Analysis of lean metabolic-associated fatty liver disease among young and middle-aged people and its risk factors

doi:10.3969/j.issn.1004-583X.2025.02.005

Abstract

Abstract:

Objective To explore the metabolic-associated fatty liver disease (MAFLD) in young and middle-aged people and its risk factors. Methods From January 2022 to December 2023, clinical data of 16 173 young and middle-aged people receiving physical examinations in the Health Management Center of Nanchong Central Hospital were collected. Lean MAFLD and risk factors in them were analyzed. Results All lean MAFLD patients were male, and most of them aged 45-59 years with a body mass index (BMI) ranging from 20-23 kg/m². There were significant differences in age, gender, BMI, blood pressure, fasting plasma glucose (FPG), blood lipids and blood uric acid (UA) between the two groups (P<0.05). The detection rate of abnormal glucose metabolism in the lean MAFLD group was 12.5%, which was significantly higher than that in the lean non-MAFLD group (P<0.001). The detection rates of abnormal lipid metabolism, hypertriglyceridemia, low high density lipoprotein and mixed hyperlipidemia were 62.8%, 33.7%, 17.6% and 18.4%, respectively, which were significantly higher than those in the lean non-MAFLD group (P<0.001). Hypercholesterolemia was detected in 7.4% of lean MAFLD, which was significantly lower than that in lean non-MAFLD group (P<0.001). The detection rate of UA metabolic abnormalities was 26.9%, which was significantly higher than that of lean non-MAFLD group (P<0.001). Multivariate logistic regression analysis showed that gender, age, BMI, hypertension, abnormal glucose metabolism, triglyceride (TG), mixed hyperlipidemia, high-density lipoprotein cholesterol (HDL-C) and hyperuricemia were the independent risk factors of lean MAFLD. Conclusion Interventions on the related risk factors should be conducted as early as possible. Strengthening the early health education for the physical examination population, and taking measures against the risk factors of MAFLD are expected to reduce the incidence of MAFLD.

Key words: non-alcoholic fatty liver disease, risk factors, cross-sectional study

CLC Number:

R575.5

Tong Mingxia, Chen Ke, Xiang Xiaocong, Zhou Lifeng. Analysis of lean metabolic-associated fatty liver disease among young and middle-aged people and its risk factors[J]. Clinical Focus, 2025, 40(2): 128-132.

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https://lchc.magtechjournal.com/EN/Y2025/V40/I2/128

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References 28

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组别	例数	性别[例(%)]				年龄[例(%)]				BMI[例(%)]
组别	例数	男		女		18~44岁		45~59岁		<18 kg/m²		18~<20 kg/m²		20~<23 kg/m²
瘦型非MAFLD组	15 484	4 424(28.6)		11 060(71.4)		9 065(58.5)		6 419(41.5)		603(3.9)		2 981(19.2)		11 900(76.9)
瘦型MAFLD组	689	689(100.0)		0		271(39.3)		418(60.7)		2(0.3)		29(4.2)		658(95.5)
χ²值		1 553.402				99.772				132.652
P值		<0.001				<0.001				<0.001
组别	收缩压 (mmHg)		舒张压 (mmHg)		FPG (mmol/L)		TC (mmol/L)		TG (mmol/L)		HDL-C (mmol/L)		LDL-C (mmol/L)	血UA (μmol/L)
瘦型非MAFLD组	117.85±14.92		72.21±10.27		4.85±0.92		4.89±0.94		1.12±0.72		1.55±0.35		2.72±0.77	286.78±73.20
瘦型MAFLD组	126.97±15.80		79.80±10.69		5.69±2.41		5.26±1.08		2.26±2.08		1.26±0.32		3.24±0.83	371.51±79.18
t值	-15.672		-18.960		-21.152		-9.975		-35.750		21.862		-17.419	-29.622
P值	<0.001		<0.001		<0.001		<0.001		<0.001		<0.001		<0.001	<0.001

组别	例数	性别[例(%)]				年龄[例(%)]				BMI[例(%)]
组别	例数	男		女		18~44岁		45~59岁		<18 kg/m²		18~<20 kg/m²		20~<23 kg/m²
瘦型非MAFLD组	15 484	4 424(28.6)		11 060(71.4)		9 065(58.5)		6 419(41.5)		603(3.9)		2 981(19.2)		11 900(76.9)
瘦型MAFLD组	689	689(100.0)		0		271(39.3)		418(60.7)		2(0.3)		29(4.2)		658(95.5)
χ²值		1 553.402				99.772				132.652
P值		<0.001				<0.001				<0.001
组别	收缩压 (mmHg)		舒张压 (mmHg)		FPG (mmol/L)		TC (mmol/L)		TG (mmol/L)		HDL-C (mmol/L)		LDL-C (mmol/L)	血UA (μmol/L)
瘦型非MAFLD组	117.85±14.92		72.21±10.27		4.85±0.92		4.89±0.94		1.12±0.72		1.55±0.35		2.72±0.77	286.78±73.20
瘦型MAFLD组	126.97±15.80		79.80±10.69		5.69±2.41		5.26±1.08		2.26±2.08		1.26±0.32		3.24±0.83	371.51±79.18
t值	-15.672		-18.960		-21.152		-9.975		-35.750		21.862		-17.419	-29.622
P值	<0.001		<0.001		<0.001		<0.001		<0.001		<0.001		<0.001	<0.001

组别	例数	血压			糖代谢异常	高胆固醇血症	高甘油三酯血症	混合型高脂血症	低高密度脂蛋白血症	高尿酸血症
组别	例数	正常	高血压病	血压高值	糖代谢异常	高胆固醇血症	高甘油三酯血症	混合型高脂血症	低高密度脂蛋白血症	高尿酸血症
瘦型非MAFLD组	15 484	9 179(59.3)	1 552(10.0)	4 753(30.7)	233(1.5)	2 019(13.0)	1 142(7.4)	711(4.6)	523(3.4)	1 209(7.8)
瘦型MAFLD组	689	219(31.8)	170(24.7)	300(43.5)	86(12.5)	51(7.4)	232(33.7)	127(18.4)	121(17.6)	185(26.9)
χ²值		253.626			411.090	18.782	586.779	257.205	347.105	303.690
P值		<0.001			<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	血压			糖代谢异常	高胆固醇血症	高甘油三酯血症	混合型高脂血症	低高密度脂蛋白血症	高尿酸血症
组别	例数	正常	高血压病	血压高值	糖代谢异常	高胆固醇血症	高甘油三酯血症	混合型高脂血症	低高密度脂蛋白血症	高尿酸血症
瘦型非MAFLD组	15 484	9 179(59.3)	1 552(10.0)	4 753(30.7)	233(1.5)	2 019(13.0)	1 142(7.4)	711(4.6)	523(3.4)	1 209(7.8)
瘦型MAFLD组	689	219(31.8)	170(24.7)	300(43.5)	86(12.5)	51(7.4)	232(33.7)	127(18.4)	121(17.6)	185(26.9)
χ²值		253.626			411.090	18.782	586.779	257.205	347.105	303.690
P值		<0.001			<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

因素	回归系数	标准误	Waldχ²值	P值	OR值	95%CI
因素	回归系数	标准误	Waldχ²值	P值	OR值	下限	上限
性别(女)	-19.168	267.626	0.005	<0.001	0	0	0
年龄(45~59岁)	0.323	0.093	11.954	<0.001	1.381	1.150	1.658
18 kg/m²≤BMI<20 kg/m²	0.934	0.742	1.585	0.208	2.544	0.746	15.944
20 kg/m²≤BMI<23 kg/m²	2.069	0.717	8.319	0.004	7.920	2.490	48.231
高血压病	0.432	0.122	12.509	<0.001	1.540	1.211	1.955
糖代谢异常	0.965	0.159	36.984	<0.001	2.624	1.918	3.574
脂代谢异常	0.131	0.283	0.215	0.643	1.140	0.644	1.960
高TC	0.251	0.088	8.187	0.004	1.285	1.082	1.527
高TG	1.073	0.265	16.396	<0.001	2.924	1.765	5.005
混合型高脂血症	1.082	0.287	14.200	<0.001	2.950	1.700	5.256
低HDL-C	0.318	0.153	4.323	0.038	1.374	1.016	1.850
高尿酸血症	0.485	0.103	22.185	<0.001	1.624	1.325	1.985