Background There are limited prospective data among overweight and obese individuals on the prevalence of advanced fibrosis, and cirrhosis using advanced MRI-based methods in the USA. The aim of this study was to fill that gap in knowledge by prospectively determining the MRI-based prevalence of steatotic liver disease (SLD) and its subcategories, advanced fibrosis and cirrhosis among overweight and obese individuals residing in the USA. Methods This is a cross-sectional analysis of prospectively enrolled overweight or obese adults aged 40–75 years from primary care and community-based settings in Southern California. Participants were classified as having SLD if MRI proton density fat fraction ≥5%, and subclassified as metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD) and alcohol-related liver disease (ALD) consistently with the new nomenclature guidance per AASLD–EASL–ALEH. Advanced fibrosis and cirrhosis were defined as magnetic resonance elastography (MRE) ≥3.63 kPa and MRE ≥4.67 kPa, respectively. Results The cohort included 539 participants with mean (±SD) age of 51.5 (±13.1) years and body mass index of 32.6 (±6.2) kg/m2, respectively. The prevalence of SLD, advanced fibrosis and cirrhosis was 75%, 10.8% and 4.5%, respectively. The prevalence of MASLD, MetALD and ALD was 67.3%, 4.8% and 2.6%, respectively. There was no difference in prevalence of advanced fibrosis and cirrhosis among subcategories. Conclusions Using advanced MRI methods among community-dwelling overweight and obese adults, the prevalence of cirrhosis was 4.5%. Most common SLD subcategory was MASLD with 67% of individuals, whereas MetALD and ALD were less common. Systematic screening for advanced fibrosis among overweight/obese adults may be considered. Data are not available.

中文翻译：

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美国社区超重和肥胖人群中脂肪性肝病、晚期纤维化和肝硬化的患病率


背景 在美国，使用基于 MRI 的先进方法，关于超重和肥胖个体中晚期纤维化和肝硬化患病率的前瞻性数据有限。本研究的目的是通过前瞻性确定居住在美国的超重和肥胖个体中基于 MRI 的脂肪性肝病 （SLD） 及其亚类别、晚期纤维化和肝硬化的患病率来填补这一知识空白。方法 这是对来自南加州初级保健和社区环境的 40-75 岁前瞻性招募的超重或肥胖成年人的横断面分析。如果 MRI 质子密度脂肪分数 ≥5%，参与者被归类为患有 SLD，并细分为代谢功能障碍相关脂肪性肝病 （MASLD）、代谢功能障碍和酒精相关肝病 （MetALD） 和酒精相关肝病 （ALD），与根据 AASLD-EASL-ALEH 的新命名指南一致。晚期纤维化和肝硬化定义为磁共振弹性成像 （MRE） ≥3.63 kPa 和 MRE ≥4.67 kPa。结果 该队列包括 539 名参与者，平均 （±SD） 年龄分别为 51.5 （±13.1） 岁，体重指数为 32.6 （±6.2） kg/m2。SLD 、晚期纤维化和肝硬化的患病率分别为 75% 、 10.8% 和 4.5%。MASLD 、 MetALD 和 ALD 的患病率分别为 67.3% 、 4.8% 和 2.6%。不同亚类别之间的晚期纤维化和肝硬化患病率没有差异。结论 使用先进的 MRI 方法，在社区居住的超重和肥胖成人中，肝硬化的患病率为 4.5%。最常见的 SLD 亚类别是 MASLD，占 67%，而 MetALD 和 ALD 较少见。 可以考虑对超重/肥胖成人进行晚期纤维化的系统筛查。数据不可用。