Hanh Doan Le Minh, Vu Le Thuong, Hanh Tran Le Doan, Du Tran Thanh, Thao Doan Le Minh, Huy Au Nhat, Huong Le Thi Thu, Cong Vo Hong Minh, Hai Nguyen Hoang, Tuong Tran Thi Khanh
Internal Medicine Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
Pulmonary Department, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Chronic Obstr Pulm Dis. 2025 Jul 30;12(4):294-303. doi: 10.15326/jcopdf.2024.0591.
Metabolic dysfunction-associated fatty liver disease (MAFLD) affects approximately 38.7% of individuals globally and potentially leads to cirrhosis and hepatocellular carcinoma. This study aims to investigate the prevalence, characteristics, and impact of MAFLD on the frequency of exacerbations in chronic obstructive pulmonary disease (COPD) patients in Vietnam.
This cross-sectional descriptive study involved stable COPD patients, and using FibroScan to detect fatty liver while applying the 2020 Asian Pacific Association for the Study of the Liver criteria for a MAFLD diagnosis.
Of the 168 COPD patients, 48.8% were diagnosed with MAFLD. Patients with MAFLD had significantly worse lung function, with a lower forced expiratory volume in 1 second (57.2% versus 67.0%, =0.002) and forced vital capacity (80.8% versus 88.1%, =0.009), compared to those without MAFLD. The frequency of exacerbations was higher in the MAFLD group, with 46.3% experiencing ≥2 exacerbations in the previous year, compared to 30.2% in the non-MAFLD group (=0.032). Elevated controlled attenuation parameter (CAP) scores (>289dB/m) were strongly associated with frequent exacerbations in the previous year (odds ratio [OR] 5.64, =0.001). MAFLD was also identified as an independent factor increasing the risk of exacerbation (OR 3.64, =0.014).
Nearly half of the COPD patients were diagnosed with MAFLD. MAFLD is associated with worse lung function and an increased frequency of exacerbations in the past year. Elevated CAP scores were found to be a significant risk factor for frequent exacerbations in the past year. MAFLD is an independent risk factor for exacerbations in COPD patients.
代谢功能障碍相关脂肪性肝病（MAFLD）影响着全球约38.7%的人口，并有可能导致肝硬化和肝细胞癌。本研究旨在调查越南慢性阻塞性肺疾病（COPD）患者中MAFLD的患病率、特征及其对急性加重频率的影响。
这项横断面描述性研究纳入了病情稳定的COPD患者，使用FibroScan检测脂肪肝，并采用2020年亚太肝脏研究协会标准诊断MAFLD。
在168例COPD患者中，48.8%被诊断为MAFLD。与无MAFLD的患者相比，MAFLD患者的肺功能明显更差，1秒用力呼气量更低（57.2%对67.0%，P=0.002），用力肺活量也更低（80.8%对88.1%，P=0.009）。MAFLD组的急性加重频率更高，在前一年有46.3%的患者发生≥2次急性加重，而非MAFLD组为30.2%（P=0.032）。控制衰减参数（CAP）评分升高（>289dB/m）与前一年频繁急性加重密切相关（优势比[OR]5.64，P=0.001）。MAFLD也被确定为增加急性加重风险的独立因素（OR 3.64，P=0.014）。
近一半的COPD患者被诊断为MAFLD。MAFLD与更差的肺功能以及过去一年中急性加重频率增加有关。发现CAP评分升高是过去一年频繁急性加重的重要危险因素。MAFLD是COPD患者急性加重的独立危险因素。
