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MAFLD Criteria May Overlook a Subtype of Patient with Steatohepatitis and Significant Fibrosis
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy ( IF 2.8 ) Pub Date : 2021-07-27 , DOI: 10.2147/dmso.s316096 Jiaofeng Huang 1 , Wenjuan Xue 2 , Mingfang Wang 1 , Yinlian Wu 1 , Medha Singh 3 , Yueyong Zhu 1, 4 , Rahul Kumar 5 , Su Lin 1
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy ( IF 2.8 ) Pub Date : 2021-07-27 , DOI: 10.2147/dmso.s316096 Jiaofeng Huang 1 , Wenjuan Xue 2 , Mingfang Wang 1 , Yinlian Wu 1 , Medha Singh 3 , Yueyong Zhu 1, 4 , Rahul Kumar 5 , Su Lin 1
Affiliation
Introduction: Metabolic associated fatty liver disease (MAFLD) is a novel concept for fatty liver disease. Different from non-alcoholic fatty liver disease (NAFLD), the diagnosis of MAFLD requires the presence of metabolic risks. This study aimed to characterize patients with liver steatosis but without metabolic risks (non-MR-steatosis) which may not be diagnosed by MAFLD criteria.
Methods: Consecutive patients who underwent biopsy were included in this study. The clinic-pathological characteristics of non-MR-steatosis, NAFLD and MAFLD were compared.
Results: A total of 1217 cases were included. There were 426 (35.00%) cases with MAFLD, 585 (48.07%) with NAFLD and 168 (13.80%) with non-MR-steatosis. The majority of the cases were infected with HBV (93.26%). The age and metabolic profiles were highest in MAFLD and lowest in non-MR-steatosis. The body mass index (BMI) level was also lowest in non-MR-steatosis (20.78 ± 1.54 kg/m2). The ALT and AST levels of the non-MR-steatosis group were not statistically different from those of MAFLD or NAFLD groups (p > 0.05). Histologically, there was no significant difference in the degrees of inflammation and fibrosis among the three groups. The severity of steatosis in non-MR-steatosis group was lower than MAFLD or NAFLD groups (p < 0.05). These results were consistent in both HBV and non-HBV subgroups.
Conclusion: MAFLD criteria may overlook some steatotic patients without metabolic risks, who may also have steatohepatitis and significant fibrosis.
Keywords: metabolic associated fatty liver disease, nonalcoholic fatty liver disease, metabolic risks, lean NAFLD, biopsy
中文翻译：
MAFLD 标准可能忽视脂肪性肝炎和严重纤维化患者的亚型
简介：代谢相关脂肪肝病（MAFLD）是脂肪肝病的一个新概念。与非酒精性脂肪性肝病（NAFLD）不同，MAFLD 的诊断需要存在代谢风险。本研究旨在表征患有肝脏脂肪变性但无代谢风险（非 MR 脂肪变性）的患者，这些患者可能无法通过 MAFLD 标准进行诊断。
方法：本研究纳入连续接受活检的患者。比较非MR脂肪变性、NAFLD和MAFLD的临床病理特征。
结果：共纳入1217例。其中MAFLD 426 例（35.00%），NAFLD 585 例（48.07%），非MR 脂肪变性168 例（13.80%）。大多数病例感染了乙型肝炎病毒（93.26%）。 MAFLD 的年龄和代谢特征最高，非 MR 脂肪变性的年龄和代谢特征最低。非 MR 脂肪变性患者的体重指数 (BMI) 水平也最低 (20.78 ± 1.54 kg/m 2 )。非 MR 脂肪变性组的 ALT 和 AST 水平与 MAFLD 或 NAFLD 组没有统计学差异 (p > 0.05)。组织学上，三组炎症和纤维化程度无显着差异。非 MR 脂肪变性组的脂肪变性严重程度低于 MAFLD 或 NAFLD 组 (p < 0.05)。这些结果在 HBV 和非 HBV 亚组中都是一致的。
结论： MAFLD标准可能会忽视一些没有代谢风险的脂肪变性患者，这些患者也可能患有脂肪性肝炎和明显的纤维化。
关键词：代谢相关性脂肪肝、非酒精性脂肪肝、代谢风险、瘦 NAFLD、活检
更新日期：2021-07-27
Methods: Consecutive patients who underwent biopsy were included in this study. The clinic-pathological characteristics of non-MR-steatosis, NAFLD and MAFLD were compared.
Results: A total of 1217 cases were included. There were 426 (35.00%) cases with MAFLD, 585 (48.07%) with NAFLD and 168 (13.80%) with non-MR-steatosis. The majority of the cases were infected with HBV (93.26%). The age and metabolic profiles were highest in MAFLD and lowest in non-MR-steatosis. The body mass index (BMI) level was also lowest in non-MR-steatosis (20.78 ± 1.54 kg/m2). The ALT and AST levels of the non-MR-steatosis group were not statistically different from those of MAFLD or NAFLD groups (p > 0.05). Histologically, there was no significant difference in the degrees of inflammation and fibrosis among the three groups. The severity of steatosis in non-MR-steatosis group was lower than MAFLD or NAFLD groups (p < 0.05). These results were consistent in both HBV and non-HBV subgroups.
Conclusion: MAFLD criteria may overlook some steatotic patients without metabolic risks, who may also have steatohepatitis and significant fibrosis.
Keywords: metabolic associated fatty liver disease, nonalcoholic fatty liver disease, metabolic risks, lean NAFLD, biopsy
中文翻译：
MAFLD 标准可能忽视脂肪性肝炎和严重纤维化患者的亚型
简介：代谢相关脂肪肝病（MAFLD）是脂肪肝病的一个新概念。与非酒精性脂肪性肝病（NAFLD）不同，MAFLD 的诊断需要存在代谢风险。本研究旨在表征患有肝脏脂肪变性但无代谢风险（非 MR 脂肪变性）的患者，这些患者可能无法通过 MAFLD 标准进行诊断。
方法：本研究纳入连续接受活检的患者。比较非MR脂肪变性、NAFLD和MAFLD的临床病理特征。
结果：共纳入1217例。其中MAFLD 426 例（35.00%），NAFLD 585 例（48.07%），非MR 脂肪变性168 例（13.80%）。大多数病例感染了乙型肝炎病毒（93.26%）。 MAFLD 的年龄和代谢特征最高，非 MR 脂肪变性的年龄和代谢特征最低。非 MR 脂肪变性患者的体重指数 (BMI) 水平也最低 (20.78 ± 1.54 kg/m 2 )。非 MR 脂肪变性组的 ALT 和 AST 水平与 MAFLD 或 NAFLD 组没有统计学差异 (p > 0.05)。组织学上，三组炎症和纤维化程度无显着差异。非 MR 脂肪变性组的脂肪变性严重程度低于 MAFLD 或 NAFLD 组 (p < 0.05)。这些结果在 HBV 和非 HBV 亚组中都是一致的。
结论： MAFLD标准可能会忽视一些没有代谢风险的脂肪变性患者，这些患者也可能患有脂肪性肝炎和明显的纤维化。
关键词：代谢相关性脂肪肝、非酒精性脂肪肝、代谢风险、瘦 NAFLD、活检
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