Discrepancies between Nonalcoholic and Metabolic-associated Fatty Liver Disease by Multiple Steatosis Assessment  

作　　者：Congxiang Shao Junzhao Ye Xin Li Yansong Lin Shiting Feng Bing Liao Wei Wang Xiaorong Gong Bihui Zhong 

机构地区：[1]Department of Gastroenterology of the First Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,China [2]Department of Gastroenterology,Affiliated Dongguan People’s Hospital,Southern Medical University(Dongguan People’s Hospital),Dongguan,Guangdong,China [3]Department of Radiology of the First Affiliated Hospital,Sun Yat-sen Univer-sity,Guangzhou,Guangdong,China [4]Department of Pathology of the First Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,China [5]Department of Medical Ultrasonics of the First Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,China [6]Department of Gastroenterology,First Affiliated Hospital,Guangzhou Medical University,Guangzhou,Guangdong,China

出　　处：《Journal of Clinical and Translational Hepatology》2022年第6期1013-1026,共14页临床与转化肝病杂志（英文版）

基　　金：National Natural Science Foundation of China(81870404,81670518,81170392);Guangdong Science and Technology Department(2014A020212118);Chinese Foundation for Hepatitis Prevention and Control(TQGB20140083);China postdoctoral science foundation(2020M683128).

摘　　要：Background and Aims:The redefinition of metabolic-as-sociated fatty liver disease(MAFLD)from nonalcoholic fat-ty liver disease(NAFLD)has caused a revolution in clinical practice,and the characteristics of patients with steatosis but not MAFLD remain unclear.The aims were to compare the diagnosis rate of MAFLD in NAFLD using different steato-sis methods and explore the features of non-MAFLD-NAFLD and MAFLD-non-NAFLD.Methods:A cross-sectional study enrolling consecutive individuals was conducted at three medical centers in southern China from January 2015 to September 2020.Steatosis was evaluated by liver biopsy or magnetic resonance imaging-based proton density fat frac-tion(MRI-PDFF),ultrasound,controlled attenuation param-eter(CAP),and fatty liver index(FLI).Fibrosis was assessed by the NAFLD fibrosis score,transient elastography,or shear wave elastography.Results:The study enrolled 14,985 Chi-nese adults.The agreement of MAFLD and NAFLD diagnoses were 83%for FLI,95%for ultrasound,94%for both CAP and MRI-PDFF,and 95%for liver biopsy.The body mass index,blood pressure and lipid levels among non-MAFLD-NAFLD pa-tients were similar metabolic parameters(p>0.05 for all),but not the alanine aminotransferase and the proportion of pa-tients with insulin resistance,which were significantly higher in non-MAFLD-NAFLD with significant fibrosis.Conclusions:The new MAFLD definition ruled out 5-17%of NAFLD cases.NAFLD and MAFLD-NAFLD involved more severe metabolic abnormalities than MAFLD and MAFLD-non-NAFLD.Non-MAFLD-NAFLD patients with significant fibrosis had more se-vere liver injury and increased glycemic dysregulation within the normal range.Attention should be paid to its progression.

关 键 词：Controlled attenuation parameter Fatty liver index Liver biopsy Metabolic-associated fatty liver disease Magnetic resonance imaging-based proton density fat fraction 

分 类 号：R575[医药卫生—消化系统]