Abdelrahman M Attia, Mohammad Saeid Rezaee-Zavareh, Yee Hui Yeo, Minsun Kwak, Hyunseok Kim, Mazen Noureddin, Ju Dong Yang
{"title":"COVID-19大流行期间美国脂肪变性肝病和肝纤维化的变化","authors":"Abdelrahman M Attia, Mohammad Saeid Rezaee-Zavareh, Yee Hui Yeo, Minsun Kwak, Hyunseok Kim, Mazen Noureddin, Ju Dong Yang","doi":"10.1097/HC9.0000000000000806","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Steatotic liver diseases (SLDs) and their subcategories-metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD), and alcohol-associated liver disease (ALD)-significantly contribute to liver-related and extrahepatic morbidity and mortality. This project aimed to assess the landscape of SLDs and clinically significant fibrosis (CSF) before (2017-2020) and during (2021-2023) the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using National Health and Nutrition Examination Survey (NHANES) data, we analyzed 8965 prepandemic and 6337 pandemic participants aged ≥18 years. The main evaluated outcomes were changes in age-adjusted mean CSF, mean controlled attenuation parameter score, and age-adjusted prevalence of MASLD, MetALD, and ALD before and during the pandemic.</p><p><strong>Results: </strong>The age-adjusted prevalence of SLDs changed significantly (p=0.003) between the prepandemic and pandemic periods. ALD prevalence rose from 0.94% to 2.27%, MetALD from 2.60% to 4.42%, while MASLD declined from 30.13% to 25.46%. Vigorous and moderate physical activity decreased significantly (p<0.001), whereas moderate/excessive alcohol intake increased (p<0.001). The prevalence of CSF increased from 8.3% to 10.5% (p=0.028). Multivariable analyses showed the COVID-19 pandemic (adjusted OR: 1.47, 95% CI: 1.00-2.17) and moderate/excessive alcohol intake (adjusted OR: 2.13, 95% CI: 1.15-3.95) were associated with CSF. In addition, older age, higher body mass index, larger waist circumference, prediabetes/diabetes, and lower income were each independently associated with CSF.</p><p><strong>Conclusions: </strong>Our study highlights a shift in SLDs in the United States during the COVID-19 pandemic, showing a decrease in MASLD and increases in MetALD and ALD, with an alarming increase in the prevalence of CSF, likely reflecting lifestyle changes, including physical inactivity and alcohol consumption.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"9 9","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412732/pdf/","citationCount":"0","resultStr":"{\"title\":\"Changing landscape of steatotic liver diseases and liver fibrosis in the United States during the COVID-19 pandemic.\",\"authors\":\"Abdelrahman M Attia, Mohammad Saeid Rezaee-Zavareh, Yee Hui Yeo, Minsun Kwak, Hyunseok Kim, Mazen Noureddin, Ju Dong Yang\",\"doi\":\"10.1097/HC9.0000000000000806\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Steatotic liver diseases (SLDs) and their subcategories-metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD), and alcohol-associated liver disease (ALD)-significantly contribute to liver-related and extrahepatic morbidity and mortality. This project aimed to assess the landscape of SLDs and clinically significant fibrosis (CSF) before (2017-2020) and during (2021-2023) the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using National Health and Nutrition Examination Survey (NHANES) data, we analyzed 8965 prepandemic and 6337 pandemic participants aged ≥18 years. The main evaluated outcomes were changes in age-adjusted mean CSF, mean controlled attenuation parameter score, and age-adjusted prevalence of MASLD, MetALD, and ALD before and during the pandemic.</p><p><strong>Results: </strong>The age-adjusted prevalence of SLDs changed significantly (p=0.003) between the prepandemic and pandemic periods. ALD prevalence rose from 0.94% to 2.27%, MetALD from 2.60% to 4.42%, while MASLD declined from 30.13% to 25.46%. Vigorous and moderate physical activity decreased significantly (p<0.001), whereas moderate/excessive alcohol intake increased (p<0.001). The prevalence of CSF increased from 8.3% to 10.5% (p=0.028). Multivariable analyses showed the COVID-19 pandemic (adjusted OR: 1.47, 95% CI: 1.00-2.17) and moderate/excessive alcohol intake (adjusted OR: 2.13, 95% CI: 1.15-3.95) were associated with CSF. In addition, older age, higher body mass index, larger waist circumference, prediabetes/diabetes, and lower income were each independently associated with CSF.</p><p><strong>Conclusions: </strong>Our study highlights a shift in SLDs in the United States during the COVID-19 pandemic, showing a decrease in MASLD and increases in MetALD and ALD, with an alarming increase in the prevalence of CSF, likely reflecting lifestyle changes, including physical inactivity and alcohol consumption.</p>\",\"PeriodicalId\":12978,\"journal\":{\"name\":\"Hepatology Communications\",\"volume\":\"9 9\",\"pages\":\"\"},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412732/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hepatology Communications\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/HC9.0000000000000806\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hepatology Communications","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HC9.0000000000000806","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Changing landscape of steatotic liver diseases and liver fibrosis in the United States during the COVID-19 pandemic.
Background: Steatotic liver diseases (SLDs) and their subcategories-metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD), and alcohol-associated liver disease (ALD)-significantly contribute to liver-related and extrahepatic morbidity and mortality. This project aimed to assess the landscape of SLDs and clinically significant fibrosis (CSF) before (2017-2020) and during (2021-2023) the COVID-19 pandemic.
Methods: Using National Health and Nutrition Examination Survey (NHANES) data, we analyzed 8965 prepandemic and 6337 pandemic participants aged ≥18 years. The main evaluated outcomes were changes in age-adjusted mean CSF, mean controlled attenuation parameter score, and age-adjusted prevalence of MASLD, MetALD, and ALD before and during the pandemic.
Results: The age-adjusted prevalence of SLDs changed significantly (p=0.003) between the prepandemic and pandemic periods. ALD prevalence rose from 0.94% to 2.27%, MetALD from 2.60% to 4.42%, while MASLD declined from 30.13% to 25.46%. Vigorous and moderate physical activity decreased significantly (p<0.001), whereas moderate/excessive alcohol intake increased (p<0.001). The prevalence of CSF increased from 8.3% to 10.5% (p=0.028). Multivariable analyses showed the COVID-19 pandemic (adjusted OR: 1.47, 95% CI: 1.00-2.17) and moderate/excessive alcohol intake (adjusted OR: 2.13, 95% CI: 1.15-3.95) were associated with CSF. In addition, older age, higher body mass index, larger waist circumference, prediabetes/diabetes, and lower income were each independently associated with CSF.
Conclusions: Our study highlights a shift in SLDs in the United States during the COVID-19 pandemic, showing a decrease in MASLD and increases in MetALD and ALD, with an alarming increase in the prevalence of CSF, likely reflecting lifestyle changes, including physical inactivity and alcohol consumption.
期刊介绍：
Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction.
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