探讨有脂肪变性和无脂肪变性个体中mld、MASLD和代谢综合征的诊断准确性。

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-04-01 DOI:10.1016/j.aohep.2025.101818

Mariana M. Ramírez-Mejía , Stephany M. Castañeda-Castillo , Mohammed Eslam , Nahum Méndez-Sánchez

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引用次数: 0

摘要

将非酒精性脂肪性肝病（NAFLD）重新命名为代谢功能障碍相关脂肪性肝病（NAFLD）和代谢功能障碍相关脂肪性肝病（MASLD），标志着理解这一复杂疾病的一个重要里程碑，认识到代谢功能障碍的作用超越了简单的排除过量饮酒。然而，尽管取得了这些进展，重新定义的标准在其诊断准确性方面产生了重大争议。这场争论集中在几个关键问题上，如标准的广度、它们在不同人群中的适用性以及过度诊断的风险。本研究的目的是探讨MAFLD、MASLD和代谢综合征标准在肝脂肪变性患者和非肝脂肪变性患者的识别和分类中的应用，目的是确定这两个标准在临床使用中的适用性。材料和患者回顾性研究对600名在墨西哥墨西哥城Medica Sur诊所和基金会接受常规检查的患者进行了研究。数据收集自临床评估、影像学研究和实验室测试。采用振动控制瞬时弹性成像技术诊断肝脏脂肪变性。根据各定义所建立的标准对MAFLD、MASLD和代谢综合征进行诊断。结果在肝脂肪变性人群中，MASLD患病率为89.4%，MAFLD患病率为81.5%，代谢综合征患病率为32.8%。有趣的是，与MAFLD（28.1%）和MetS（8.2%）相比，没有肝脂肪变性的个体符合MASLD标准的比例更高（53.2%）。敏感性和特异性分析显示，MAFLD表现平衡，而MASLD表现出较高的敏感性和较低的特异性。敏感性和特异性分析显示，MAFLD的表现平衡，而MASLD的敏感性略高，但特异性低得多。在评估代谢风险概况时，发现患有MAFLD和代谢综合征的个体比患有MASLD的个体风险更高。结论smafld是一种平衡的诊断框架，具有可靠的敏感性和特异性。虽然MASLD具有较高的敏感性，但其特异性较低

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Exploring the diagnostic accuracy of MAFLD, MASLD and metabolic syndrome in individuals with and without steatosis.

Introduction and Objectives

The renaming of non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) marks a crucial milestone in the understanding of this complex disease, recognizing the role of metabolic dysfunction beyond the simple exclusion of excessive alcohol consumption. However, despite these advances, the redefined criteria have generated significant debate around their diagnostic accuracy. This debate centers on several key issues, such as the breadth of the criteria, their applicability in different populations, and the risk of overdiagnosis. The aim of this study is to explore the application of the MAFLD, MASLD and metabolic syndrome criteria in the identification and categorization of individuals with and without hepatic steatosis, with the objective of determining the suitability of both criteria for clinical use.

Materials and Patients

A retrospective study was conducted with 600 individuals who attended routine check-ups at Medica Sur Clinic and Foundation, Mexico City, Mexico. Data were collected from clinical evaluations, imaging studies and laboratory tests. The diagnosis of hepatic steatosis was made using vibration-controlled transient elastography. The diagnosis of MAFLD, MASLD and metabolic syndrome was made according to the criteria established for each definition.

Results

Among individuals with hepatic steatosis, prevalence rates were 89.4% for MASLD, 81.5% for MAFLD (81.5%), and 32.8% for metabolic syndrome. Interestingly, a higher proportion of individuals without hepatic steatosis met MASLD criteria (53.2%) compared with MAFLD (28.1) and MetS (8.2%) criteria. Sensitivity and specificity analysis revealed a balanced performance of MAFLD, whereas MASLD showed higher sensitivity but lower specificity. Sensitivity and specificity analysis revealed a balanced performance of MAFLD, whereas MASLD showed slightly higher sensitivity but much lower specificity. When assessing the metabolic risk profile, individuals with MAFLD and metabolic syndrome were found to be at higher risk than those with MASLD.

Conclusions

MAFLD emerges as a balanced diagnostic framework, offering reliable sensitivity and specificity. Although MASLD exhibits higher sensitivity, its lower specificity

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来源期刊

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.