Abstract:

Objective The incidence and assessment of metabolic associated fatty liver disease （MAFLD） in liver transplantation （LT） recipients is not well studied. This study aimed to investigate the incidence of MAFLD， in LT recipients， and to evaluate the diagnostic potency of different criteria of MAFLD including VCTE， BMI， waisthip ratio and somatotype in a large LT center in China. Methods LT recipients regularly followed up at the Affiliated Hospital of Qingdao University from March 2021 to April 2021 were included. Demographic characteristics and clinical information were collected. Vibration-controlled transient elastography （VCTE） and bioelectrical impedance analysis techniques were used. Diagnostic potency of VCTE， body mass index （BMI）， waist-hip ratio and somatotype for MAFLD were evaluated， respectively. Results A total of 101 LT recipients were finally enrolled and 34 cases （33.7%） were diagnosed with MAFLD. LT recipients with MAFLD had significantly higher BMI， waist-hip ratio， visceral fat index， and controlled attenuation parameter （CAP） value than those without MAFLD. The optimal cutoff CAP value （233 dB/m） for diagnosing MAFLD obtained the sensitivity and specificity of 76.47% and 92.54% with an AUROC value of 0.883（95% CI＝0.804 ～ 0.938）. BMI （＞ 26 kg/m2 ） and waist-hip ratio （＞ 0.88） were inferior to CAP value in the diagnostic potency，but they both had higher sensitivity （85.29%）. Conclusion The incidence of MAFLD in LT recipients is 33.7%. BMI，waist-to-hip ratio， visceral fat index and CAP had their own advantages in assessing MAFLD in adult LT recipients. 

Key words:

"> Liver transplantation ； , metabolic associated fatty liver disease ； , vibration-controlled transient elastography； , somatotype； , waist-hip ratio

摘要：

目的 肝移植（liver transplantation， LT）受者中代谢相关性脂肪肝（metabolic associated fatty liverdisease， MAFLD）的发病率和评估尚未得到充分研究。本研究旨在调查本中心 LT 受者中 MAFLD 的发病率，并分析比较 CAP 值、BMI、腰臀比、体型等 MAFLD 评估指标在 LT 受者中的诊断效能。方法 对 2021 年3 月至 2021 年 4 月在青岛大学附属医院定期随访的成人 LT 受者进行瞬时弹性成像（vibration-controlled transient elastography， VCTE）和生物电阻抗分析，并分别评估 VCTE、体重指数（body mass index， BMI）、腰臀比和体 型对 LT 人群 MAFLD 的诊断效力。结果 本研究最终纳入的 101 例 LT 受者中，MAFLD 的发病率为 33.7% （34/101）。患有 MAFLD 的 LT 受者的体重指数、腰臀比、内脏脂肪指数和受控衰减参数（controlled attenuationparameter， CAP）均明显高于无 MAFLD 的 LT 受者。诊断 MAFLD 的最佳 CAP 临界值为 233 dB/m，其灵敏度和特异度分别为 76.47% 和 92.54%，AUROC 值为 0.883（95% CI ＝ 0.804 ～ 0.938），优于 BMI（＞ 26 kg/m2 ） 和腰臀比（＞ 0.88）的诊断效力，但后两者的灵敏度均较高（85.29%）。结论 LT 受者中 MAFLD 的发生率较高（33.7%）。在评估成人 LT 受者的 MAFLD 方面，BMI、腰臀比、内脏脂肪指数及 CAP 各有优势。

关键词:  , 肝移植 ； 代谢相关性脂肪肝 ； 瞬时弹性成像 ； 体型 ； 腰臀比