Division of Endocrinology, Diabetes and Metabolism, University of Florida College of Medicine, Gainesville, Florida, USA.
Advanced Magnetic Resonance Imaging and Spectroscopy Facility, McKnight Brain Institute, University of Florida, Gainesville, Florida, USA.
Obesity (Silver Spring). 2024 Oct;32(10):1967-1974. doi: 10.1002/oby.24130.
The objective of this study was to determine the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in young compared with older adults.
Individuals (n = 1420) with (63%) and without type 2 diabetes mellitus (T2D; 37%) who attended internal medicine clinics and did not have a known history of MASLD underwent laboratory evaluation and transient elastography to assess for hepatic steatosis and fibrosis. Magnetic resonance elastography and liver biopsy were recommended when indicated.
A total of 243 participants were ages <45 years, and 1177 were ages ≥45 years. Obesity, T2D, and metabolic syndrome were highly prevalent in young adults. Frequencies of steatosis and fibrosis were high in young adults (50.2% and 7.5% vs. older adults 52.7% and 9.9%, respectively) and were significantly higher in those with both obesity and T2D (71.1% and 15.7%, respectively; p < 0.01). In young adults, T2D and obesity were the strongest risk factors for hepatic fibrosis (odds ratios 4.33 [95% CI: 1.37-13.68] and 1.16 [95% CI: 1.07-1.25], respectively; p < 0.05).
There is a high prevalence of clinically significant hepatic fibrosis in young adults with cardiometabolic risk factors. Up to one in seven young adults with obesity and T2D had clinically significant hepatic fibrosis on elastography. This highlights the need to screen young adults with cardiometabolic risk factors for MASLD for early detection and intervention.
本研究旨在确定与老年人相比，年轻人代谢功能障碍相关脂肪性肝病（MASLD）的患病率。
参加内科诊所就诊且无 MASLD 已知病史的个体（n=1420）进行实验室评估和瞬时弹性成像，以评估肝脂肪变性和纤维化。建议在有指征时进行磁共振弹性成像和肝活检。
共有 243 名参与者年龄<45 岁，1177 名参与者年龄≥45 岁。肥胖、2 型糖尿病（T2D）和代谢综合征在年轻人中非常普遍。年轻人的脂肪变性和纤维化频率较高（分别为 50.2%和 7.5%，而老年人分别为 52.7%和 9.9%），并且在肥胖和 T2D 并存的患者中明显更高（分别为 71.1%和 15.7%；p<0.01）。在年轻人中，T2D 和肥胖是肝纤维化的最强危险因素（比值比 4.33[95%CI：1.37-13.68]和 1.16[95%CI：1.07-1.25]；p<0.05）。
有代谢风险因素的年轻人中存在较高比例的临床显著肝纤维化。多达七分之一的肥胖和 T2D 年轻人在弹性成像上存在临床显著的肝纤维化。这突出表明需要对有代谢风险因素的年轻人进行 MASLD 筛查，以进行早期发现和干预。
