Camilla Dalby Hansen, Johanne Kragh Hansen, Mads Israelsen, Peter Andersen, Laura Maarit Pikkupeura, Katrine Prier Lindvig, Sara Elizabeth Stinson, Helle Lindholm Schnefeld, Julie Tellerup, Maria Fogt, Nikolaj Torp, Maria Kjærgaard, Katrine Tholstrup Bech, Katrine Holtz Thorhauge, Stine Johansen, Ida Spedtsberg, Emil Deluran, Ida Falk Villesen, Sönke Detlefsen, Torben Hansen, Maja Thiele
{"title":"社区中有代谢和酒精风险个体中脂肪变性肝病的患病率、严重程度和决定因素","authors":"Camilla Dalby Hansen, Johanne Kragh Hansen, Mads Israelsen, Peter Andersen, Laura Maarit Pikkupeura, Katrine Prier Lindvig, Sara Elizabeth Stinson, Helle Lindholm Schnefeld, Julie Tellerup, Maria Fogt, Nikolaj Torp, Maria Kjærgaard, Katrine Tholstrup Bech, Katrine Holtz Thorhauge, Stine Johansen, Ida Spedtsberg, Emil Deluran, Ida Falk Villesen, Sönke Detlefsen, Torben Hansen, Maja Thiele","doi":"10.1016/j.jhep.2025.06.020","DOIUrl":null,"url":null,"abstract":"<h3>Background & Aims</h3>Individuals with steatotic liver disease (SLD) are affected by metabolic dysfunction and/or high alcohol consumption; however, the prevalence of SLD in at-risk individuals remains underexplored. In at-risk individuals, we aimed to investigate the prevalence and severity of SLD and subclasses: metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD)<h3>Methods</h3>Between Oct 2017 and Nov 2022, citizens aged 30-75 years were recruited 1:1 into: a) Metabolic cohort with BMI >30 kg/m<sup>2</sup> and/or type 2 diabetes without prolonged increased alcohol consumption, b) Alcohol cohort with ongoing/prior increased alcohol consumption. We assessed liver steatosis by controlled attenuation parameter (CAP), liver fibrosis by liver stiffness measurements (LSM) and performed liver biopsies in participants with LSM ≥8 kPa.<h3>Results</h3>We included 3,123 participants; 1,599 in the metabolic cohort and 1,524 in the alcohol cohort. In total, 2,197 (70%) were diagnosed with SLD:1,603 (51%) with MASLD, 398 (13%) with MetALD, and 196 (6.3%) with ALD. Of 307 (9.8%) with LSM ≥8 kPa, 169 underwent liver biopsy (55%). In the metabolic cohort, 1,237 (77%) had SLD, 147 (9.2%) had LSM ≥8 kPa, and 24 (1.5%) had biopsy-confirmed advanced liver fibrosis. In the alcohol cohort, 960 (63%) had SLD, 160 (10.5%) had LSM ≥8 kPa, and 46 (3.1%) had biopsy-confirmed advanced liver fibrosis. Across subclasses, ALD demonstrated highest liver disease severity (LSM ≥8 kPa: 25%; biopsy-confirmed advanced fibrosis: 8%), and severity was comparable between MASLD and MetALD (LSM ≥8 kPa: 12%, biopsy-confirmed advanced fibrosis: 3%).<h3>Conclusions</h3>Among individuals with cardiometabolic and/or alcohol risk factors, 70% had SLD, 10% had elevated liver stiffness, and 2% had biopsy-confirmed advanced liver fibrosis.Clinicaltrials.gov: NCT03308916<h3>Impact and implications</h3>Steatotic liver disease (SLD) remains underdiagnosed in the general population. This study provides new population-based data on its prevalence and severity among individuals with metabolic and/or alcohol-related risk. These findings are relevant to clinicians, researchers, and public health planners, as prevalence data are essential to inform evolving screening strategies. Methodological limitations, including the cross-sectional design and limited generalizability, should be considered when interpreting the results.","PeriodicalId":15888,"journal":{"name":"Journal of Hepatology","volume":"6 1","pages":""},"PeriodicalIF":26.8000,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence, severity and determinants of steatotic liver disease among individuals with metabolic and alcohol risk from the community\",\"authors\":\"Camilla Dalby Hansen, Johanne Kragh Hansen, Mads Israelsen, Peter Andersen, Laura Maarit Pikkupeura, Katrine Prier Lindvig, Sara Elizabeth Stinson, Helle Lindholm Schnefeld, Julie Tellerup, Maria Fogt, Nikolaj Torp, Maria Kjærgaard, Katrine Tholstrup Bech, Katrine Holtz Thorhauge, Stine Johansen, Ida Spedtsberg, Emil Deluran, Ida Falk Villesen, Sönke Detlefsen, Torben Hansen, Maja Thiele\",\"doi\":\"10.1016/j.jhep.2025.06.020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3>Background & Aims</h3>Individuals with steatotic liver disease (SLD) are affected by metabolic dysfunction and/or high alcohol consumption; however, the prevalence of SLD in at-risk individuals remains underexplored. In at-risk individuals, we aimed to investigate the prevalence and severity of SLD and subclasses: metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD)<h3>Methods</h3>Between Oct 2017 and Nov 2022, citizens aged 30-75 years were recruited 1:1 into: a) Metabolic cohort with BMI >30 kg/m<sup>2</sup> and/or type 2 diabetes without prolonged increased alcohol consumption, b) Alcohol cohort with ongoing/prior increased alcohol consumption. We assessed liver steatosis by controlled attenuation parameter (CAP), liver fibrosis by liver stiffness measurements (LSM) and performed liver biopsies in participants with LSM ≥8 kPa.<h3>Results</h3>We included 3,123 participants; 1,599 in the metabolic cohort and 1,524 in the alcohol cohort. In total, 2,197 (70%) were diagnosed with SLD:1,603 (51%) with MASLD, 398 (13%) with MetALD, and 196 (6.3%) with ALD. Of 307 (9.8%) with LSM ≥8 kPa, 169 underwent liver biopsy (55%). In the metabolic cohort, 1,237 (77%) had SLD, 147 (9.2%) had LSM ≥8 kPa, and 24 (1.5%) had biopsy-confirmed advanced liver fibrosis. In the alcohol cohort, 960 (63%) had SLD, 160 (10.5%) had LSM ≥8 kPa, and 46 (3.1%) had biopsy-confirmed advanced liver fibrosis. Across subclasses, ALD demonstrated highest liver disease severity (LSM ≥8 kPa: 25%; biopsy-confirmed advanced fibrosis: 8%), and severity was comparable between MASLD and MetALD (LSM ≥8 kPa: 12%, biopsy-confirmed advanced fibrosis: 3%).<h3>Conclusions</h3>Among individuals with cardiometabolic and/or alcohol risk factors, 70% had SLD, 10% had elevated liver stiffness, and 2% had biopsy-confirmed advanced liver fibrosis.Clinicaltrials.gov: NCT03308916<h3>Impact and implications</h3>Steatotic liver disease (SLD) remains underdiagnosed in the general population. 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Prevalence, severity and determinants of steatotic liver disease among individuals with metabolic and alcohol risk from the community
Background & Aims
Individuals with steatotic liver disease (SLD) are affected by metabolic dysfunction and/or high alcohol consumption; however, the prevalence of SLD in at-risk individuals remains underexplored. In at-risk individuals, we aimed to investigate the prevalence and severity of SLD and subclasses: metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD)
Methods
Between Oct 2017 and Nov 2022, citizens aged 30-75 years were recruited 1:1 into: a) Metabolic cohort with BMI >30 kg/m2 and/or type 2 diabetes without prolonged increased alcohol consumption, b) Alcohol cohort with ongoing/prior increased alcohol consumption. We assessed liver steatosis by controlled attenuation parameter (CAP), liver fibrosis by liver stiffness measurements (LSM) and performed liver biopsies in participants with LSM ≥8 kPa.
Results
We included 3,123 participants; 1,599 in the metabolic cohort and 1,524 in the alcohol cohort. In total, 2,197 (70%) were diagnosed with SLD:1,603 (51%) with MASLD, 398 (13%) with MetALD, and 196 (6.3%) with ALD. Of 307 (9.8%) with LSM ≥8 kPa, 169 underwent liver biopsy (55%). In the metabolic cohort, 1,237 (77%) had SLD, 147 (9.2%) had LSM ≥8 kPa, and 24 (1.5%) had biopsy-confirmed advanced liver fibrosis. In the alcohol cohort, 960 (63%) had SLD, 160 (10.5%) had LSM ≥8 kPa, and 46 (3.1%) had biopsy-confirmed advanced liver fibrosis. Across subclasses, ALD demonstrated highest liver disease severity (LSM ≥8 kPa: 25%; biopsy-confirmed advanced fibrosis: 8%), and severity was comparable between MASLD and MetALD (LSM ≥8 kPa: 12%, biopsy-confirmed advanced fibrosis: 3%).
Conclusions
Among individuals with cardiometabolic and/or alcohol risk factors, 70% had SLD, 10% had elevated liver stiffness, and 2% had biopsy-confirmed advanced liver fibrosis.Clinicaltrials.gov: NCT03308916
Impact and implications
Steatotic liver disease (SLD) remains underdiagnosed in the general population. This study provides new population-based data on its prevalence and severity among individuals with metabolic and/or alcohol-related risk. These findings are relevant to clinicians, researchers, and public health planners, as prevalence data are essential to inform evolving screening strategies. Methodological limitations, including the cross-sectional design and limited generalizability, should be considered when interpreting the results.
期刊介绍:
The Journal of Hepatology is the official publication of the European Association for the Study of the Liver (EASL). It is dedicated to presenting clinical and basic research in the field of hepatology through original papers, reviews, case reports, and letters to the Editor. The Journal is published in English and may consider supplements that pass an editorial review.