The Association Between Nonalcoholic Fatty Liver Disease and Metabolic Abnormalities in The United States Population.
The Association Between Nonalcoholic Fatty Liver Disease and Metabolic Abnormalities in The United States Population.
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DOI：
10.1097/mcg.0000000000000666
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发表时间：
2017-02
影响因子：
2.9
通讯作者：
Liangpunsakul S
中科院分区：
文献类型：
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作者：
Jinjuvadia R;Antaki F;Lohia P;Liangpunsakul S
需要更好地了解美国人口中代谢综合征 (MetS) 及其个体代谢异常患者中非酒精性脂肪肝 (NAFLD) 的患病率和晚期纤维化的发生率。我们的目标是通过使用大型美国人口数据库——第三次全国健康和营养检查调查 (NHANES III) 来研究这些问题。我们的研究队列共有 11,674 人。 NAFLD 的定义是，在没有病毒性肝炎、大量饮酒、转铁蛋白水平升高和使用导致肝脂肪变性的药物的情况下，肝脏超声显示存在中度至重度肝脂肪变性。使用非侵入性方法（NAFLD 纤维化评分）确定 NAFLD 患者的晚期纤维化情况。 MetS 的定义基于国家胆固醇教育计划成人治疗小组 III 的定义。纳入研究队列中 NAFLD 的患病率为 18.2%（95% CI 16.5–19.9）。代谢异常的个体患病率较高（MetS：43.2％，腰围增加：31.2％，空腹血糖受损/糖尿病：41.2％，高甘油三酯水平：34.7％，低HDL：27.8％，高血压：29.2％）。与对照组相比，MetS 患者的 NAFLD 患病率显着更高（aOR：11.5，95% CI 8.9-14.7）。还注意到肝脏脂肪变性的严重程度随着代谢异常数量的增加而增加。在个体代谢异常中，腰围增加、空腹血糖受损/糖尿病、高甘油三酯和低高密度脂蛋白水平被发现与 NAFLD 独立相关。空腹血糖受损/糖尿病患者和有五种代谢异常的患者晚期纤维化发生率较高（分别为 18.6% 和 30.3%）。在没有任何代谢异常的个体中，NAFLD 的患病率为 6.1%。在代谢异常的个体中，NAFLD 的患病率和晚期纤维化的发生率显着较高。
Prevalence of nonalcoholic fatty liver disease (NAFLD) and rate of advanced fibrosis among individuals with metabolic syndrome (MetS) and its individual metabolic abnormalities needs better understanding in the United States population. We aim to study these by using a large United States population database, the Third National Health and Nutrition Examination Survey (NHANES III). A total of 11,674 individuals were included in our study cohort. NAFLD was defined as presence of moderate to severe hepatic steatosis on liver ultrasound in absence of viral hepatitis, significant alcohol use, elevated transferrin level and medication use leading to hepatic steatosis. Advanced fibrosis among those with NAFLD was determined using noninvasive method, the NAFLD Fibrosis Score. MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III definition. The prevalence of NAFLD among included study cohort was 18.2% (95% CI 16.5–19.9). Individuals with metabolic abnormalities demonstrated higher prevalence (MetS: 43.2%, increased waist circumference: 31.2%, impaired fasting glucose/diabetes: 41.2%, high triglyceride level: 34.7%, low HDL: 27.8%, high blood pressure: 29.2%). The individuals with MetS had significantly higher NAFLD prevalence compared to controls (aOR: 11.5, 95% CI 8.9–14.7). The severity of hepatic steatosis was also noted to increase with higher number of metabolic abnormalities. Among individual metabolic abnormalities, increased waist circumference, impaired fasting glucose/diabetes, high triglyceride and low HDL levels were found to be independently associated with NAFLD. Individuals with impaired fasting glucose/diabetes and those with five metabolic abnormalities had higher rate of advanced fibrosis (18.6% and 30.3% respectively). Prevalence of NAFLD among individuals without any metabolic abnormality was 6.1%. Prevalence of NAFLD and rate of advanced fibrosis are significantly high among individuals with metabolic abnormalities.