Prevalence， influencing factors， and fibrosis risk stratification of metabolic dysfunction-associated fatty liver disease in the health check-up population in Beijing， China

Haiqing GUO; Mingliang LI; Feng LIU; Jing ZHANG

doi:10.12449/JCH250408

Volume 41 Issue 4

Apr. 2025

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2025 > 41(4): 643-649

PDF( 876 KB)

Prevalence， influencing factors， and fibrosis risk stratification of metabolic dysfunction-associated fatty liver disease in the health check-up population in Beijing， China

DOI: 10.12449/JCH250408

1.
Center for Diagnosis and Treatment of Fatty Liver Disease，Beijing YouAn Hospital，Capital Medical University，Beijing 100069，China
2.
Beijing Physical Examination Center，Beijing 100036，China

Research funding:

Beijing Municipal Administration of Hospitals Incubating Program (PX2023061);

Scientific Research Project of Beijing Youan Hospital (YNKTXF2021003)

More Information

Corresponding author: ZHANG Jing， zjyouan@ccmu.edu.cn （ORCID： 0000-0002-3082-8330）
Received Date: 2024-09-08
Accepted Date: 2024-10-11
Published Date: 2025-04-25

Abstract

Abstract

Objective To identify the patients with metabolic dysfunction-associated fatty liver disease （MAFLD） among the health check-up population， and to perform stratified management of patients with the low， medium， and high risk of advanced fibrosis based on noninvasive fibrosis scores. Methods A cross-sectional study was conducted among 3 125 individuals who underwent physical examination in Beijing Physical Examination Center from December 2017 to December 2019， and they were divided into MAFLD group with 1 068 individuals and non-MAFLD group with 2 057 individuals. According to BMI， the MAFLD group was further divided into lean MAFLD group （125 individuals with BMI<24 kg/m²） and non-lean MAFLD group （943 individuals with BMI≥24 kg/m²）. Indicators including demographic data， past history， laboratory examination， and liver ultrasound were compared between groups. Fibrosis-4 （FIB-4） score， NAFLD fibrosis score （NFS）， aspartate aminotransferase-to-platelet ratio index （APRI）， and BARD score were calculated for the patients in the MAFLD group to assess the risk of advanced fibrosis. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. A logistic regression analysis was used to investigate the influence of each indicator in MAFLD. Results Compared with the non-MAFLD group， the MAFLD group had significantly higher age （Z=-9.758， P<0.05）， proportion of male patients （χ²=137.555， P<0.05）， and levels of body weight （Z=-27.987， P<0.05）， BMI （Z=-32.714， P<0.05）， waist circumference （Z=-31.805， P<0.05）， hip circumference （Z=-26.342， P<0.05）， waist-hip ratio （Z=-28.554， P<0.05）， alanine aminotransferase （ALT）（Z=-25.820， P<0.05）， aspartate aminotransferase （AST）（Z=-16.894， P<0.05）， gamma-glutamyl transpeptidase （GGT）（Z=-25.069， P<0.05）， alkaline phosphatase （Z=-12.533， P<0.05）， triglyceride （Z=-27.559）， total cholesterol （Z=-7.833， P<0.05）， low-density lipoprotein cholesterol （LDL-C）（Z=-8.222， P<0.05）， and uric acid （UA）（Z=-20.024， P<0.05）， as well as a significantly higher proportion of patients with metabolic syndrome （MetS）（χ²=578.220， P<0.05）， significantly higher prevalence rates of hypertension （χ²=241.694， P<0.05）， type 2 diabetes （χ²=796.484， P<0.05）， and dyslipidemia （χ²=369.843， P<0.05）， and a significant reduction in high-density lipoprotein cholesterol （HDL-C）（Z=23.153， P<0.001）. The multivariate logistic regression analysis showed that male sex （odds ratio ［OR］=1.45， 95% confidence interval ［CI］： 1.203‍ ‍—‍ ‍1.737）， ALT （OR=1.05， 95%CI： 1.046‍ ‍—‍ ‍1.062）， LDL-C （OR=1.23， 95%CI： 1.102‍ ‍—‍ ‍1.373）， and comorbidity with MetS （OR=5.97， 95%CI： 4.876‍ ‍—‍ ‍7.316） were independently associated with MAFLD. Compared with the non-lean MAFLD group， the lean MAFLD group had significantly higher age （Z=3.736， P<0.05） and HDL-C （Z=2.679， P<0.05） and significant reductions in the proportion of male patients （χ²=28.970， P<0.05）， body weight （Z=-14.230， P<0.05）， BMI （Z=-18.188， P<0.05）， waist circumference （Z=-13.451， P<0.05）， hip circumference （Z=-13.317， P<0.05）， ALT （Z=-4.519， P<0.05）， AST （Z=-2.258， P<0.05）， GGT （Z=-4.592， P<0.05）， UA （Z=-4.415， P<0.05）， the proportion of patients with moderate or severe fatty liver disease or MetS （χ²=42.564， P<0.05）， and the prevalence rates of hypertension （χ²=12.057， P<0.05） and type 2 diabetes （χ²=3.174， P<0.05）. Among the patients with MAFLD， 10 patients （0.9%） had an FIB-4 score of >2.67， 4 patients （0.4%） had an NFS score of >0.676， 8 patients （0.7%） had an APRI of >1， and 551 patients （51.6%） had a BARD score of ≥2. Conclusion There is a relatively high prevalence rate of MAFLD among the health check-up population in Beijing， but with a relatively low number of patients with a high risk of advanced fibrosis， and such patients need to be referred to specialized hospitals for liver diseases.
- Metabolic Dysfunction-Associated Fatty Liver Disease,
- Prevalence,
- Root Cause Analysis,
- Fibrosis,
- Beijing

FullText(HTML)

References(20)

References

[1]	ZHOU JH, ZHOU F, WANG WX, et al. Epidemiological features of NAFLD from 1999 to 2018 in China[J]. Hepatology, 2020, 71( 5): 1851- 1864. DOI: 10.1002/hep.31150.
[2]	ZHAO Q, MENG XY, WANG Y, et al. Development and validation of a predicting nomogram for metabolic associated fatty liver disease in patients with type 2 diabetes mellitus[J/CD]. Chin J Liver Dis(Electronic Version), 2024, 16( 2): 48- 54. DOI: 10.3969/j.issn.1674-7380.2024.02.009. 赵倩, 孟祥英, 王奕, 等. 2型糖尿病患者代谢相关脂肪性肝病列线图预测模型的建立与验证[J/CD]. 中国肝脏病杂志(电子版), 2024, 16( 2): 48- 54. DOI: 10.3969/j.issn.1674-7380.2024.02.009.
[3]	DUELL PB, WELTY FK, MILLER M, et al. Nonalcoholic fatty liver disease and cardiovascular risk: A scientific statement from the American heart association[J]. Arterioscler Thromb Vasc Biol, 2022, 42( 6): e168- e185. DOI: 10.1161/ATV.0000000000000153.
[4]	SUN DQ, TARGHER G, BYRNE CD, et al. An international Delphi consensus statement on metabolic dysfunction-associated fatty liver disease and risk of chronic kidney disease[J]. Hepatobiliary Surg Nutr, 2023, 12( 3): 386- 403. DOI: 10.21037/hbsn-22-421.
[5]	THOMAS JA, KENDALL BJ, DALAIS C, et al. Hepatocellular and extrahepatic cancers in non-alcoholic fatty liver disease: A systematic review and meta-analysis[J]. Eur J Cancer, 2022, 173: 250- 262. DOI: 10.1016/j.ejca.2022.06.051.
[6]	WANG YK, WEI SY, LIU C, et al. A new definition of fatty liver disease: from nonalcoholic fatty liver disease to metabolic asso-ciated fatty liver disease[J]. Chin J Dig Surg, 2023, 22( S1): 117- 121. DOI: 10.3760/cma.j.cn115610-20230909-00080. 王永康, 魏诗雨, 刘昌, 等. 脂肪性肝病新定义: 从非酒精性脂肪性肝病到代谢功能障碍相关脂肪性肝病[J]. 中华消化外科杂志, 2023, 22( S1): 117- 121. DOI: 10.3760/cma.j.cn115610-20230909-00080.
[7]	Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the prevention and treatment of metabolic dysfunction-associated(non-alcoholic) fatty liver disease(Version 2024)[J]. J Prac Hepatol, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163. 中华医学会肝病学分会. 代谢相关(非酒精性)脂肪性肝病防治指南(2024年版)[J]. 实用肝脏病杂志, 2024, 27( 4): 494- 510. DOI: 10.3760/cma.j.cn501113-20240327-00163.
[8]	NAN YM, AN JH, BAO JF, et al. The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease[J]. J Hepatol, 2021, 75( 2): 454- 461. DOI: 10.1016/j.jhep.2021.05.003.
[9]	DUSEJA A, SINGH SP, DE A, et al. Indian national association for study of the liver(INASL) guidance paper on nomenclature, diagnosis and treatment of nonalcoholic fatty liver disease(NAFLD)[J]. J Clin Exp Hepatol, 2023, 13( 2): 273- 302. DOI: 10.1016/j.jceh.2022.11.014.
[10]	RIGOR J, DIEGUES A, PRESA J, et al. Noninvasive fibrosis tools in NAFLD: Validation of APRI, BARD, FIB-4, NAFLD fibrosis score, and hepamet fibrosis score in a Portuguese population[J]. Postgrad Med, 2022, 134( 4): 435- 440. DOI: 10.1080/00325481.2022.2058285.
[11]	SANCHEZ-BAO AM, SOTO-GONZALEZ A, DELGADO-BLANCO M, et al. Identifying advanced MAFLD in a cohort of T2DM and clinical features[J]. Front Endocrinol(Lausanne), 2023, 14: 1058995. DOI: 10.3389/fendo.2023.1058995.
[12]	ARSLAN AY, CELIK S, AMIN F, et al. Prevalence, determinants, and fibrosis risk stratification of metabolic-associated fatty liver disease in a Turkish primary care setting: A retrospective study[J]. Hepatol Forum, 2023, 5( 2): 63- 67. DOI: 10.14744/hf.2023.2023.0027.
[13]	LIU ZY, ZHUANG YJ, DONG X, et al. Construction of non-invasive diagnostic model for liver fibrosis in nonalcoholic fatty liver disease[J]. Clin J Med Offic, 2024, 52( 7): 688- 691. DOI: 10.16680/j.1671-3826.2024.07.07. 刘正一, 庄颖洁, 董旭, 等. 非酒精性脂肪性肝病肝纤维化无创诊断模型构建[J]. 临床军医杂志, 2024, 52( 7): 688- 691. DOI: 10.16680/j.1671-3826.2024.07.07.
[14]	MAN S, DENG YH, MA Y, et al. Prevalence of liver steatosis and fibrosis in the general population and various high-risk populations: A nationwide study with 5.7 million adults in China[J]. Gastroenterology, 2023, 165( 4): 1025- 1040. DOI: 10.1053/j.gastro.2023.05.053.
[15]	MUZUROVIĆ E, MIKHAILIDIS DP, MANTZOROS C. Non-alcoholic fatty liver disease, insulin resistance, metabolic syndrome and their association with vascular risk[J]. Metabolism, 2021, 119: 154770. DOI: 10.1016/j.metabol.2021.154770.
[16]	TANG A, NG CH, PHANG PH, et al. Comparative burden of metabolic dysfunction in lean NAFLD vs non-lean NAFLD-A systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2023, 21( 7): 1750- 1760. e 12. DOI: 10.1016/j.cgh.2022.06.029.
[17]	ZOU ZY, WONG VW, FAN JG. Epidemiology of nonalcoholic fatty liver disease in non-obese populations: Meta-analytic assessment of its prevalence, genetic, metabolic, and histological profiles[J]. J Dig Dis, 2020, 21( 7): 372- 384. DOI: 10.1111/1751-2980.12871.
[18]	CHEN XN, GOH GB, HUANG JF, et al. Validation of non-invasive fibrosis scores for predicting advanced fibrosis in metabolic-associated fatty liver disease[J]. J Clin Transl Hepatol, 2022, 10( 4): 589- 594. DOI: 10.14218/JCTH.2021.00311.
[19]	WU YL, KUMAR R, WANG MF, et al. Validation of conventional non-invasive fibrosis scoring systems in patients with metabolic associated fatty liver disease[J]. World J Gastroenterol, 2021, 27( 34): 5753- 5763. DOI: 10.3748/wjg.v27.i34.5753.
[20]	AMPUERO J, PAIS R, ALLER R, et al. Development and validation of hepamet fibrosis scoring system-a simple, noninvasive test to identify patients with nonalcoholic fatty liver disease with advanced fibrosis[J]. Clin Gastroenterol Hepatol, 2020, 18( 1): 216- 225. e 5. DOI: 10.1016/j.cgh.2019.05.051.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(1) / Tables(4)

Get Citation

PDF

XML

Article Metrics

Article views (697) PDF downloads(104)

Prevalence， influencing factors， and fibrosis risk stratification of metabolic dysfunction-associated fatty liver disease in the health check-up population in Beijing， China

DOI: 10.12449/JCH250408

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Prevalence， influencing factors， and fibrosis risk stratification of metabolic dysfunction-associated fatty liver disease in the health check-up population in Beijing， China

DOI: 10.12449/JCH250408

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content