Prevalence and Risk Factors of Metabolic-Associated Fatty Liver Disease Among Hospital Staff

Figures & data

Table 1 Anthropometrical and Metabolic Characteristics Among MAFLD and Non-MAFLD Participants

Variable	MAFLD (223)	Non-MAFLD (661)	p
Gender
Male	122	160	<0.001
Female	101	501
Age, years	40 (31–51)	32 (27–39)	<0.001
H. pylori infection	120 (53.8)	177 (26.8)	<0.001
BMI			<0.001
Normal	129	498
Overweight	67	135
Obese	27	28
Hypertension			<0.001
Yes	46	64
No	177	597
Diabetes			<0.001
Yes	16	8
No	207	653
Eating out			<0.001
Yes	93	163
No	130	498
Regular exercise			<0.001
Yes	36	204
No	187	457
Drinking			0.910
Yes	29	88
No	194	573
Cr, μmoI/L	70 (58–84)	58 (52–70)	<0.001
Uric acid, µmol/L	397 (341–458)	304 (262–370)	<0.001
Uric acid/Cr	5.67 (4.89–6.54)	5.11 (4.38–5.83)	<0.001
FPG, mmol/L	5.39 (5.05–5.96)	5.07 (4.75–5.42)	<0.001
TG, mmol/L	1.63 (1.12–2.48)	0.82 (0.6–1.2)	<0.001
CHOL, mmo/L	5.27 (4.62–5.90)	4.74 (4.10–5.31)	<0.001
HDL-C, mmo/L	1.19 (0.98–1.41)	1.43 (1.23–1.68)	0.103
LDL-C, mmo/L	2.99 (2.50–3.71)	2.77 (2.23–3.28)	<0.001
TyG	8.86 (8.49–9.34)	8.10 (7.75–8.51)	<0.001
TBIL, umol/L	12 (9.9–16.4)	12.5 (9.9–16.7)	0.482
RBC× (10^12/L)	5.1 (4.78–5.54)	4.72 (4.43–5.07)	<0.001
PLT (×10^9/L)	274 (227–319)	262 (224–307)	0.263
LYM (×10^9/L)	2.44 (1.96–2.78)	2.15 (1.79–2.55)	<0.001
RDW (%)	12.6 (12.2–13)	12.5 (12–13.1)	0.483
RLR	5.28 (4.53–6.41)	5.91 (4.91–7.23)	<0.001
RPR	0.46 (0.39–0.57)	0.48 (0.42–0.56)	0.151

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; Cre, creatinine; FBG, fasting blood glucose; TG, Triglyceride; CHOL, cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TyG, triglyceride-glucose; PLT, platelet; LYM, lymphocyte; RDW, red blood cell distribution width; RLR, RDW-to-lymphocyte ratio; RPR, RDW-to-platelet ratio; RBC, red blood cell.

Table 2 Multivariate Logistic Regression Analysis of Factors Associated with MAFLD

Variable	B	SE	Waldx²	P	OR (95% CI)
Gender	−0.02	0.396	0.003	0.96	0.98 (0.451, 2.131)
Age, years	0.077	0.016	22.395	<0.001	1.08 (1.046, 1.115)
H. pylori infection	−1.454	0.301	23.384	<0.001	0.234 (0.13, 0.421)
Cr, μmoI/L	0.016	0.025	0.421	0.516	1.016 (0.968, 1.067)
Uric acid, µmol/L	0.003	0.005	0.311	0.577	1.003 (0.993, 1.012)
Uric acid/Cr	0.313	0.291	1.153	0.283	1.367 (0.773, 2.419)
LYM (×10^9/L)	−0.486	0.409	1.411	0.235	0.615 (0.276, 1.372)
RLR	−0.19	0.138	1.898	0.168	0.827 (0.632, 1.083)
FPG, mmol/L	−0.058	0.149	0.153	0.696	0.944 (0.705, 1.263)
TG, mmol/L	0.049	0.281	0.03	0.863	1.05 (0.606, 1.819)
TyG	1.946	0.505	14.833	< 0.001	7.001 (2.6, 18.847)
CHOL, mmo/L	−0.472	0.29	2.655	0.103	0.624 (0.354, 1.1)
LDL-C, mmo/L	0.731	0.334	4.798	0.028	2.076 (1.08, 3.993)
RBC× (10^12/L)	0.869	0.265	10.752	0.001	2.386 (1.419, 4.012)
Hypertension	−0.118	0.358	0.109	0.741	0.888 (0.44, 1.792)
Diabetes	−0.222	0.78	0.081	0.776	0.801 (0.174, 3.692)
Eating out	−3.029	0.348	75.539	<0.001	0.048 (0.024, 0.096)
Regular exercise	3.136	0.353	78.957	<0.001	23.017 (11.524, 45.969)
Overweight	1.359	0.451	9.075	0.003	3.891 (1.607, 9.417)
Obese	0.18	0.434	0.172	0.679	1.197 (0.511, 2.803)

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; Cre, creatinine; FBG, fasting blood glucose; CHOL, cholesterol; LDL-C, low-density lipoprotein cholesterol; TyG, triglyceride-glucose; LYM, lymphocyte; RDW, red blood cell distribution width; RLR, RDW-to-LYM ratio; RBC, red blood cell; TG, Triglyceride.

Table 3 ROC Curve of Clinical Indices in the Diagnosis of MAFLD

Variable	AUC (95% CI)	p	Sensitivity	Specificity	Optimal Cut-off Value	Youden Index
Older age	0.683 (0.644, 0.721)	<0.001	0.646	0.628	34.5	0.274
TyG	0.819 (0.788, 0.851)	<0.001	0.807	0.696	8.4037	0.503
RBC	0.689 (0.649, 0.728)〕	<0.001	0.767	0.545	4.765	0.312
H.pylori infection	0.635 (0.592, 0.679)	<0.001	0.538	0.732	/	0.27
LDL-C	0.600 (0.556, 0.664)	<0.001	0.475	0.702	3.155	0.177
Eating out	0.585 (0.541, 0.630)	<0.001	0.417	0.753	/	0.17
Regular exercise	0.574 (0.532, 0.615)	0.001	0.309	0.839	/	0.148
Overweight	0.593 (0.549, 0.638)	<0.001	0.422	0.753	/	0.175
TyG+RBC	0.833 (0.803, 0.862)	<0.001	0.762	0.769	0.7334	0.531
TyG+RBC+LDL-C	0.834 (0.804, 0.864)	<0.001	0.803	0.728	0.2248	0.531
Model (all)	0.910 (0.886, 0.934)	<0.001	0.794	0.908	0.3774	0.702

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; TyG, triglyceride-glucose; RBC, red blood cell; LDL-C, low-density lipoprotein cholesterol.

Figure 1 ROC curve of clinical indices in the diagnosis of MAFLD.

Table 4 Anthropometrical and Metabolic Characteristics Among Male MAFLD Participants

Variable	MAFLD (122)	Non-MAFLD (160)	p
Age, years	39 (32–52)	37 (29–51)	0.111
H. pylori infection	78 (63.9)	77 (48.1)	0.011
BMI			0.006
Normal	63 (51.6)	59 (36.9)
Overweight	40 (32.8)	83 (51.9)
Obese	19 (15.6)	18 (11.3)
Hypertension			0.771
Yes	27 (22.1)	33 (20.6)
No	95 (77.9)	127 (79.4)
Diabetes			0.049
Yes	10 (8.2)	4 (2.5)
No	112 (91.8)	156 (97.5)
Eating out			0.024
Yes	52 (42.6)	47 (29.4)
No	70 (57.4)	113 (70.6)
Regular exercise			<0.001
Yes	24 (19.7)	80 (50.0)
No	98 (80.3)	80 (50.0)
Drinking			0.011
Yes	24 (19.7)	54 (33.7)
No	98 (80.3)	106 (66.3)
Cr, μmoI/L	82 (73–89)	81 (73–89)	0.394
Uric acid, µmol/L	419 (390–496)	392 (338–441)	<0.001
Uric acid/Cr	5.29 (4.54–6.03)	4.84 (4.25–5.47)	<0.001
FPG, mmol/L	5.31 (5.06–5.98)	5.23 (4.82–5.52)	0.002
TG, mmol/L	1.76 (1.16–2.82)	1.08 (0.75–1.46)	<0.001
CHOL, mmo/L	5.18±1.04	4.91±0.94	0.025
LDL-C, mmo/L	2.95 (2.38–3.58)	3.0 (2.50–3.50)	0.689
TyG	8.93 (8.54–9.45)	8.40 (8.06–8.74)	<0.001
TBIL, umol/L	12.8 (10.6–17.5)	13.8 (10.9–19.9)	0.066
RBC× (10^12/L)	5.39 (5.01–5.64)	5.19 (4.87–5.51)	0.005
PLT (×10^9/L)	258 (211–287)	251 (213–284)	0.690
LYM (×10^9/L)	2.41 (1.90–2.81)	2.19 (1.86–2.57)	0.053
RDW (%)	12.4 (12.1–12.9)	12.4 (11.9–12.9)	0.586
RLR	5.29 (4.46–6.47)	5.72 (4.79–6.99)	0.096
RPR	0.05 (0.04–0.06)	0.05 (0.04–0.06)	0.769

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; Cre, creatinine; FBG, fasting blood glucose; TG, Triglyceride; CHOL, cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TyG, triglyceride-glucose; PLT, platelet; LYM, lymphocyte; RDW, red blood cell distribution width; RLR, RDW-to-LYM ratio; RPR, RDW-to-PLT ratio; RBC, red blood cell.

Table 5 ROC Curve of Clinical Indices in the Diagnosis of Male MAFLD

Variable	AUC (95% CI)	p	Sensitivity	Specificity	Optimal Cut-off Value	Youden Index
TyG	0.765 (0.708, 0.821)	<0.001	0.648	0.787	8.7873	0.435
Uric acid, µmol/L	0.666 (0.531, 0.663)	<0.001	0.828	0.444	383.5	0.272
H.pylori infection	0.579 (0.512, 0.646)	0.023	0.639	0.519	/	0.158
Regular exercise	0.652 (0.588, 0.716)	<0.001	0.5	0.803	/	0.303
Drinking	0.570 (0.504, 0.637)	0.043	0.338	0.803	/	0.141
TyG+UA	0.784 (0.731, 0.836)	<0.001	0.639	0.794	0.4612	0.433
Model (5)	0.892 (0.855, 0.929)	<0.001	0.77	0.856	0.4809	0.626

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; TyG, triglyceride-glucose.

Figure 2 ROC curve of clinical indices in the diagnosis of male MAFLD.

Table 6 Anthropometrical and Metabolic Characteristics Among Female MAFLD and Non-MAFLD Female Participants

Variable	MAFLD (101)	Non-MAFLD (501)	p
Age, years	41 (30–49)	30 (26–37)	<0.001
H. pylori infection	42 (41.6)	100 (20.0)	<0.001
BMI			<0.001
Normal	66 (65.3)	439 (87.6)
Overweight	27 (26.7)	52 (10.4)
Obese	8 (7.9)	10 (2.0)
Hypertension			<0.001
Yes	19 (18.8)	31 (6.2)
No	82 (81.2)	470 (93.8)
Diabetes			0.001
Yes	6 (5.9)	4 (0.8)
No	95 (94.1)	497 (99.2)
Eating out			<0.001
Yes	41 (40.6)	116 (23.2)
No	60 (59.4)	385 (76.8)
Regular exercise			0.006
Yes	12 (11.9)	124 (24.8)
No	89 (88.1)	377 (75.2)
Drinking			0.525
Yes	5 (5.0)	34 (6.8)
No	96 (95.0)	467 (93.2)
Cr, μmoI/L	57 (51–63)	55 (50–61)	0.125
Uric acid, µmol/L	351 (299–405)	289 (253–329)	<0.001
Uric acid/Cr	5.96 (5.27–7.10)	5.20 (4.46–5.98)	<0.001
FPG, mmol/L	5.48 (4.96–5.93)	5.04 (4.70–5.37)	<0.001
TG, mmol/L	1.57 (1.00–2.09)	0.76 (0.56–1.10)	<0.001
CHOL, mmo/L	5.31 (4.74–6.06)	4.68 (4.07–5.25)	<0.001
LDL-C, mmo/L	3.21 (2.64–3.79)	2.67 (2.16–3.20)	<0.001
TyG	8.84 (8.36–9.23)	8.01 (7.70–8.39)	<0.001
TBIL, umol/L	11.5 (9.3–14.4)	12.0 (9.6–15.5)	0.175
RBC× (10^12/L)	4.80 (4.51–5.10)	4.63 (4.37–4.89)	<0.001
PLT (×10^9/L)	297 (245–340)	266 (228–313)	0.003
LYM (×10^9/L)	2.48 (2.05–2.77)	2.12 (1.77–2.54)	<0.001
RDW (%)	12.8 (12.2–13.1)	12.5 (12.0–13.2)	0.139
RLR	5.28 (4.64–6.15)	5.99 (5.02–7.33)	<0.001
RPR	0.04 (0.04–0.05)	0.05 (0.04–0.06)	0.001

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; Cre, creatinine; FBG, fasting blood glucose; TG, Triglyceride; CHOL, cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TyG, triglyceride-glucose; PLT, platelet; LYM, lymphocyte; RDW, red blood cell distribution width; RLR, RDW-to-LYM ratio; RPR, RDW-to-PLT ratio; RBC, red blood cell.

Table 7 Multivariate Logistic Regression Analysis of Factors Associated with Female MAFLD

Variable	B	SE	Waldx²	P	OR (95% CI)
Age, years	0.021	0.01	4.141	0.042	1.021 (1.001, 1.042)
H. pylori infection	0.503	0.216	5.399	0.02	1.653 (1.082, 2.527)
BMI
Normal	–	–	–	–	–
Overweight	0.415	0.779	0.285	0.594	1.515 (0.329, 6.971)
Obese	0.013	0.761	0	0.987	1.013 (0.228, 4.502)
Hypertension	0.511	0.54	0.896	0.344	1.667 (0.579, 4.801)
Diabetes	1.039	1.275	0.664	0.415	2.825 (0.232, 34.366)
Eating out	−3.031	0.458	43.853	<0.001	0.048 (0.02, 0.118)
Regular exercise	2.896	0.483	35.952	<0.001	18.098 (7.023, 46.638)
Uric acid, µmol/L	0.004	0.003	1.04	0.308	1.004 (0.997, 1.01)
Uric acid/Cr	0.25	0.168	2.199	0.138	1.284 (0.923, 1.786)
FPG, mmol/L	0.314	0.272	1.337	0.248	1.369 (0.804, 2.331)
TG, mmol/L	0.014	0.454	0.001	0.975	1.014 (0.417, 2.469)
CHOL, mmo/L	−0.288	0.403	0.51	0.475	0.75 (0.34, 1.653)
LDL-C, mmo/L	0.551	0.454	1.472	0.225	1.734 (0.713, 4.221)
TyG	1.474	0.751	3.853	0.049	4.367 (1.002, 19.03)
RBC	0.792	0.363	4.767	0.029	2.209 (1.084, 4.499)
PLT	0.006	0.004	1.902	0.168	1.006 (0.998, 1.014)
LYM (×10^9/L)	−0.348	0.605	0.33	0.566	0.706 (0.216, 2.313)
RLR	−0.231	0.204	1.286	0.257	0.793 (0.532, 1.183)
RPR	21.128	17.383	1.477	0.224	-

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; Cre, creatinine; FPG, fasting blood glucose; CHOL, cholesterol; LDL-C, low-density lipoprotein cholesterol; TyG, triglyceride-glucose; LYM, lymphocyte; RDW, red blood cell distribution width; RLR, RDW-to-LYM ratio; RBC, red blood cell; PLT, platelet; RPR, RDW-to-PLT ratio.

Table 8 ROC Curve of Clinical Indices in the Diagnosis of Female MAFLD

Variable	AUC (95% CI)	p	Sensitivity	Specificity	Optimal Cut-off Value	Youden Index
Eating out	0.587 (0.524, 0.651)	0.006	0.406	0.768	/	0.174
Regular exercise	0.564 (0.507, 0.622)	0.041	0.248	0.881	/	0.129
Older age	0.714 (0.660, 0.767)	<0.001	0.535	0.806	39.5	0.341
TyG	0.818 (0.773, 0.863)	<0.001	0.871	0.631	8.155	0.502
RBC	0.620 (0.559, 0.681)	<0.001	0.614	0.631	4.735	0.245
H.pylori infection	0.608 (0.544, 0.672)	0.001	0.416	0.8	/	0.216
TyG+RBC	0.824 (0.782, 0.867)	<0.001	0.703	0.792	0.1866	0.495
TyG+RBC+older age+H.pylori infection+Eating out+Regular exercise	0.902 (0.867, 0.937)	<0.001	0.822	0.858	0.1885	0.68

Abbreviations: MAFLD, metabolic-associated fatty liver disease; H. pylori, Helicobacter pylori; TyG, triglyceride-glucose; RBC, red blood cell.

Figure 3 ROC curve of clinical indices in the diagnosis of female MAFLD.