Alhomaid Ahmad, Chauhan Sukhjinder, Katamreddy Yamini, Sidhu Avideep, Sunkara Praveena, Desai Rupak
Nazareth Hospital, 2601 Holme Ave, Philadelphia, PA, 19152, USA.
Baptist Floyd Hospital, New Albany, USA.
Obes Pillars. 2025 Feb 18;13:100168. doi: 10.1016/j.obpill.2025.100168. eCollection 2025 Mar.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. Although the epidemiology of MASLD and its association with metabolically healthy obesity (MHO) is well-studied in the United States, data for Asian Americans with MHO is limited. We sought to evaluate the association of MASLD in young Asian American patients with MHO.
This was a retrospective, matched cohort, database review of Asian American Individuals. After excluding adult hospitalizations with metabolic risk factors (hypertension, diabetes, or hyperlipidemia), we identified all National Inpatient Sample (2019) admissions with obesity (MHO) and MASLD using relevant ICD-10-CM codes. We matched (1:1) propensity scores for age, sex, household income, hospital location, and teaching status to obtain cohorts with and without obesity (MHO+) vs. (MHO-). Categorical and continuous data were compared using the Chi-square and Mann-Whitney U tests. The primary endpoint was the prevalence and adjusted multivariable odds/predictors of MASLD in (MHO+) vs. (MHO-) cohort.
In the adjusted multivariate regression for demographics, and comorbidities, the (MHO+) cohort was associated with higher odds of admissions with MASLD (OR 4.07, 95%CI 2.02-8.19, p < 0.001). In addition, among the (MHO+) cohort, higher rates of MASLD-related hospitalizations were observed in males (OR 8.40, p < 0.001), females (OR 2.69, p = 0.025), high-income quartiles (OR 10.51, p < 0.001), no prior bariatric surgery (OR 4.07, p < 0.001), non-tobacco users(OR 4.16, p < 0.001), and non-hypothyroid patients (OR 4.00, p < 0.001) compared to the (MHO-) cohort. There was no statistically significant difference in the groups with low-income quartiles, tobacco use disorder, and hypothyroidism.
This nationwide analysis demonstrates that (MHO+) is associated with a higher prevalence of MASLD. In the (MHO+) cohort, there was an association of MASLD with sex, high-income quartile, no prior bariatric surgery, non-tobacco use, and non-hypothyroidism. Further prospective multicenter studies are needed to evaluate the association of MASLD in (MHO+) patients with comorbid conditions.
代谢功能障碍相关脂肪性肝病（MASLD）是全球慢性肝病的主要病因。尽管在美国对MASLD的流行病学及其与代谢健康型肥胖（MHO）的关联已有充分研究，但关于患有MHO的亚裔美国人的数据有限。我们试图评估年轻的患有MHO的亚裔美国患者中MASLD的关联情况。
这是一项对亚裔美国人的回顾性、匹配队列数据库回顾研究。在排除患有代谢风险因素（高血压、糖尿病或高脂血症）的成人住院病例后，我们使用相关的国际疾病分类第十版临床修正版（ICD-10-CM）编码，在全国住院样本（2019年）中识别出所有患有肥胖（MHO）和MASLD的病例。我们对年龄、性别、家庭收入、医院位置和教学状态的倾向得分进行（1:1）匹配，以获得有肥胖（MHO+）和无肥胖（MHO-）的队列。使用卡方检验和曼-惠特尼U检验对分类数据和连续数据进行比较。主要终点是MHO+队列与MHO-队列中MASLD的患病率及调整后的多变量比值/预测因素。
在对人口统计学和合并症进行的调整多变量回归分析中，MHO+队列与因MASLD入院的较高比值相关（比值比4.07，95%置信区间2.02 - 8.19，p < 0.001）。此外，在MHO+队列中，与MHO-队列相比，男性（比值比8.40，p < 0.001）、女性（比值比2.69，p = 0.025）、高收入四分位数人群（比值比10.51，p < 0.001）、未接受过减肥手术者（比值比4.07，p < 0.001）、不吸烟者（比值比4.16，p < 0.001）以及非甲状腺功能减退患者（比值比4.00，p < 0.001）中，MASLD相关住院率更高。低收入四分位数人群、烟草使用障碍患者和甲状腺功能减退患者组之间无统计学显著差异。
这项全国性分析表明，MHO+与MASLD的较高患病率相关。在MHO+队列中，MASLD与性别、高收入四分位数、未接受过减肥手术、不吸烟以及非甲状腺功能减退有关。需要进一步开展前瞻性多中心研究，以评估患有合并症的MHO+患者中MASLD的关联情况。
