Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease

Lei Miao; Li Yang; Li-Sha Guo; Qiang-Qiang Shi; Teng-Fei Zhou; Yang Chen; Huai Zhang; Hui Cai; Zhi-Wei Xu; Shuan-Ying Yang; Hai Lin; Zhe Cheng; Ming-Yang Zhu; Xu Nan; Shuai Huang; Ya-Wen Zheng; Giovanni Targher; Christopher D Byrne; Yu-Ping Li; Ming-Hua Zheng; Cheng-Shui Chen

doi:10.14218/JCTH.2021.00306

Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease

J Clin Transl Hepatol. 2022 Apr 28;10(2):230-237. doi: 10.14218/JCTH.2021.00306. Epub 2022 Jan 4.

Authors

Lei Miao^{1

2

3

4}, Li Yang^{1

3}, Li-Sha Guo³, Qiang-Qiang Shi^{1

3}, Teng-Fei Zhou^{1

3}, Yang Chen^{1

3}, Huai Zhang⁵, Hui Cai⁶, Zhi-Wei Xu⁷, Shuan-Ying Yang⁸, Hai Lin⁹, Zhe Cheng¹⁰, Ming-Yang Zhu^{1

3}, Xu Nan³, Shuai Huang³, Ya-Wen Zheng³, Giovanni Targher¹¹, Christopher D Byrne¹², Yu-Ping Li^{1

3}, Ming-Hua Zheng^{4

13}, Cheng-Shui Chen^{1

3}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
² Department of Gastroenterology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
³ The Interventional Pulmonary Key Laboratory of Zhejiang Province, Wenzhou, Zhejiang, China.
⁴ NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
⁵ Department of Biostatistics and Records Room, Medical Quality Management Office, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
⁶ Department of Respiratory Medicine, Zhong Shan Hospital Affiliated to Shanghai Fudan University, Shanghai, China.
⁷ Clinical Research Service Center, People's Hospital of Henan Provincial, Zhengzhou, Henan, China.
⁸ Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China.
⁹ Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
¹⁰ Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
¹¹ Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
¹² Southampton National Institute for Health Research Biomedical Research Center, University Hospital Southampton, Southampton General Hospital, Southampton, UK.
¹³ Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang, China.

Abstract

Background and aims: We compared lung function parameters in nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD), and examined the association between lung function parameters and fibrosis severity in MAFLD.

Methods: In this cross-sectional study, we randomly recruited 2,543 middle-aged individuals from 25 communities across four cities in China during 2016 and 2020. All participants received a health check-up including measurement of anthropometric parameters, biochemical variables, liver ultrasonography, and spirometry. The severity of liver disease was assessed by the fibrosis (FIB)-4 score.

Results: The prevalence of MAFLD was 20.4% (n=519) and that of NAFLD was 18.4% (n=469). After adjusting for age, sex, adiposity measures, smoking status, and significant alcohol intake, subjects with MAFLD had a significantly lower predicted forced vital capacity (FVC, 88.27±17.60% vs. 90.82±16.85%, p<0.05) and lower 1 s forced expiratory volume (FEV₁, 79.89±17.34 vs. 83.02±16.66%, p<0.05) than those with NAFLD. MAFLD with an increased FIB-4 score was significantly associated with decreased lung function. For each 1-point increase in FIB-4, FVC was diminished by 0.507 (95% CI: -0.840, -0.173, p=0.003), and FEV₁ was diminished by 0.439 (95% CI: -0.739, -0.140, p=0.004). The results remained unchanged when the statistical analyses was performed separately for men and women.

Conclusions: MAFLD was significantly associated with a greater impairment of lung function parameters than NAFLD.

Keywords: Liver fibrosis score; Lung function; MAFLD; NAFLD.