Shift in prevalence and systemic inflammation levels from NAFLD to MAFLD: a population-based cross-sectional study

Abstract

Background The difference in prevalence and systemic inflammatory (SI) status from non-alcoholic fatty liver disease (NAFLD) to newly defined metabolic dysfunction-associated fatty liver disease (MAFLD) was less reported. Therefore, we estimated the prevalence and summarized the systemic inflammation levels of MAFLD and NAFLD in a general population from Southern China to explore the potential effect of the transformation of disease definition. Methods In total, 6718 subjects aged 35–74 years old from a general population cohort were enrolled. Logistic regression and restricted cubic spline (RCS) models were used to examine the relationship between 15 SI indicators and NAFLD and MAFLD. The receiver operating characteristic (ROC) curve was used to investigate their predictive value for MAFLD and NAFLD. Results The prevalence of MAFLD and NAFLD was 34.7% and 32.4%, respectively. Their overlapping rate was 89.7%, while only 8.3% and 1.9% of participants were MAFLD-only and NAFLD-only. Among three FLD groups, the MAFLD-only group had the highest levels of 8 SI indicators. The non-FLD group had the lower levels of all 15 SI indicators compared with all FLD subgroups. The odds ratios (ORs) of 10 SI indicators were significant in both multivariable-adjusted logistic regression and RCS analyses of MAFLD or NAFLD. ROC analysis showed that the AUC values of all SI were lower than 0.7 in both MAFLD and NAFLD. Conclusions MAFLD could cover more FLD than NAFLD, and the MAFLD-only group had a more severe inflammation status, whereas the NAFLD-only exhibited lower levels.