Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Gastroenterology, Guangzhou University of Traditional Chinese Medicine Affiliated Foshan Hospital of Traditional Chinese Medicine, Foshan, China.
J Gastroenterol Hepatol. 2024 Aug;39(8):1636-1647. doi: 10.1111/jgh.16554. Epub 2024 May 2.
The introduction of the latest nomenclature, metabolic associated steatotic liver disease (MASLD), proposed by the multi-society without Asian society consensus statement, aims to redefine the diagnostic criteria for metabolic associated fatty liver disease (MAFLD). However, its effect on the epidemiology in Asia remains unclear.
We conducted a population-based cross-sectional survey on fatty liver disease using multistage stratified random sampling of participants from Guangzhou, a representative area in China (ChiCTR2000033376). Demographic, socioeconomic, lifestyle, and laboratory data were collected. Hepatic steatosis and the severity of fibrosis were assessed using FibroScan.
A total of 7388 individuals were recruited, the proportion of which meeting the definitions for nonalcoholic fatty liver disease (NAFLD), MAFLD, and MASLD were 2359 (31.9%), 2666 (36.1%), and 2240 (30.3%), respectively. One hundred and twenty (1.6%) patients had cryptogenic SLD, and 537 (7.3%) patients were diagnosed with MetALD. MASLD did not significantly differ from NAFLD and MAFLD, except that MAFLD patients had a lower proportion of males, hypertension, and diabetes and were less likely to consume tea (P < 0.05). Both cryptogenic SLD and MASLD non-MAFLD patients exhibited milder hepatic steatosis and a lower frequency of liver injury than NAFLD, MAFLD, or MASLD patients (all P < 0.05). An increased HOMA-IR (adjusted OR: 1.33, 95% CI: 1.10-2.03) was associated with higher risk of moderate-to-severe steatosis for MASLD non-MAFLD patients, while consuming more cups of tea (P for trend = 0.015) showed inverse associations.
Irrespective of terminology used is that fatty liver disease is highly prevalent in the Han Chinese population. Differences in insulin resistance and lifestyle risk factors are associated with redefinition disparities.
多学会联合亚洲学会共识声明提出的最新命名法——代谢相关脂肪性肝病（MASLD），旨在重新定义代谢相关脂肪性肝病（MAFLD）的诊断标准。然而，其对亚洲流行病学的影响尚不清楚。
我们采用多阶段分层随机抽样的方法，从中国有代表性的地区广州选取参与者进行基于人群的脂肪肝疾病横断面调查（ChiCTR2000033376）。收集人口统计学、社会经济学、生活方式和实验室数据。使用 FibroScan 评估肝脂肪变性和纤维化的严重程度。
共纳入 7388 人，符合非酒精性脂肪性肝病（NAFLD）、MAFLD 和 MASLD 定义的比例分别为 2359（31.9%）、2666（36.1%）和 2240（30.3%）。120 例（1.6%）患者为隐源性 SLD，537 例（7.3%）患者诊断为 MetALD。MASLD 与 NAFLD 和 MAFLD 无显著差异，除 MAFLD 患者中男性、高血压和糖尿病的比例较低，且饮茶的可能性较低（P<0.05）。隐源性 SLD 和 MASLD 非 MAFLD 患者的肝脂肪变性较轻，肝损伤频率低于 NAFLD、MAFLD 或 MASLD 患者（均 P<0.05）。较高的 HOMA-IR（调整后的 OR：1.33，95%CI：1.10-2.03）与 MASLD 非 MAFLD 患者发生中重度脂肪变性的风险增加相关，而饮茶量增加（趋势 P=0.015）呈负相关。
无论使用何种术语，脂肪肝疾病在汉族人群中均高度流行。胰岛素抵抗和生活方式危险因素的差异与重新定义的差异有关。
