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中国城市人群中代谢相关脂肪性肝病及其相关肝纤维化的比例和临床特征

Proportion and clinical characteristics of metabolic-associated fatty liver disease and associated liver fibrosis in an urban Chinese population.

作者信息

Hou Mengmeng, Gu Qi, Cui Jiawei, Dou Yao, Huang Xiuhong, Li Jie, Qiao Liang, Nan Yuemin

机构信息

Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China.

Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu 210008, China.

出版信息

Chin Med J (Engl). 2025 Apr 5;138(7):829-837. doi: 10.1097/CM9.0000000000003141. Epub 2024 Aug 26.

Abstract

BACKGROUND

Metabolic-associated fatty liver disease (MAFLD) is the predominant form of chronic liver disease worldwide. This study was designed to investigate the proportion and characteristics of MAFLD within the general Chinese population and to identify the contributory risk factors for liver fibrosis among MAFLD individuals.

METHODS

The participants were recruited from a cohort undergoing routine health evaluations at the Third Hospital of Hebei Medical University between May 2019 and March 2023. The diagnosis of MAFLD was based on the established clinical practice guidelines. The fibrosis-4 index score (FIB-4) was employed to evaluate hepatic fibrosis, with a FIB-4 score of ≥1.3 indicating significant fibrosis. Binary logistic regression analyses were used to determine risk factors associated with significant hepatic fibrosis in MAFLD.

RESULTS

A total of 22,970 participants who underwent comprehensive medical examinations were included in the analysis. The overall proportion of MAFLD was 28.77% (6608/22,970), with 16.87% (1115/6608) of these patients showing significant fibrosis as assessed using FIB-4. Independent risk factors for significant liver fibrosis in MAFLD patients were male (odds ratio [OR] = 0.676, 95% confidence interval [CI]: 0.558-0.821), hepatitis B surface antigen (HBsAg) positivity (OR = 2.611, 95% CI: 1.557-4.379), body mass index ≥23.00 kg/m 2 (OR = 0.632, 95% CI: 0.470-0.851), blood pressure ≥130/85 mmHg (OR = 1.885, 95% CI: 1.564-2.272), and plasma glucose ≥5.6 mmol/L (OR = 1.815, 95% CI: 1.507-2.186) (all P <0.001).

CONCLUSIONS

The proportion of MAFLD in an urban Chinese population is 28.77%. About 16.87% of MAFLD patients presented with significant liver fibrosis. Independent risk factors for significant liver fibrosis in MAFLD patients should be noticed.

摘要

背景

代谢相关脂肪性肝病(MAFLD)是全球慢性肝病的主要形式。本研究旨在调查中国普通人群中MAFLD的比例和特征,并确定MAFLD患者肝纤维化的促成危险因素。

方法

参与者来自2019年5月至2023年3月在河北医科大学第三医院接受常规健康评估的队列。MAFLD的诊断基于既定的临床实践指南。采用纤维化-4指数评分(FIB-4)评估肝纤维化,FIB-4评分≥1.3表明存在显著纤维化。采用二元逻辑回归分析确定MAFLD中与显著肝纤维化相关的危险因素。

结果

共有22970名接受全面体检的参与者纳入分析。MAFLD的总体比例为28.77%(6608/22970),其中16.87%(1115/6608)的患者经FIB-4评估显示存在显著纤维化。MAFLD患者显著肝纤维化的独立危险因素为男性(优势比[OR]=0.676,95%置信区间[CI]:0.558-0.821)、乙肝表面抗原(HBsAg)阳性(OR=2.611,95%CI:1.557-4.379)、体重指数≥23.00kg/m²(OR=0.632,95%CI:0.470-0.851)、血压≥130/85mmHg(OR=1.885,95%CI:1.564-2.272)和血糖≥5.6mmol/L(OR=1.815,95%CI:1.507-2.186)(均P<0.001)。

结论

中国城市人群中MAFLD的比例为28.77%。约16.87%的MAFLD患者存在显著肝纤维化。应注意MAFLD患者显著肝纤维化的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e70/11970824/9cfdf736e9aa/cm9-138-829-g001.jpg

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