Ekpor Emmanuel, Akyirem Samuel, Adade Duodu Precious
School of Nursing and Midwifery, University of Ghana, Accra, Ghana.
Christian Health Association of Ghana, Accra, Ghana.
PLOS Glob Public Health. 2024 May 6;4(5):e0002835. doi: 10.1371/journal.pgph.0002835. eCollection 2024.
Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes (T2D) are interconnected metabolic disorders with significant health implications. However, a comprehensive understanding of the extent of their co-occurrence in Africa is lacking. The aim of this review was to determine the prevalence of MAFLD and its association with glycemic control (HbA1c) in persons with T2D in Africa. A systematic search was conducted on PubMed, Medline, Embase, Scopus, Global Health, and Web of Science from their inception to December 6, 2023. Data on MAFLD prevalence and correlation coefficients regarding its association with glycemic control were pooled through random effect meta-analyses. Potential sources of heterogeneity were investigated using subgroup analysis and meta-regression. A total of 10 studies were included in the meta-analysis of MAFLD prevalence, while 2 were incorporated in the analysis of the association between MAFLD and glycemic control. The pooled prevalence of MAFLD in persons with T2D was 48.1% (95% CI: 36.1-60.3). The subgroup analysis revealed regional variations in MAFLD prevalence, with rates of 44.7% (95% CI: 28.7-62.0) in sub-Saharan Africa and 55.3% (95% CI: 36.2-73.0) in Northern Africa. Additionally, we observed an increasing trend in MAFLD prevalence, recording 55.1% (95% CI: 43.6-66.1) in the recent five years. There was a weak positive correlation between MAFLD and HbA1c (r = 0.33, 95% CI: 0.18-0.47). The findings of this study highlight a high prevalence of MAFLD in persons with T2D in Africa, with a suggested link between MAFLD and suboptimal glycemic control. Therefore, healthcare providers should prioritize the screening and management of MAFLD in individuals with T2D to enhance their metabolic health.
代谢功能障碍相关脂肪性肝病（MAFLD）和2型糖尿病（T2D）是相互关联的代谢紊乱疾病，对健康有重大影响。然而，目前尚缺乏对它们在非洲同时发生情况的全面了解。本综述的目的是确定非洲T2D患者中MAFLD的患病率及其与血糖控制（糖化血红蛋白）的关联。对PubMed、Medline、Embase、Scopus、Global Health和Web of Science从创建到2023年12月6日进行了系统检索。通过随机效应荟萃分析汇总了关于MAFLD患病率及其与血糖控制关联的相关系数数据。使用亚组分析和元回归研究了潜在的异质性来源。共有10项研究纳入了MAFLD患病率的荟萃分析，2项研究纳入了MAFLD与血糖控制关联的分析。T2D患者中MAFLD的合并患病率为48.1%（95%置信区间：36.1 - 60.3）。亚组分析显示MAFLD患病率存在区域差异，撒哈拉以南非洲为44.7%（95%置信区间：28.7 - 62.0），北非为55.3%（95%置信区间：36.2 - 73.0）。此外，我们观察到MAFLD患病率呈上升趋势，最近五年记录为55.1%（95%置信区间：43.6 - 66.1）。MAFLD与糖化血红蛋白之间存在弱正相关（r = 0.33，95%置信区间：0.18 - 0.47）。本研究结果凸显了非洲T2D患者中MAFLD的高患病率，提示MAFLD与血糖控制不佳之间存在联系。因此，医疗保健提供者应优先对T2D个体进行MAFLD的筛查和管理，以改善他们的代谢健康。
