Gender-specific prevalence of metabolic-associated fatty liver disease among government employees in Tianjin, China: a cross-sectional study

Huang, Ya‐Ping; Shi, Z.; Zhang, Minying; Wang, Yi; Wang, Wenhong; Li, Jing; Li, Chunjun; Lin, Jin Ding

doi:10.1136/bmjopen-2021-056260

Cited by 11 publications

(10 citation statements)

References 38 publications

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“…Previous studies noted that women over the age of 60 had a higher prevalence of MAFLD than men, possibly influenced by menopause in women ( 30 , 31 ). Moreover, the peak prevalence of MAFLD was between the ages of 18 and 50 in other studies, which supported our suggestion that middle-aged people were more likely to develop MAFLD compared with older people ( 32 , 33 ). Possible reasons for a higher MAFLD prevalence in younger patients were as follows: middle-aged people were more susceptible to sedentary lifestyles, obesity, and stressful socioeconomic status, which increased MAFLD risk; elderly patients experienced an increased overall mortality partially caused by fatty liver; and the deceased patients were excluded from the MAFLD population ( 34 , 35 ).…”

Section: Discussionsupporting

confidence: 91%

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: Discussionsupporting

confidence: 91%

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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“…Moreover, the peak MAFLD prevalence occurred earlier in males (approximately 51 years of age) than in females (approximately 66 years of age). This finding has also been reported ( 49 – 51 ). Potential reasons for the high prevalence in middle-aged males include sociocultural issues, life stress, and alcohol consumption in middle age.…”

Section: Discussionsupporting

confidence: 89%

The prevalence of MAFLD and its association with atrial fibrillation in a nationwide health check-up population in China

et al. 2022

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Background and aimsThe epidemiological characteristics of MAFLD and its relationship with atrial fibrillation (AF) are limited in China. Therefore, we explored the epidemiological characteristics of MAFLD from adults along with the association of MAFLD and 12-ECG diagnosed AF in a nationwide population from health check-up centers.MethodsThis observational study used cross-sectional and longitudinal studies with 2,083,984 subjects from 2009 to 2017. Age-, sex-, and regional-standardized prevalence of MAFLD was estimated. Latent class analysis (LCA) was used to identify subclusters of MAFLD. Multivariable logistic regression and mixed-effects Cox regression models were used to analyze the relationship between MAFLD and AF.ResultsThe prevalence of MAFLD increased from 22.75% to 35.58% during the study period, with higher rates in males and populations with high BMI or resided in northern regions. The MAFLD population was clustered into three classes with different metabolic features by LCA. Notably, a high proportion of MAFLD patients in all clusters had overweight and prediabetes or diabetes. The MAFLD was significantly associated with a higher risk of AF in the cross-sectional study and in the longitudinal study. In addition, the coexistence of prediabetes or diabetes had the largest impact on subsequent AF.ConclusionOur findings suggested a high prevalence of MAFLD and a high prevalence of other metabolic diseases in the MAFLD population, particularly overweight and glucose dysregulation. Moreover, MAFLD was associated with a significantly higher risk for existing and subsequent subclinical AF in the Chinese population.

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“…For some high-risk populations such as employed adults with frequently irregular lifestyles and shift work [ 3 , 4 ], the MAFLD is of concern. As is reported, the prevalence of MAFLD in employed adults is around 40% in China [ 5 – 7 ]. Stacks of evidence suggested that MAFLD is closely associated with poor health consequences, such as cirrhosis and hepatocellular carcinoma [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 98%

Comparison of the prognostic value of a comprehensive set of predictors in identifying risk of metabolic-associated fatty liver disease among employed adults

Yang

Wang

et al. 2023

BMC Public Health

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Objective Metabolic-associated fatty liver disease (MAFLD) is of concern in employed adults, while the crucial indicators in predicting MAFLD are understudied in this population. We aimed to investigate and compare the prediction performance of a set of indicators for MAFLD in employed adults. Methods A cross-sectional study recruiting 7968 employed adults was conducted in southwest China. MAFLD was assessed by abdominal ultrasonography and physical examination. Comprehensive indicators of demographics, anthropometric, lifestyle, psychological, and biochemical indicators were collected by questionnaire or physical examination. All indicators were evaluated for importance in predicting MAFLD by random forest. A prognostic model based on multivariate regression model was constructed to obtain a prognostic index. All indicators and prognostic index were compared to evaluate their prediction performance in predicting MAFLD by the receiver operating characteristic (ROC) curve, calibration plot, and Decision curve analysis (DCA). Results Triglyceride Glucose-Body Mass Index (TyG-BMI), BMI, TyG, triglyceride (TG)/high-density lipoprotein-cholesterol (HDL-C), and TG ranked the top five important indicators, and TyG-BMI performed the most accurate prediction of MAFLD according to the ROC curve, calibration plot and DCA. The area under the ROC curves (AUCs) of the five indicators were all over 0.7, with TyG-BMI (cut-off value: 218.284, sensitivity: 81.7%, specificity: 78.3%) suggesting the most sensitive and specific indicator. All five indicators showed higher prediction performance and net benefit than the prognostic model. Conclusion This epidemiological study firstly compared a set of indicators to evaluate their prediction performance in predicting MAFLD risk among employed adults. Intervention targeting powerful predictors can be helpful to reduce the MAFLD risk among employed adults.

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Gender-specific prevalence of metabolic-associated fatty liver disease among government employees in Tianjin, China: a cross-sectional study

Cited by 11 publications

References 38 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

The prevalence of MAFLD and its association with atrial fibrillation in a nationwide health check-up population in China

Comparison of the prognostic value of a comprehensive set of predictors in identifying risk of metabolic-associated fatty liver disease among employed adults

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