Kim Donghee, Danpanichkul Pojsakorn, Wijarnpreecha Karn, Cholankeril George, Loomba Rohit, Ahmed Aijaz
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Clin Mol Hepatol. 2025 Apr;31(2):382-393. doi: 10.3350/cmh.2024.0987. Epub 2024 Nov 29.
BACKGROUND/AIMS: Multi-society experts proposed the adoption of new terminology, metabolic dysfunctionassociated steatotic liver disease (MASLD) and steatotic liver disease (SLD). We studied the current prevalence of SLD and its subcategories in the US.
Using the recent National Health and Nutrition Examination Survey from 2017 to 2023, we analyzed data from 12,199 participants (≥18 years) who completed transient elastography. SLD and its subcategories, including MASLD, metabolic and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD), were categorized according to consensus nomenclature.
The age-adjusted prevalence of SLD (cut-off: 285 dB/m) was 35.0% (95% confidence interval [CI] 33.4-36.7). Within this category, the age-adjusted prevalence for MASLD was 31.9% (95% CI 30.4-33.4), MetALD 2.2% (95% CI 1.8-2.6), and ALD 0.8% (95% CI 0.6-1.1). The prevalence of SLD and MASLD showed a statistically insignificant decrease during COVID-19, while ALD increased without significance. In contrast, the prevalence of advanced fibrosis in SLD was significantly higher during the COVID-19 era, at 9.8% for 285 dB/m and 7.8% for 263 dB/m, compared to 7.4% (P=0.039) and 6% (P=0.041) in the pre-COVID-19 era. The proportion of advanced fibrosis and cirrhosis in individuals with ALD was two-fold higher than MASLD and MetALD, largely due to increases during the COVID-19 era.
While the prevalence of SLD and its subcategories remained stable, there was a significant increase in advanced fibrosis among SLD individuals during the COVID-19 era, with ALD having a proportion of advanced fibrosis and cirrhosis that was twice as high as MASLD and MetALD.
背景/目的：多学会专家提议采用新术语，即代谢功能障碍相关脂肪性肝病（MASLD）和脂肪性肝病（SLD）。我们研究了美国目前SLD及其亚类的患病率。
利用2017年至2023年最近的全国健康和营养检查调查，我们分析了12199名完成瞬时弹性成像的参与者（≥18岁）的数据。SLD及其亚类，包括MASLD、代谢和酒精相关肝病（MetALD）以及酒精相关肝病（ALD），根据共识命名法进行分类。
年龄调整后的SLD患病率（临界值：285 dB/m）为35.0%（95%置信区间[CI] 33.4 - 36.7）。在这一类别中，年龄调整后的MASLD患病率为31.9%（95% CI 30.4 - 33.4），MetALD为2.2%（95% CI 1.8 - 2.6），ALD为0.8%（95% CI 0.6 - 1.1）。在新冠疫情期间，SLD和MASLD的患病率呈现出无统计学意义的下降，而ALD的患病率则无显著增加。相比之下，在新冠疫情期间，SLD中晚期纤维化的患病率显著更高，285 dB/m时为9.8%，263 dB/m时为7.8%，而在新冠疫情前的患病率分别为7.4%（P = 0.039）和6%（P = 0.041）。ALD患者中晚期纤维化和肝硬化的比例比MASLD和MetALD高两倍，这主要是由于新冠疫情期间的增加。
虽然SLD及其亚类的患病率保持稳定，但在新冠疫情期间，SLD患者中晚期纤维化显著增加，ALD的晚期纤维化和肝硬化比例是MASLD和MetALD的两倍。
