Prevalence of Nonalcoholic Fatty Liver Disease in the United States: The Third National Health and Nutrition Examination Survey, 1988-1994
Prevalence of Nonalcoholic Fatty Liver Disease in the United States: The Third National Health and Nutrition Examination Survey, 1988-1994
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DOI：
10.1093/aje/kws448
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发表时间：
2013-07-01
影响因子：
5
通讯作者：
Clark, Jeanne M.
中科院分区：
文献类型：
--
作者：
Lazo, Mariana;Hernaez, Ruben;Clark, Jeanne M.
先前对美国人群中非酒精性脂肪性肝病（NAFLD）患病率的估计依赖于肝酶的测量，可能低估了这种疾病的负担。我们使用了12454名成年人的超声数据，这些成年人参加了1988年至1994年在美国进行的第三次全国健康和营养检查调查。我们将NAFLD定义为在没有酒精摄入升高的情况下，超声检查显示肝脏脂肪变性。在美国人群中，肝脂肪变性和NAFLD的患病率分别为21.4%和19.0%，相当于全国估计有32.5万（95%可信区间：299,3500）万成人肝脂肪变性和28.8万（95%可信区间：2660,3120）万成人NAFLD。在调整了年龄、收入、受教育程度、体重指数(体重(kg)/身高（m)(2)）和糖尿病状况后，NAFLD在墨西哥裔美国人中（24.1%）比非西班牙裔白人（17.8%）和非西班牙裔黑人（13.5%）更常见（P = 0.001），在男性中（20.2%）比女性（15.8%）更常见（P < 0.001）。肝脂肪变性和NAFLD也与糖尿病、无糖尿病人群的胰岛素抵抗、血脂异常和肥胖独立相关。我们的研究结果扩展了之前对美国人口中NAFLD患病率的全国估计，并强调了这种疾病的负担。男性、墨西哥裔美国人、糖尿病和肥胖症患者是受影响最大的群体。
Previous estimates of the prevalence of nonalcoholic fatty liver disease (NAFLD) in the US population relied on measures of liver enzymes, potentially underestimating the burden of this disease. We used ultrasonography data from 12,454 adults who participated in the Third National Health and Nutrition Examination Survey, conducted in the United States from 1988 to 1994. We defined NAFLD as the presence of hepatic steatosis on ultrasonography in the absence of elevated alcohol consumption. In the US population, the rates of prevalence of hepatic steatosis and NAFLD were 21.4% and 19.0%, respectively, corresponding to estimates of 32.5 (95% confidence interval: 29.9, 35.0) million adults with hepatic steatosis and 28.8 (95% confidence interval: 26.6, 31.2) million adults with NAFLD nationwide. After adjustment for age, income, education, body mass index (weight (kg)/height (m)(2)), and diabetes status, NAFLD was more common in Mexican Americans (24.1%) compared with non-Hispanic whites (17.8%) and non-Hispanic blacks (13.5%) (P = 0.001) and in men (20.2%) compared with women (15.8%) (P < 0.001). Hepatic steatosis and NAFLD were also independently associated with diabetes, with insulin resistance among people without diabetes, with dyslipidemia, and with obesity. Our results extend previous national estimates of the prevalence of NAFLD in the US population and highlight the burden of this disease. Men, Mexican Americans, and people with diabetes and obesity are the most affected groups.