.1%、特定病因 SLD 为 1.3%和隐匿性 SLD 为 0.1%。与 MASLD 组患者相比,MetALD 组患者更年轻,主要为男性,且血清天冬氨酸转氨酶、γ-谷氨酰转肽酶和甘油三酯水平较高。
结论:使用 MRI-PDFF 评估的 NAFLD 和 MASLD 的患病率相似,MASLD 占 NAFLD 患者的 97.3%。单独的 MetALD 亚类可能具有与 MASLD 不同的临床特征。
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