县级因素和可预防的早期肝脏死亡率在代谢功能障碍相关的肥胖性肝病中
James M Paik1,2, Shira Zelber-Sagi1,3, Annette Paik1,2,4
1The Global NASH/MASH Council, Washington, DC.
JAMA network open
|October 20, 2025
概括
大多数因代谢功能障碍相关的脂肪性肝病 (MASLD) 的过早肝脏死亡是可以预防的. 较高的可预防的MASLD-PLM率与农村地区的身体不活动和肥胖等因素有关.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 肝脏疾病研究 肝脏疾病研究
背景情况:
- 代谢功能障碍相关的脂肪性肝病 (MASLD) 是美国早期肝脏死亡 (PLM) 的一个不断增长的原因.
- 可预防的MASLD-PLM的比例及其相关的上游因素尚未得到充分了解.
研究的目的:
- 量化美国各县可预防的MASLD-PLM的负担.
- 确定与可预防的MASLD-PLM变化相关的县级因素.
主要方法:
- 一项生态,横截面研究,使用县级死亡率和2011-2020年共变量数据.
- MASLD-PLM定义为与肝脏相关的死亡,其原因是MASLD,在男性和女性的年龄门内.
- 可预防的MASLD-PLM比率通过比较县率与低死亡率州来计算;用于评估因素关联的结构方程建模.
主要成果:
- 在2011-2020年期间,估计有44.1%至58.0%的MASLD-PLM死亡是可以预防的.
- 在农村地区观察到更高的可预防的MASLD-PLM比例,并与身体不活动,肥胖,可预防的住院治疗和糖尿病有关.
- 上游因素包括有限的运动友好环境,糟糕的食品环境和更高的无保险率.
结论:
- 大多数MASLD-PLM是可以预防的,在农村,社会经济弱势和医疗服务不足的地区造成重大负担.
- 社区层面的因素与可预防的MASLD-PLM有关,这表明了干预和进一步研究的潜在目标.
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