Background:The recently proposed definition of metabolic dysfunction-associated fatty liver disease(MAFLD)is based on the co-existence of hepatic steatosis with other metabolic disorders,including obe-sity and metabolic risk abnormalities such as hyperglycemia,high blood pressure and dyslipidemia.This study aimed to assess MAFLD severity according to the presence of metabolic abnormalities and obesity.Methods:Using transient elastography,hepatic steatosis and fibrosis severity were assessed by measur-ing the controlled attenuation parameter and liver stiffness measurement.A total of 1163 patients with MAFLD were categorized into the following four groups according to metabolic risk abnormalities and obesity presence:non-obese without metabolic risk abnormality group(Group 1;reference group);non-obese with metabolic risk abnormality group(Group 2);obese without metabolic risk abnormality group(Group 3);and obese with metabolic risk abnormality group(Group 4).A multiple logistic regression analysis was performed to determine severe hepatic steatosis and fibrosis risk in each group in both un-adjusted and adjusted models.Results:In the adjusted model,the odds ratios(ORs)[95％confidence interval(Cl)]for severe hepatic steatosis in Groups 2,3,and 4 were 1.07(0.61-1.88),2.43(1.44-4.08),and 4.07(2.56-6.48),respectively(Ptrend＜0.001).For liver fibrosis,compared with Group 1,Group 2 showed no significant increases in OR,whereas Groups 3 and 4(obese groups)showed significant increases(OR = 4.70,95％CI:1.24-17.82 and OR = 6.43,95％Cl:1.88-22.02,respectively).Conclusions:Obesity,rather than metabolic abnormality,is the principal determinant of severe hepatic steatosis and fibrosis in patients with MAFLD.

Ji Hye Huh;Kwang Joon Kim;Seung Up Kim;Bong-Soo Cha;Byung-Wan Lee

Division of Endocrinology and Metabolism,Department of Internal Medicine,Hallym University Sacred Heart Hospital,Anyang 14068,Korea;Division of Geriatrics,Department of Internal Medicine,Yonsei University College of Medicine,Seoul 03722,Korea;Division of Endocrinology and Metabolism,Department of Internal Medicine,Yonsei University College of Medicine,Seoul 03722,Korea;Institute of Gastroenterology,Department of Internal Medicine,Yonsei University College of Medicine,Seoul 03722,Korea

国际肝胆胰疾病杂志(英文版)

[1]Ji Hye Huh;Kwang Joon Kim;Seung Up Kim;Bong-Soo Cha;Byung-Wan Lee-.Obesity is an important determinant of severity in newly defined metabolic dysfunction-associated fatty liver disease)[J].国际肝胆胰疾病杂志(英文版),2022(03):241-247

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Obesity,important,determinant,severity,newly,defined,metabolic,dysfunction,associated,fatty,liver,disease,Background,recently,proposed,definition,MAFLD,existence,hepatic,steatosis,other,disorders,including,risk,abnormalities,such,hyperglycemia,high,blood,pressure,dyslipidemia,This,study,aimed,according,presence,obesity,Methods,Using,transient,elastography,fibrosis,were,assessed,by,controlled,attenuation,parameter,stiffness,measurement,total,patients,categorized,into,following,four,groups,obese,without,abnormality,reference,multiple,logistic,regression,analysis,was,performed,determine,severe,each,both,adjusted,models,Results,In,odds,ratios,ORs,confidence,interval,Cl,Groups,respectively,Ptrend,For,compared,showed,significant,increases,whereas,Conclusions,rather,than,principal

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