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

Lei, Fang; Qin, Jianghui; Song, Xiaohui; Liu, Ye-Mao; Chen, Mingming; Sun, Tao; Huang, Xuewei; Deng, Ke‐Qiong; Zuo, Xiuran; Yao, Dongai; Xu, Lijuan; Lü, Hongyan; Wang, Gang; Liu, Feng; Chen, Lidong; Luo, Jie; Xia, Jiahong; Wang, Lin; Yang, QiongYu; Zhang, Peng; Ji, Yan‐Xiao; Zhang, Xiaojing; She, Zhi‐Gang; Zeng, Qiang; Li, Hongliang; Cai, Jingjing

doi:10.3389/fendo.2022.1007171

Cited by 18 publications

(14 citation statements)

References 65 publications

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“…They could supply more messages about the associations between resistance to THs and MAFLD occurrence. Our results revealed that MAFLD prevalence was 34.47% in the euthyroid 6 This research showed that the MAFLD group was characterized by higher TT3RI, TFQI FT3 and FT3/FT4 levels in comparison with the non-MAFLD group. The morbidity of MAFLD raised with increasing TFQI FT3 and FT3/FT4 levels when multiple potential confounders were adjusted.…”

Section: Discussionsupporting

confidence: 54%

“…3 Accumulating evidence suggested that MAFLD patients had more significant cirrhosis and hepatic cellular cancer (HCC) compared to non-alcoholic fatty liver disease (NAFLD) patients. 4,5 Besides, numerous previous studies found that MAFLD was correlated with greater rates of overweight, 3 glucose dysregulation, 6 atrial fibrillation, 6 cardiovascular diseases (CVD) mortality 7 and all-cause mortality. 8,9 The prevalence of MAFLD has led to a continuous increase of the social medical burden.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study

Liu¹,

Xing²,

Nie³

et al. 2023

DMSO

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Thyroid hormones (THs) exert instrumental effects in regulating lipids metabolism. Whereas, research investigating the relationship between sensitivity indices to THs and metabolic dysfunction-associated fatty liver disease (MAFLD) have contradicted this. This study was designed to approach the correlation between sensitivity indices to THs and MAFLD in euthyroid subjects. Methods: An overall sample of 6356 euthyroid participants were enrolled in a Chinese hospital. Free triiodothyronine to free thyroxine ratio (FT3/FT4), thyrotropin triiodothyronine resistance index (TT3RI), thyrotropin thyroxine resistance index (TT4RI), thyroid stimulating hormone index (TSHI) and thyroid feedback quantile-based indices (TFQI FT3 and TFQI FT4 ) were collected as sensitivity indicators to THs. Participants were split into two groups based on whether they suffered with MAFLD or not. And participants were categorized into quartiles based on sensitivity indicators to THs. The effects of sensitivity indices to THs on MAFLD were analyzed using regression analysis. Bootstrap was performed to assess the mediation effect of triglyceride glucose (TyG) index on the relationship between sensitivity parameters to THs and MAFLD. Results: The incidence of MAFLD in euthyroid subjects was 34.47%. As FT3/FT4, TT3RI and TFQI FT3 levels rose, so did the MAFLD prevalence. After adjustment for confounders, logistic regression analyses indicated that the high-level FT3/FT4 and TFQI FT3 still remained risk factors for MAFLD. The relevance of FT3/FT4 and MAFLD was stronger among those whose age ≤ 40 years and had nonvisceral obesity. And the interrelation between TFQI FT3 and MAFLD was stronger in subjects whose age ≤ 40 years. Mediation analyses suggested that TyG index had a noteworthy indirect impact on the relationship between FT3/FT4, TFQI FT3 and MAFLD. Conclusion: Increased FT3/FT4 and TFQI FT3 were significantly related to MAFLD prevalence in populations with normal thyroid function. TyG index partly mediated the relevance between FT3/FT4, TFQI FT3 and MAFLD.

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study

Liu¹,

Xing²,

Nie³

et al. 2023

DMSO

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“…A meta-analysis of 19 observational studies (involving about 7 million individuals) showed that MAFLD was closely associated with increased prevalence and incidence of permanent AF, QTc interval prolongation and some cardiac conduction defects [ 61 ]. In a nationwide health check-up population in China (including more than 2 million individuals), Lei et al found that MAFLD was associated with a higher risk of having and developing permanent AF [ 62 ]. Decoin et al [ 63 ] analyzed a cohort of United States patients after AF ablation and found that advanced liver fibrosis (estimated by non-invasive fibrosis biomarkers) in those with MAFLD was associated with adverse atrial remodeling and AF recurrence following catheter ablation.…”

Section: Consensus Statements and Recommendationsmentioning

confidence: 99%

An international multidisciplinary consensus statement on MAFLD and the risk of CVD

Zhou,

Targher,

Byrne

et al. 2023

Hepatol Int

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Background Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25–30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists. Methods and results A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management. Conculsions The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research. Supplementary Information The online version contains supplementary material available at 10.1007/s12072-023-10543-8.

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“…This new term highlights the systematic metabolic disturbances that accompany fatty liver. Our previous study based on a nationwide health examination population in China showed that the prevalence of MAFLD rose rapidly from 22.8% to 35.6% in 2009-2017 ( 7 ). Subclinical atherosclerosis was considered a precursor to clinical atherosclerosis and is significantly associated with a high risk of CVDs.…”

Section: Introductionmentioning

confidence: 99%

Metabolic dysfunction-associated fatty liver disease increased the risk of subclinical carotid atherosclerosis in China

Lei

Wang

et al. 2023

Front. Endocrinol.

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Background and aimsMetabolic dysfunction-associated fatty liver disease (MAFLD) was proposed to substitute NAFLD in 2020. This new term highlights the systematic metabolic disturbances that accompany fatty liver. We evaluated the correlations between MAFLD and subclinical carotid atherosclerosis (SCA) based on a nationwide health examination population in China.MethodsWe performed a nationwide cross-sectional population and a Beijing retrospective cohort from 2009 to 2017. SCA was defined as elevated carotid intima-media thickness. The multivariable logistic and Cox models were used to analyze the association between MAFLD and SCA.Results153,482 participants were included in the cross-sectional study. MAFLD was significantly associated with SCA in fully adjusted models, with an odds ratio of 1.66; 95% confidence interval (CI): 1.62-1.70. This association was consistent in the cohort, with a hazard ratio (HR) of 1.31. The association between baseline MAFLD and incident SCA increased with hepatic steatosis severity. Subgroup analysis showed an interaction between age and MAFLD, with a higher risk in younger groups (HR:1.67, 95% CI: 1.17-2.40).ConclusionIn this large cross-section and cohort study, MAFLD was significantly associated with the presence and development of SCA. Further, the risk was higher among MAFLD individuals with high hepatic steatosis index and young adults.

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

Cited by 18 publications

References 65 publications

Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study

Association Between Sensitivity to Thyroid Hormones and Metabolic Dysfunction-Associated Fatty Liver Disease in Euthyroid Subjects: A Cross-Sectional Study

An international multidisciplinary consensus statement on MAFLD and the risk of CVD

Metabolic dysfunction-associated fatty liver disease increased the risk of subclinical carotid atherosclerosis in China

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