根据 2023 年标准,按种族或民族划分的美国脂肪变性患病率差异。

IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Luis Antonio Díaz, Jeffrey V. Lazarus, Eduardo Fuentes-López, Francisco Idalsoaga, Gustavo Ayares, Hailemichael Desaleng, Pojsakorn Danpanichkul, Thomas G. Cotter, Winston Dunn, Francisco Barrera, Karn Wijarnpreecha, Mazen Noureddin, Naim Alkhouri, Ashwani K. Singal, Robert J. Wong, Zobair M. Younossi, Mary E. Rinella, Patrick S. Kamath, Ramon Bataller, Rohit Loomba, Marco Arrese, Juan Pablo Arab
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引用次数: 0

摘要

导言:2023命名法定义了脂肪肝(SLD)的标准,包括代谢功能障碍相关SLD(MASLD)、酒精相关肝病(ALD)以及重叠的MASLD/ALD(MetALD)。我们的目的是根据这一新命名法评估美国成年人中 SLD 患病率的种族和民族差异:我们利用 2017-2018 年美国国家健康与营养调查(NHANES)数据库开展了一项横断面研究。我们根据受控衰减参数≥288 dB/m、肝硬度≥7.2 kPa或转氨酶水平升高来确定SLD。饮酒阈值根据更新的 SLD 定义确定。我们采用 NHANES 调查的复杂设计来估算患病率。我们采用了带有复杂设计权重的多变量逻辑回归:共纳入 5532 人。平均年龄为 45.4 岁,50.9% 为女性。经调整后,MASLD 的估计患病率为 42.4%(95% CI:41.1-43.8%),MetALD 为 1.7%(95% CI:1.3-2.0%),ALD 为 0.6%(95% CI:0.3-0.8%)。西班牙裔的 SLD 患病率较高,但不同种族/族裔群体之间因 SLD 导致的晚期纤维化患病率没有显著差异。在 MASLD 中,男性、40-64 岁和≥65 岁的人、西班牙裔、有医疗保险的人、较高的体重指数、糖尿病、高血压、高甘油三酯血症、低高密度脂蛋白胆固醇或使用降脂药与较高的风险独立相关,而黑人的风险最低。在 MetALD 中,在调整后的多变量分析中,男性和较高的体重指数与 MetALD 的较高风险独立相关。在ALD方面,调整后的多变量分析表明,只有医疗保险与较低的ALD风险独立相关:结论:MASLD 在美国的发病率很高,尤其是在男性、老年人和西班牙裔中。MetALD和ALD的患病率很高,但可能被低估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Disparities in steatosis prevalence in the United States by Race or Ethnicity according to the 2023 criteria

Disparities in steatosis prevalence in the United States by Race or Ethnicity according to the 2023 criteria
The 2023 nomenclature defined criteria for steatotic liver disease (SLD), including metabolic dysfunction-associated SLD (MASLD), alcohol-associated liver disease (ALD), and the overlapping MASLD/ALD (MetALD). We aimed to assess racial and ethnic disparities in the SLD prevalence among United States (US) adults based on this new nomenclature. We undertook a cross-sectional study employing the 2017–2018 National Health and Nutrition Examination Survey (NHANES) database. We identified SLD according to a controlled attenuation parameter ≥288 dB/m, liver stiffness ≥7.2 kPa, or elevated aminotransferase levels. Alcohol use thresholds were established according to the updated SLD definition. We estimated prevalences using the complex design of the NHANES survey. Multivariable logistic regressions with complex design weights were employed. A total of 5532 individuals are included. The mean age is 45.4 years, and 50.9% are women. The adjusted estimated prevalence of MASLD is 42.4% (95% CI: 41.1–43.8%), MetALD 1.7% (95% CI: 1.3–2.0%), and ALD 0.6% (95% CI: 0.3–0.8%). Hispanics exhibit a higher prevalence of SLD, but there are no significant differences in advanced fibrosis prevalence due to SLD among racial/ethnic groups. In MASLD, men, individuals aged 40–64 and ≥65 years, Hispanics, those with health insurance, higher BMI, diabetes, hypertension, hypertriglyceridemia, and low high-density lipoprotein (HDL) cholesterol or use of lipid-lowering agents are independently associated with a higher risk, while Blacks have the lowest risk. In MetALD, men and higher BMI are independently associated with a higher risk of MetALD in adjusted multivariable analysis. In ALD, the adjusted multivariable analysis shows that only health insurance is independently associated with a lower ALD risk. MASLD prevalence is high in the US, especially in men, older individuals, and Hispanics. MetALD and ALD prevalence was substantial but could be underestimated. This study aims to estimate the prevalence of different types of fatty liver disease, in which excess fat occurs in the liver. A particular type of fatty liver disease that is not caused by excess alcohol consumption affects 42.4% of adults in the USA, with men, older adults, and Hispanics being more likely to have this form of liver disease. People with health insurance are less likely to have liver disease caused by excess alcohol consumption. These results highlight the importance of targeted prevention efforts in people with a higher risk of developing liver disease. Future public health strategies should focus on reducing risk factors and providing equitable healthcare access. Díaz et al. estimate the prevalence of steatotic liver disease (SLD) in adults in the United States. Increased waist circumference, excess weight, abnormal glucose metabolism, and hypertension are associated with a higher risk of advanced fibrosis in SLD, with sex, hispanic ethnicity and lack of health insurance associated with certain types.
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