Epidemiology and Clinical Outcomes of Metabolic (Dysfunction)-associated Fatty Liver Disease

Lin, Huapeng; Zhang, Xinrong; Li, Guanlin; Wong, Grace Lai–Hung; Wong, Vincent Wai‐Sun

doi:10.14218/jcth.2021.00201

Cited by 33 publications

(26 citation statements)

References 118 publications

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“…As one of the metabolic disorders, metabolic dysfunction-associated fatty liver disease (MAFLD), formerly named non-alcoholic fatty liver disease (NAFLD), is referred to as the “hepatic manifestation of the metabolic syndrome” and causes a progressive liver disease group including steatosis, fibrosis, cirrhosis, and hepatocellular carcinoma ( 5 ). MAFLD is centered on hepatic fat accumulation and comorbid with obesity, T2DM, or evidence of metabolic dysregulation, with a prevalence of 25.9%–38.0% in the general population ( 6 ). Moreover, a recent meta-analysis estimated that T2DM patients had a higher risk developing MAFLD than the general population, with a prevalence of 55.5%–70% ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

Wang

Jin

et al. 2022

Front. Endocrinol.

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AimsThere is still a debate about the relationship between serum iron and metabolic dysfunction-associated fatty liver disease (MAFLD). Furthermore, few relevant studies were conducted in type 2 diabetes mellitus (T2DM). Therefore, this study aimed to explore the association of serum iron levels with MAFLD in Chinese patients with T2DM.MethodsThis cross-sectional, real-world study consisted of 1,467 Chinese T2DM patients. MAFLD was diagnosed by abdominal ultrasonography. Based on serum iron quartiles, the patients were classified into four groups. Clinical characteristics were compared among the four groups, and binary logistic analyses were used to assess the associations of serum iron levels and quartiles with the presence of MAFLD in T2DM.ResultsAfter adjusting for gender, age, and diabetes duration, significantly higher prevalence of MAFLD was found in the second (45.7%), third (45.2%), and fourth (47.0%) serum iron quartiles than in the first quartiles (26.8%), with the highest MAFLD prevalence in the fourth quartile (p < 0.001 for trend). Moreover, increased HOMA2-IR (p = 0.003 for trend) and decreased HOMA2-S (p = 0.003 for trend) were observed across the serum iron quartiles. Fully adjusted binary logistic regression analyses indicated that both increased serum iron levels (OR: 1.725, 95% CI: 1.427 to 2.085, p < 0.001) and quartiles (p < 0.001 for trend) were still closely associated with the presence of MAFLD in T2DM patients even after controlling for multiple confounding factors.ConclusionsThere is a positive correlation between the presence of MAFLD and serum iron levels in T2DM patients, which may be attributed to the close association between serum iron and insulin resistance. Serum iron levels may act as one of the indicators for evaluating the risk of MAFLD in T2DM individuals.

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Section: Introductionmentioning

confidence: 99%

Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

Wang

Jin

et al. 2022

Front. Endocrinol.

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“…The main complication causing death in patients with MAFLD is CVD. However, liver-related complications are more common in patients with advanced fibrosis or cirrhosis and account for the majority of deaths ( Lin et al, 2021 ). The currently widely accepted treatment recommendations for MAFLD are lifestyle changes aimed at weight loss, and there are no drugs approved for the therapy of MAFLD at this stage ( Eslam et al, 2020b ; Fouad et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Integrative analysis of gut microbiota and fecal metabolites in metabolic associated fatty liver disease patients

Lin-de

Dai

et al. 2022

Front. Microbiol.

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ObjectiveMetabolic associated fatty liver disease (MAFLD) affects nearly a quarter of the world’s population. Our study aimed to characterize the gut microbiome and overall changes in the fecal and serum metabolomes in MAFLD patients.MethodsThirty-two patients diagnosed with MAFLD and 30 healthy individuals (control group, CG) were included in this study, the basic clinical characteristics and laboratory test results including routine biochemistry, etc. were recorded for all, and their serum and fecal samples were collected. A portion of the fecal samples was subjected to 16S rDNA sequencing, and the other portion of the fecal samples and serum samples were subjected to non-targeted metabolomic detection based on liquid chromatography-mass spectrometry (LC–MS). Statistical analysis of clinical data was performed using SPSS software package version 25.0 (SPSS Inc., Chicago, IL, United States). The analysis of 16S rDNA sequencing results was mainly performed by R software (V. 2.15.3), and the metabolomics data analysis was mainly performed by CD 3.1 software. Two-tailed p value < 0.05 was considered statistically significant.ResultsThe 16S sequencing data suggested that the species richness and diversity of MAFLD patients were reduced compared with controls. At the phylum level, the relative abundance of Bacteroidota, Pseudomonadota, and Fusobacteriota increased and Bacillota decreased in MAFLD patients. At the genus level, the relative abundances of Prevotella, Bacteroides, Escherichia-Shigella, etc. increased. 2,770 metabolites were detected in stool samples and 1,245 metabolites were detected in serum samples. The proportion of differential lipid metabolites in serum (49%) was higher than that in feces (21%). There were 22 differential metabolites shared in feces and serum. And the association analysis indicated that LPC 18:0 was positively correlated with Christensenellaceae_R-7_group, Oscillospiraceae_UCG-002; neohesperidin was also positively correlated with Peptoniphilus, Phycicoccus, and Stomatobaculum.ConclusionMicrobial sequencing data suggested decreased species richness and diversity and altered β-diversity in feces. Metabolomic analysis identified overall changes in fecal and serum metabolites dominated by lipid molecules. And the association analysis with gut microbes provided potentially pivotal gut microbiota-metabolite combinations in MAFLD patients, which might provide new clues for further research on the disease mechanism and the development of new diagnostic markers and treatments.

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“…MAFLD not only increases the risk of liver-related complications (cirrhosis or hepatocellular carcinoma), but also affects the risk of cardiovascular disease, type 2 diabetes mellitus, and other extrahepatic diseases. 17 The definition of MAFLD does not clearly identify the risk of liver fibrosis or other histological features. 16 However, in a population based, cross-sectional study, MAFLD criteria were superior to the old NAFLD criteria for identifying patients with high liver stiffness measured by transient elastography.…”

mentioning

confidence: 99%

Metabolic Syndrome: A Warning Sign of Liver Fibrosis

Seo

2022

Journal of Obesity & Metabolic Syndrome

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Epidemiology and Clinical Outcomes of Metabolic (Dysfunction)-associated Fatty Liver Disease

Cited by 33 publications

References 118 publications

Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study

Integrative analysis of gut microbiota and fecal metabolites in metabolic associated fatty liver disease patients

Metabolic Syndrome: A Warning Sign of Liver Fibrosis

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