Objective: To explore the clinical features of fatty liver disease (FLD) from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MASLD), so as to elucidate its clinical application value under three renames. Methods: Patients who were hospitalized in the Department of Hepatology, Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, from January 2020 to September 2023 and met the diagnosis of NAFLD, metabolic-associated fatty liver disease (MAFLD), or MASLD were selected as the research subjects. The clinical indicators differences among the three groups of patients were compared, mainly including general information (age, gender, body mass index, past history, etc.), serological indicators (liver and kidney function, blood lipids, blood sugar, coagulation function, etc.), non-invasive liver fibrosis indicators, fat attenuation parameters, etc. Measurement data were analyzed using ANOVA and the rank sum test, while count data were analyzed using the χ(2) test. Results: NAFLD, MAFLD, and MASLD prevalence rates among 536 cases were 64.0%, 93.7%, and 100%, respectively. 318 cases (59.3%) met the three fatty liver names at the same time among them. Male population proportions in NAFLD, MAFLD, and MASLD were 30.9%, 55.8%, and 53.9%, respectively. The alcohol consumption history proportion was 0, 36.7%, and 36.0%, respectively. The smoking history proportion was 7.0%, 31.9%, and 30.6%, respectively. The body mass index was (27.66 ± 3.97), (28.33 ± 3.63), and (27.90 ± 3.89) kg/m(2), respectively. The γ-glutamyltransferase levels were 26.6 (18.0, 47.0) U/L, 31.0 (20.0, 53.0) U/L, and 30.8 (19.8, 30.8) U/L, respectively. The high-density lipoprotein cholesterol levels were 1.07 (0.90, 1.23) mmol/L, 1.02 (0.86, 1.19) mmol/L, and 1.03 (0.87,1.21) mmol/L, respectively. Sequentially measured uric acid was (322.98 ± 84.51) μmol/L, (346.57 ± 89.49) μmol/L, and (344.89 ±89.67) μmol/L, respectively. Sequentially measured creatinine was 69.6 (62.9, 79.0) μmol/L, 73.0 (65.0, 83.5) μmol/L, and 73.0 (65.0, 83.0) μmol/L, respectively. The sequential analysis of obesity proportion was 74.3%, 81.7%, and 76.5%, respectively, with statistically significant differences (P<0.05). Conclusion: Compared with the NAFLD population, the MAFLD and MASLD populations were predominantly male, obese, and had a history of smoking and drinking. The levels of γ-glutamyltransferase, uric acid, and creatinine were slightly higher, while the levels of high-density lipoprotein cholesterol were lower. MASLD appeared in NAFLD and MAFLD on the basis of inheritance and progression, emphasizing once again the important role of metabolic factors in a fatty liver.
目的： 探讨从非酒精性脂肪性肝病（NAFLD）到代谢功能障碍相关脂肪性肝病（MASLD），3次脂肪肝更名下患者的临床特征，阐明其临床应用价值。 方法： 选取2020年1月至2023年9月在新疆医科大学附属中医医院肝病科住院，分别符合NAFLD、代谢相关脂肪性肝病（MAFLD）、MASLD诊断的患者为研究对象，比较3组患者间各临床指标的差异，主要包括一般资料（年龄、性别、体质量指数、既往史等）、血清学指标（肝肾功能、血脂、血糖、凝血功能等）、无创肝纤维化指标、脂肪衰减参数等。计量资料采用ANOVA方差分析、秩和检验，计数资料采用χ (2)检验。 结果： 在536例脂肪肝患者中，其中NAFLD、MAFLD、MASLD的患病率分别为64.0%、93.7%、100%，其中有318例（59.3%）同时满足3种脂肪肝命名。NAFLD、MAFLD、MASLD人群中，男性占比依次为30.9%、55.8%、53.9%；有饮酒史的占比依次为0、36.7%、36.0%；有吸烟史的占比依次为7.0%、31.9%、30.6%；体质量指数依次为（27.66±3.97）、（28.33±3.63）、（27.90±3.89）kg/m(2)；γ-谷氨酰转移酶依次为26.6（18.0，47.0）U/L、31.0（20.0，53.0）U/L、30.8（19.8，30.8）U/L；高密度脂蛋白胆固醇依次为1.07（0.90,1.23）mmol/L、1.02（0.86,1.19）mmol/L、1.03（0.87,1.21）mmol/L；尿酸依次为（322.98±84.51）μmol/L、（346.57±89.49）μmol/L、（344.89±89.67）μmol/L；肌酐依次为69.6（62.9，79.0）μmol/L、73.0（65.0，83.5）μmol/L、73.0（65.0，83.0）μmol/L；肥胖的占比依次为74.3%、81.7%、76.5%，差异均有统计学意义（P值均< 0.05）。 结论： 与NAFLD人群相比，MAFLD、MASLD人群以男性居多，形体多肥胖，且多有吸烟和饮酒史，γ-谷氨酰转移酶、尿酸、肌酐的水平稍高和高密度脂蛋白胆固醇的水平较低。MASLD的提出是在NAFLD、MAFLD基础上的继承与发展，再次强调代谢因素在脂肪肝中的重要地位。.
Keywords: Differences in clinical characteristics; Fatty liver; Metabolic associated fatty liver disease; Metabolic dysfunction- associated steatotic liver disease.