心脏代谢紊乱对住院病人代谢相关性脂肪肝(MAFLD)诊断的影响:2016-2020年国家统计局数据库的5年回顾性研究。

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Adedeji Adenusi MD, MPH
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引用次数: 0

摘要

治疗领域心血管疾病/心血管疾病风险因素背景在美国,心血管代谢紊乱是与心血管事件和心源性猝死风险增加相关的健康问题。然而,只有少数研究探讨了这些健康状况对 MAFLD 增长趋势的影响。本研究旨在探讨心脏代谢紊乱对美国医院中被诊断为 MAFLD 患者的影响。我们的主要结果是 MAFLD,而预测因素是心血管代谢综合征(高血压、糖尿病、慢性肾脏病、血脂异常、肥胖)和共变量(种族、年龄、性别)。我们进行了描述性分析、双变量和多变量逻辑回归,以确定与 MAFLD 相关的潜在预测因素。结果共分析了 252,254,979 名住院患者,其中 112,375 名住院患者的主要诊断为 MAFLD/NAFLD。MAFLD主要诊断为女性(61.3%)、45岁以上(89.4%)、白人(78.4%)、肥胖(66.2%)、无血脂异常(55.1%)、代谢综合征(98.8%)、高血压(66.2%)、糖尿病(80.4%)和慢性肾病(67.7%)。与体重指数正常的患者相比,肥胖患者被诊断为 MAFLD 的几率是后者的两倍。(aOR=2.319[95%CI 2.223-2.419],p<.0001)。相反,与无血脂异常的患者相比,有血脂异常的患者被诊断为 MAFLD 的可能性较低。(0.903[0.870-0.936],p<.0001)。与非代谢综合征患者相比,代谢综合征患者被诊断为 MAFLD 的几率是后者的四倍。(4.353[3.583-5.289],p< .0001)。与非高血压患者相比,高血压患者被诊断为 MAFLD 的可能性较小。(1.044 [1.003-1.086], p=0.0348).与非糖尿病和非慢性肾脏病患者相比,糖尿病或慢性肾脏病患者被诊断为 MAFLD 的几率分别增加了两倍。(在这两类患者中,糖尿病和慢性肾脏病患者被诊断为 MAFLD 的几率分别为非糖尿病和非慢性肾脏病患者的两倍(2.439 [2.345-2.536],p< .0001)、(2.305 [2.206-2.409],p< .0001)。与白人患者相比,西班牙裔患者更有可能患有 MAFLD。(1.169[1.082-1.264],p<.0001),而黑人和亚裔患者患 MAFLD 的几率分别较低。(0.235[0.219-0.251],p<.0001)、(0.651[0.585-0.724],p<.0001)结论本研究的结果丰富了有关心脏代谢紊乱患者发生 MAFLD 的风险和模式的知识,强调了社会人口学和临床因素之间复杂的相互作用。这为改变生活方式、及早发现和治疗心脏代谢紊乱提供了进一步的信息,可作为 MAFLD 的预防策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
IMPACT OF CARDIOMETABOLIC DISORDERS ON THE DIAGNOSIS OF METABOLIC ASSOCIATED FATTY LIVER DISEASE (MAFLD) AMONG HOSPITALIZED PATIENTS: A 5-YEAR RETROSPECTIVE STUDY OF NIS DATABASE BETWEEN 2016-2020.

Therapeutic Area

ASCVD/CVD Risk Factors

Background

Cardiometabolic disorders are health conditions that are associated with increased risk for cardiovascular events and sudden cardiac death in the US. However, only a few studies explored these health conditions on the increasing trend of MAFLD. This study aims to explore the impact of cardiometabolic disorders among patients diagnosed with MAFLD in US hospitals.

Methods

We used the NIS data of 2016-2020 period for this cross-sectional study. Our main outcome was MAFLD while predictors were cardiometabolic syndrome (hypertension, diabetes, CKD, dyslipidemia, obesity) with co-variates (race, age, sex). We did descriptive analysis, bivariate and multivariate logistic regressions to identify potential predictors associated with MAFLD.

Results

A total of 252,254,979 hospitalized patients were analyzed of which 112,375 patients were hospitalized with principal diagnosis of MAFLD/NAFLD. MAFLD were predominantly diagnosed in females (61.3%), individuals over 45 years (89.4%), white (78.4%), those with obesity (66.2%), without dyslipidemia (55.1%), with metabolic syndrome (98.8%), hypertension (66.2%), diabetes (80.4%) and chronic kidney disease (67.7%). Patients with obesity were two-fold likely to be diagnosed with MAFLD compared to patients with normal BMI. (aOR= 2.319 [95%CI 2.223-2.419], p<.0001). Conversely patients with dyslipidemia were less likely to be diagnosed with MAFLD than those without dyslipidemia. (0.903 [0.870-0.936], p<.0001). Patients with metabolic syndrome were four-fold likely to be diagnosed with MAFLD compared with non-metabolic syndrome patients. (4.353 [3.583-5.289], p<.0001). Patients with hypertension had a marginal likelihood to be diagnosed with MAFLD compared to non-hypertensive patients. (1.044 [1.003-1.086], p=0.0348). Patients with diabetes or CKD were two-fold likely to be diagnosed with MAFLD compared with non-diabetic and non-CKD patients respectively. (2.439 [2.345-2.536], p<.0001), (2.305 [2.206-2.409], p<.0001). Patient of Hispanic descent were more likely to have MAFLD compared with patients of white descents. (1.169 [1.082-1.264], p<.0001), while patients from black and Asian descent were less likely to have MAFLD respectively. (0.235 [0.219-0.251], p<.0001), (0.651 [0.585-0.724], p<.0001)

Conclusions

The results of this study contribute to the body of knowledge on the risk and pattern of MAFLD among patients with cardiometabolic disorders, emphasizing the complex interplay between sociodemographic and clinical factors. This further informs lifestyle modification, early detection and treatment of cardiometabolic disorders as preventive strategy for MAFLD.
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来源期刊
American journal of preventive cardiology
American journal of preventive cardiology Cardiology and Cardiovascular Medicine
CiteScore
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