January 1, 2025Open Access

Metabolic Correlation Research Progress of Fatty Liver Disease

Q: What is the clinical evidence from this study?

Study design: Review. Population: Metabolic dysfunction-associated fatty liver disease (MAFLD) / Non-alcoholic fatty liver disease (NAFLD).

Key Result

Metabolic dysfunction-associated fatty liver disease affects over 25% of the global adult population and requires multi-modal non-invasive diagnostic models and targeted management of metabolic risk factors.

Structured PICO

Population

Individuals with or at risk for metabolic dysfunction-associated fatty liver disease (MAFLD) / non-alcoholic fatty liver disease (NAFLD)

This review highlights the escalating global and Chinese epidemiological burden of NAFLD/MAFLD, emphasizing the need for non-invasive diagnostic tools and comprehensive metabolic management.

Limitations

Liver biopsy, while the gold standard, is invasive, carries complication risks, and is subject to sampling errors.
Abdominal ultrasound has decreased penetration in obese patients and low sensitivity (60.9%-65%) for mild steatosis.
CT scans involve radiation exposure and have low sensitivity for mild fatty liver.
Magnetic resonance elastography (MRE) is highly equipment-dependent, time-consuming, and expensive.
The exact pathophysiological mechanisms of novel biomarkers like Betatrophin remain controversial and require further investigation.

Abstract

代谢相关性脂肪性肝病(metabolic dysfunction-associated fatty liver disease, MAFLD)是遗传易感个体由于营养过剩和胰岛抵抗，引起的慢性进展性肝病，疾病谱包括代谢相关(非酒精性)性脂肪肝、代谢相关性肝炎及其相关纤维化和肝硬化。于2024年7月份中华医学会肝病学分会决定将非酒精性脂肪性肝病(non -alcoholic fatty liver disease, NAFLD)正式更名为代谢相关性脂肪性肝病，本文不做区分。NAFLD全球流行率已超过总人口的四分之一，而我国形势尤为严峻，NAFLD不仅对个体健康构成重大威胁，亦导致家庭和社会医疗成本急剧攀升。因此，深入探究其流行特征、诊断策略及危险因素具有重要公共卫生意义，本文将围绕上述三方面展开系统性综述。Metabolic dysfunction-associated fatty liver disease (MAFLD) is a chronic progressive liver disease that occurs in genetically susceptible individuals due to overnutrition and insulin resistance. The disease spectrum includes metabolic-related (non-alcoholic) fatty liver, metabolic-related hepatitis, and related fibrosis and cirrhosis. In July 2024, the Chinese Society of Hepatology decided to officially rename non-alcoholic fatty liver disease (NAFLD) as MAFLD. This article does not make a distinction between the two. The global prevalence of NAFLD has exceeded a quarter of the total population, and the situation in China is particularly severe. NAFLD not only poses a significant threat to individual health but also leads to a sharp increase in medical costs for families and society. Therefore, in-depth exploration of its epidemiological characteristics, diagnostic strategies, and risk factors has important public health significance. This article will conduct a systematic review of the above three aspects.

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