FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease.

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Mário Reis Álvares-da-Silva, Márcia da Silva Vargas, Soheyla Mohd Souza Rabie, Gabriella Jonko, Patricia Gabriela Riedel, Larisse Longo, Marcelo Rodrigues Gonçalves, Vivian Cristine Luft, Dvora Joveleviths
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Abstract

Introduction and objectives: Public health policies in metabolic dysfunction-associated steatotic liver disease (MASLD) are still lacking. This study aims to estimate the prevalence and severity of MASLD in primary health care (PHC) through non-invasive markers.

Patients and methods: Two-phase study, including a retrospective (RETR) and a prospective (PROS) one, was carried out in PHC in Brazil. In RETR, metabolic and hepatic profiles of 12,054 patients, including FIB-4, were evaluated. In PROS, 350 patients were randomly selected and submitted to a clinical and nutritional assessment.

Results: RETR (65.4 % women, mean age 55.3 years old): dyslipidemia, hypertension, and type 2 diabetes mellitus (T2DM) present in 40.8 %, 34.3 %, and 12.2 % of the electronic health records, respectively. Fasting glucose >100 mg/dL in 34.5 %, and glycated hemoglobin higher than 5.7 % in 51.5 %, total cholesterol >200 mg/dL and triglycerides >150 mg/dL in 40.8 % and 32.1 %, respectively. Median FIB-4 was of 1.33, 5 % >2.67. No one had MASLD as a diagnostic hypothesis; PROS(71.8 % women, mean age 58 years old): body mass index (BMI) ≥30 kg/m² in 31.8 %. MASLD prevalence (FLI≥ 30 + cardiometabolic features) of 62.1 %; 39.4 % of patients had FLI ≥60, with higher BMI, waist circumference, fasting glucose, triglycerides, AST, ALT and GGT, as well as lower HDL-cholesterol (p < 0.001). FIB-4>1.3 in 40 % and NAFLD Fibrosis Score (NFS)>-1.45 in 59.2 % of steatotic patients.

Conclusions: There is a high prevalence of MASLD in PHC, with a significant risk of liver fibrosis. These findings reinforce we need to develop public policies to defeat MASLD epidemics.

FLI 和 FIB-4 在初级保健中诊断代谢功能障碍相关性脂肪肝:高患病率和重大疾病风险。
导言和目标:目前仍缺乏代谢功能障碍相关性脂肪肝(MASLD)的公共卫生政策。本研究旨在通过非侵入性指标估算代谢性脂肪肝在初级卫生保健(PHC)中的患病率和严重程度:研究分为两个阶段,包括回顾性研究(RETR)和前瞻性研究(PROS)。在回顾性研究中,对 12 054 名患者的代谢和肝脏状况(包括 FIB-4)进行了评估。在 PROS 中,随机挑选了 350 名患者进行临床和营养评估:RETR(65.4% 为女性,平均年龄 55.3 岁):电子健康记录中分别有 40.8%、34.3% 和 12.2% 的患者存在血脂异常、高血压和 2 型糖尿病(T2DM)。空腹血糖大于 100 毫克/分升的占 34.5%,糖化血红蛋白大于 5.7% 的占 51.5%,总胆固醇大于 200 毫克/分升和甘油三酯大于 150 毫克/分升的分别占 40.8% 和 32.1%。FIB-4 中位数为 1.33,5%>2.67。没有人将 MASLD 作为诊断假说;PROS(71.8% 为女性,平均年龄 58 岁):31.8% 的人体重指数(BMI)≥30 kg/m²。MASLD患病率(FLI≥30 + 心脏代谢特征)为62.1%;39.4%的患者FLI≥60,BMI、腰围、空腹血糖、甘油三酯、谷草转氨酶、谷丙转氨酶和谷草转氨酶较高,40%的患者高密度脂蛋白胆固醇较低(p 1.3),59.2%的脂肪肝患者非酒精性脂肪肝纤维化评分(NFS)>-1.45:结论:MASLD在初级保健中心的发病率很高,有很大的肝纤维化风险。这些发现使我们更有必要制定公共政策,以战胜MASLD的流行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of hepatology
Annals of hepatology 医学-胃肠肝病学
CiteScore
7.90
自引率
2.60%
发文量
183
审稿时长
4-8 weeks
期刊介绍: Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.
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