Metabolic dysfunction-associated steatotic liver disease (MASLD) (previously called nonalcoholic fatty liver disease, NAFLD) is associated with cardiometabolic risk factors and chronic kidney disease (CKD). However, evidence is lacking regarding whether the severity of fibrosis is affected by these risk factors and diseases and to what degree. We aimed to determine the correlation between these factors and vibration-controlled transient elastography-determined liver stiffness measurements (LSMs) and controlled attenuation parameter (CAP) values in a sample of the US population. Data from the 2017-2018 cycle of the National Health and Nutrition Examination Survey were pooled. The association between LSM and cardiometabolic risk factors and CKD was assessed using generalized linear or logistic regression analyses. In multivariate regression analyses, CAP and BMI were adjusted as confounders. Of 3647 participants, 2079 (57.1%) had NAFLD/MASLD [weighted prevalence 54.8%; 95% confidence interval (CI) 51.8-57.9%]; the weighted prevalence of significant fibrosis (LSM ≥ 7.9 kPa) was 9.7% (95% CI 8.2-11.3%). Log LSM was associated with higher levels of homeostatic model assessment of insulin resistance (β = 2.19; P = 0.017), hepatic steatosis (CAP > 248 dB/m) [odds ratio (OR) 3.66; 95% CI 2.22-6.02], type 2 diabetes (OR 2.69; 95% CI 1.72-4.20), and CKD (OR 1.70; 95% CI 1.24-2.34). These correlations did not change notably after adjustments were made for waist circumference, CAP, and BMI. LSM and CAP, although influenced by waist circumference and BMI, are good indicators of hepatic fibrosis and steatosis. LSM is associated with insulin resistance, diabetes, and CKD independent of hepatic steatosis and obesity.

中文翻译：

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代谢功能障碍相关的脂肪肝病相关的肝纤维化会增加胰岛素抵抗、2 型糖尿病和慢性肾病的风险。

代谢功能障碍相关的脂肪肝病 (MASLD)（以前称为非酒精性脂肪肝病，NAFLD）与心脏代谢危险因素和慢性肾脏病 (CKD) 相关。然而，关于纤维化的严重程度是否受到这些危险因素和疾病的影响以及影响程度如何，尚缺乏证据。我们的目的是确定这些因素与美国人口样本中振动控制瞬态弹性成像确定的肝脏硬度测量值 (LSM) 和受控衰减参数 (CAP) 值之间的相关性。汇总了 2017-2018 年全国健康和营养检查调查周期的数据。使用广义线性或逻辑回归分析评估 LSM 与心脏代谢危险因素和 CKD 之间的关联。在多变量回归分析中，CAP 和 BMI 作为混杂因素进行了调整。在 3647 名参与者中，2079 名 (57.1%) 患有 NAFLD/MASLD [加权患病率 54.8%； 95% 置信区间 (CI) 51.8-57.9%]；显着纤维化（LSM ≥ 7.9 kPa）的加权患病率为 9.7%（95% CI 8.2-11.3%）。 Log LSM 与胰岛素抵抗（β = 2.19；P = 0.017）、肝脂肪变性（CAP > 248 dB/m）的稳态模型评估水平较高相关[比值比 (OR) 3.66；P = 0.017]。 95% CI 2.22-6.02]、2 型糖尿病（OR 2.69；95% CI 1.72-4.20）和 CKD（OR 1.70；95% CI 1.24-2.34）。在调整腰围、CAP 和 BMI 后，这些相关性没有显着变化。 LSM和CAP虽然受到腰围和BMI的影响，但它们是肝纤维化和脂肪变性的良好指标。 LSM 与胰岛素抵抗、糖尿病和 CKD 相关，与肝脂肪变性和肥胖无关。