Impact renaming non-alcoholic fatty liver disease to metabolic associated fatty liver disease in prevalence, characteristics and risk factors

Table 1 Clinical characteristics of the study participants metabolic associated fatty liver disease & non-alcoholic fatty liver disease, with and without metabolic associated fatty liver disease and non-alcoholic fatty liver disease, n (%)

Characteristics	All	MAFLD	Not MAFLD	NAFLD	Not NAFLD	MAFLD & NAFLD
N	85242	34485 (40.5)	50757 (59.5)	26403 (31.0)	58839 (69.0)	23905 (28.0)
General information
Age, yr		47.19 ± 10.82	43.43 ± 11.96	47.72 ± 11.17	43.71 ± 11.66	47.85 ± 11.18
Sex
Male	49177	26627 (77.21)	22550 (44.43)	17927 (67.90)	31259 (53.12)	16350 (68.40)
Female	36065	7858 (22.79)	28207 (55.57)	8476 (32.10)	27589 (46.88)	7555 (31.60)
BMI, kg/m2		26.79 ± 2.69	22.44 ± 2.48	26.29 ± 2.84	23.29 ± 3.12	26.64 ± 2.71
Systolic blood pressure, mmHg		128.50 ± 15.42	118.67 ± 15.13	127.40 ± 15.67	120.52 ± 15.68	128.21 ± 15.69
Diastolic blood pressure, mmHg		79.97 ± 11.06	72.17 ± 10.42	78.49 ± 10.96	73.91 ± 11.24	79.06 ± 10.96
Waist circumference, cm		90.41 ± 7.68	76.78 ± 8.01	88.57±8.03	79.51 ± 10.03	89.43 ± 7.74
Hip circumference, cm		97.81 ± 5.52	91.53 ± 5.03	96.92 ± 5.63	92.80 ± 5.83	97.42 ± 5.55
Smoke
Never	57452	19713 (57.18)	37739 (74.36)	17589 (66.63)	39863 (67.76)	15824 (66.21)
Always	20951	11443 (33.19)	9508 (18.73)	6663 (25.24)	14288 (24.29)	6127 (25.64)
Smoke in the past	3106	1666 (4.83)	1440 (2.84)	1047 (3.97)	2059 (3.50)	956 (4.00)
Passive exposure to secondhand smoke	3720	1655 (4.80)	2065 (4.07)	1098 (4.16)	2622 (4.46)	992 (4.15)
Alcohol consumption
Yes	27567	14899 (44.10)	12668 (25.31)	5546 (21.31)	22021 (38.09)	5042 (21.41)
No	56275	18882 (55.90)	37393 (74.69)	20478 (78.69)	35797 (61.91)	18506 (78.59)
Diabetes
Yes	2596	1775 (5.15)	821 (1.62)	1287 (5.12)	1309 (2.22)	1287 (5.38)
No	82645	32710 (94.85)	49935 (98.38)	25116 (94.88)	57529 (97.78%)	22618 (94.61)
Inappetence
Never	57298	24017 (69.66)	33281 (65.57)	18671 (70.73)	38627 (65.65)	16988 (71.08)
Occasionally	24989	9446 (27.40)	15543 (30.62)	6976 (26.43)	18013 (30.62)	6232 (26.08)
Often	2947	1016 (2.95)	1931 (3.80)	751 (2.84)	2196 (3.73)	680 (2.85)
Take the initiative to acquire medical knowledge
Yes	48284	19268 (55.88)	29016 (57.17)	14989 (56.78)	33295 (56.59)	13534 (56.63)
No	36946	15210 (44.12)	21736 (42.83)	11409 (43.22)	25537 (43.41)	10366 (43.37)
Laboratory inspection
TG, mmol/L		2.67 ± 2.40	1.32 ± 1.00	2.38 ± 2.07	1.63 ± 1.67	2.47 ± 2.14
TC, mmol/L		5.24 ± 1.04	4.89 ± 0.92	5.19 ± 1.00	4.96 ± 0.97	5.19 ± 1.01
LDL-C, mmol/L		2.88 ± 0.89	2.86 ± 0.78	2.94 ± 0.87	2.84 ± 0.80	2.92 ± 0.88
HDL-C, mmol/L		1.18 ± 0.24	1.42 ± 0.30	1.19 ± 0.24	1.38 ± 0.31	1.18 ± 0.23
TBIL, μmol/L		13.38 ± 5.15	13.52 ± 5.28	13.24 ± 5.15	13.56 ± 5.26	13.21 ± 5.16
AST, U/L		26.83 ± 18.10	22.55 ± 17.75	25.76 ± 13.67	23.74 ± 19.70	26.00 ± 14.07
ALT, U/L		35.73 ± 27.93	21.28 ± 21.60	33.86 ± 25.81	24.09 ± 24.57	34.59 ± 26.44
A/G		1.76 ± 0.29	1.76 ± 0.31	1.75 ± 0.28	1.77 ± 0.31	1.74 ± 0.28
FPG, mmol/L		5.96 ± 1.68	5.32 ± 1.77	5.88 ± 1.62	5.44 ± 1.81	5.93 ± 1.65
HbA1c (%)		5.91 ± 0.96	5.52 ± 0.63	5.90 ± 0.95	5.59 ± 0.72	5.92 ± 0.95
BUN, mmol/L		4.97 ± 1.23	4.71 ± 1.31	4.95 ± 1.23	4.75 ± 1.31	4.97 ± 1.23
SUA, μmol/L		385.23 ± 85.79	312.61 ± 79.14	372.25 ± 85.03	328.43 ± 87.85	375.02 ± 85.10
Platelets (×109/L)		227.84 ± 54.33	225.02 ± 55.02	229.55 ± 54.92	224.64 ± 54.61	229.55 ± 55.11
Total bile acid, μmol/L		4.36 ± 5.89	3.96 ± 5.25	4.24 ± 5.13	4.07 ± 5.71	4.29 ± 5.25
Creatinine, μmol/L		77.32 ± 16.64	78.80 ± 43.80	75.62 ± 17.34	72.46 ± 41.16	75.84 ± 17.52
≥ 2 metabolic abnormalities
Yes	38399	27536 (79.85)	10863 (21.40)	19018 (72.03)	19381 (32.94)	19018 (79.56)
No	46843	6949 (20.15)	39894 (78.60)	7385 (27.97)	39458 (67.06)	4887 (20.44)
Lifestyle management
Do you often eat late night snacks
Never	56798	23097 (66.99)	33701 (66.40)	19221 (72.81)	37577 (63.87)	17377(72.70)
Occasionally	25624	10204 (29.59)	15420 (30.38)	6579 (24.92)	19045 (32.37)	5971 (24.98)
Often	2811	1179 (3.42)	1632 (3.22)	600 (2.27)	2211 (3.76)	554 (2.32)
Crapulent
Yes	5750	3175 (9.21)	2575 (5.07)	1799 (6.81)	3951 (6.72)	1706 (7.14)
No	79484	31305 (90.79)	48179 (94.93)	24600 (93.19)	54884 (93.28)	22195 (92.86)
Food preference
Light	35389	12278 (35.61)	23111 (45.54)	10875 (41.20)	24514 (41.67)	9665 (40.44)
Briny	26194	12755 (36.99)	13439 (26.48)	8694 (32.93)	17500 (29.74)	8014 (33.53)
Unclear	23649	9446 (27.40)	14203 (27.98)	6829 (25.87)	16820 (28.59)	6221 (26.03)
Drink beverage
Never	46065	18399 (82.24)	27666 (82.51)	13920 (81.90)	32145 (82.27)	12602 (81.58)
Occasionally	9198	3653 (16.33)	5545 (16.54)	2830 (16.65)	6368 (16.30)	2624 (16.99)
Often	806	320(1.43)	320 (0.95)	246 (1.45)	560 (1.43)	222 (1.44)
Exercise frequency
1-2 times/wk	21380	8441 (39.52)	12939 (41.37)	6477 (39.69)	14903 (41.04)	5820 (39.48)
3-5 times/wk	21162	8672 (40.60)	12490 (39.94)	6503 (39.85)	14659 (40.36)	5887 (39.93)
> 5 times/wk	10093	4247 (19.88)	5846 (18.69)	3338 (20.46)	6755 (18.60)	3036 (20.59)
Exercise training
Yes	52829	21444 (62.20)	31385 (61.84)	16404 (62.15)	36425 (61.91)	14825 (62.03)
No	32400	13033 (37.80)	19367 (38.16)	9991 (37.85)	22409 (38.09)	9073 (37.97)
Exercise duration
< 30 min	12701	4950 (23.17)	7751 (24.78)	4085 (25.03)	8616 (23.72)	3662 (24.84)
30-60 min	30669	12575 (58.87)	18094 (57.85)	9475 (58.06)	21194 (58.36)	8568 (58.12)
> 60 min	9266	3836 (17.96)	5430 (17.36)	2758 (16.90)	6508 (17.92)	2513 (17.05)
Labour intensity
Light physical labor	77907	31651 (91.78)	46256 (91.13)	24186 (91.60)	53721 (91.30)	21844 (91.38)
Moderate physical labor	6282	2463 (7.14)	3819 (7.52)	1940 (7.35)	4342 (7.38)	1808 (7.56)
Heavy physical labor	1053	371 (1.08)	682 (1.34)	277 (1.05)	776 (1.32)	253 (1.06)
Psychological states
Irritability
Never	43964	18836 (54.63)	25128 (49.51)	14745 (55.85)	29219 (49.67)	13428 (56.18)
Occasionally	35294	13631 (39.53)	21663 (42.68)	10152 (38.46)	25142 (42.74)	9103 (38.09)
Often	5973	2012 (5.84)	3961 (7.80)	1502 (5.69)	4471 (7.60)	1370 (5.73)
Tense and unrelaxed
Never	54907	22753 (65.99)	31154 (61.38)	17813 (67.47)	36094 (61.35)	16156 (67.59)
Occasionally	26438	10081 (29.24)	16357 (32.23)	7379 (27.95%)	19059 (32.39)	6638 (27.77%)
Often	4890	1647 (4.78)	3243 (6.39)	1208 (4.58)	3682 (6.26)	1108 (4.64)
Anxious
Never	55837	23594 (68.43)	32243 (63.53)	18363 (69.56)	37474 (63.69)	16670 (69.75)
Occasionally	25399	9578 (27.78)	15821 (31.17)	7059 (26.74)	18340 (31.17)	6337 (26.51)
Often	3999	1307 (3.79)	2692 (5.30)	977 (3.70)	3022 (5.14)	894 (3.74)
Depress
Never	59871	25192 (73.06)	34679 (68.32)	19610 (74.28)	40261 (68.43)	17811 (74.52)
Occasionally	22155	8306 (24.09)	13849 (27.29)	6040 (22.88)	16115 (27.39)	5410 (22.63)
Often	3210	982 (2.85)	2228 (4.39)	750 (2.84)	2460 (4.18)	681 (2.85)
Sleep
Well	33017	14188 (41.15)	18829 (37.10)	11027 (41.77)	21990 (37.38)	10043 (42.02)
Moderate	43242	16974 (49.23)	26268 (51.76)	12894 (48.84)	30348 (51.58)	11627 (48.65)
Bad	8974	3318 (9.62)	5656 (11.14)	2478 (9.39)	6496 (11.04)	2231 (9.33)

BMI: Body Mass Index; SUA: Serum uric acid; TG: Triglycerides; TC: Total cholesterol; LDL-C: low density lipoprotein cholesterol; HDL-C: high density lipoprotein cholesterol; TBIL: Total bilirubin; AST: Aspartate aminotransferase; ALT: Alanine transaminase; A/G: Albumin/globulin; FPG: Fasting plasma glucose; BUN: Blood urea nitrogen; HbA1c: Glycated hemoglobin.

Table 2 Univariate and multivariate logistic regression analysis of factors associated with metabolic associated fatty liver disease, n (%)

Variable	Category	Univariate analysis		Multivariable analysis
		Odds ratio (95%CI)	P value	Odds ratio (95%CI)	P value
General information
Sex	Male(ref)
	Female	0.69 (0.58-0.84)	< 0.001	0.67 (0.57-0.80)	0.001
Age		1.01 (1.01-1.02)	0.001	1.01 (1.00–1.02)	0.001
BMI, kg/m2		1.46 (1.41-1.52)	< 0.001	1.45 (1.40-1.51)	< 0.001
Systolic blood pressure, mmHg		1.00 (0.99-1.00)	0.360	None
Diastolic blood pressure, mmHg		1.01 (1.00-1.02)	0.007	1.01 (1.00–1.01)	0.002
Waist circumference, cm		1.12 (1.11-1.14)	< 0.001	1.12 (1.11-1.14)	< 0.001
Hip circumference, cm		0.95 (0.93-0.96)	< 0.001	0.95 (0.93-0.96)	< 0.001
Smoke	Never (ref)		0.409	None
	Always	1.18 (0.90-1.56)	0.236	None
	Smoke in the past	1.07 (0.80-1.43)	0.667	None
	Passive exposure to secondhand smoke	1.15 (0.80-1.65)	0.464	None
Alcohol consumption	No(ref)
	Yes	0.89 (0.78-1.01)	0.061	1.11 (0.99-1.26)	0.082
Diabetes	No(ref)
	Yes	1.16 (0.91-1.49)	0.231	None
≥ 2 metabolic abnormalities	No(ref)
	Yes	3.38 (3.00-3.82)	< 0.001	3.38 (2.99-3.81)	< 0.001
Take the initiative to acquire medical knowledge	No(ref)
	Yes	1.14 (1.02-1.26)	0.017	1.14 (1.03-1.27)	0.014
Laboratory inspection
TG, mmol/L		1.31 (1.15-1.49)	< 0.001	1.33 (1.27-1.40)	< 0.001
TC, mmol/L		1.09 (0.81-1.45)	0.578	None
LDL- C, mmol/L		1.00 (0.74-1.35)	0.997	None
HDL-C, mmol/L		0.50 (0.33-0.73)	< 0.001	0.58 (0.47-0.71)	< 0.001
TBIL, μmol/L		1.01 (1.00-1.02)	0.044	0.98 (0.98-0.99)	< 0.001
AST, U/L		0.98 (0.97-0.98)	< 0.001	1.01 (1.01-1.01)	< 0.001
ALT, U/L		1.02 (1.02-1.03)	< 0.001	1.02 (1.02-1.02)	< 0.001
A/G		1.85 (1.53-2.25)	< 0.001	0.99 (0.92-1.08)	0.884
BUN, mmol/L		0.98 (0.94-1.02)	0.388	None
FPG, mmol/L		0.97 (0.91-1.04)	0.426	None
HbA1c (%)		1.35 (1.20-1.52)	< 0.001	1.52 (1.47-1.57)	< 0.001
Total bile acid, μmol/L		1.00 (1.00-1.01)	0.395	None
SUA, μmol/L		1.00 (1.00-1.01)	< 0.001	1.01 (1.01-1.01)	< 0.001
Platelets (×109/L)		1.00 (1.00-1.00)	< 0.001	1.00 (1.00-1.00)	< 0.001
Creatinine, μmol/L		0.99 (0.99-1.00)	< 0.001	0.99 (0.99-0.99)	< 0.001
Lifestyle management
Inappetence	Never(ref)		0.597	None
	Occasionally	1.13 (0.84-1.52)	0.409	None
	Often	1.16 (0.86-1.57)	0.322	None
Do you often eat late night snacks	Never(ref)		0.529	None
	Occasionally	1.33 (0.78-2.28)	0.288
	Often	1.37 (0.79-2.35)	0.260
Crapulent	No(ref)
	Yes	0.93 (0.73-1.20)	0.586	None
Food preference	Light (ref)		0.868	None
	Briny	0.97 (0.85-1.10)	0.617
	Unclear	0.99 (0.85-1.14)	0.874
Drink beverage	Never (ref)		0.015		0.004
	Occasionally	2.66 (1.37-5.18)	0.004	1.01 (0.85-1.20)	0.917
	Often	2.69 (1.36-5.32)	0.004	0.32 (0.17-0.63)	0.001
Exercise frequency	1-2 times/wk (ref)		0.048		0.025
	3-5 times/wk	1.20 (1.03-1.40)	0.017	0.95 (0.84-1.08)	0.429
	> 5 times/wk	1.14 (1.00-1.30)	0.049	0.82 (0.71-0.95)	0.009
Exercise training		0.39 (0.04-3.58)	0.404	None
Exercise duration	< 30 min (ref)		0.049		0.045
	30-60 min	0.81 (0.68-0.96)	0.017	1.07 (0.94-1.22)	0.283
	> 60 min	0.87 (0.76-1.00)	0.045	1.24 (1.04-1.47)	0.015
Labor intensity	Light physical labor (ref)		0.049		0.026
	Moderate physical labor	0.80 (0.66-0.97)	0.024	0.78 (0.65-0.95)	0.013
	Heavy physical labor	0.79 (0.51-1.21)	0.273	0.77 (0.50-1.18)	0.226
Psychological states
Irritability	Never (ref)		0.637	None
	Occasionally	1.01 (0.89-1.15)	0.851
	Often	1.14 (0.87-1.50)	0.346
Tense and unrelaxed	Never (ref)		0.806	None
	Occasionally	0.95 (0.820-1.11)	0.351
	Often	0.96 (0.69-1.35)	0.828
Anxious	Never (ref)		0.076		0.091
	Occasionally	0.92 (0.78-1.08)	0.290	0.96 (0.85-1.07)	0.447
	Often	1.38 (0.91-2.08)	0.127	1.31 (1.00-1.73)	0.052
Depress	Never (ref)		0.211	None
	Occasionally	1.09 (0.92-1.29)	0.320
	Often	0.77 (0.49-1.21)	0.264
Sleep	Well (ref)		0.221	None
	Moderate	0.98 (0.82-1.16)	0.791
	Bad	0.89 (0.74-1.07)	0.225

BMI: Body Mass Index; SUA: Serum uric acid; TG: Triglycerides; TC: Total cholesterol; LDL-C: low density lipoprotein cholesterol; HDL-C: high density lipoprotein cholesterol; TBIL: Total bilirubin; AST: Aspartate aminotransferase; ALT: Alanine transaminase; A/G: Albumin/globulin; FPG: Fasting plasma glucose; BUN: Blood urea nitrogen; HbA1c: Glycated hemoglobin.