Metabolic Dysfunction-associated Fatty Liver Disease and Mortality Among Chinese Adults: a Prospective Cohort Study.

CONTEXT: Nonalcoholic fatty liver disease (NAFLD) was renamed metabolic dysfunction associated with fatty liver disease (MAFLD) recently. OBJECTIVE: We aimed to explore the risk of all-cause deaths in MAFLD participants and compare it with NAFLD in Chinese adults. METHODS: We enrolled 152 139 participants with abdominal ultrasonography in the Kailuan Cohort from 2006 to 2012. We categorized the participants into MAFLD and non-MAFLD, NAFLD and non-NAFLD, and 4 groups of Neither FLD, MAFLD only, NAFLD only, and MAFLD-NAFLD, respectively. We used Cox regression models to estimate the hazard ratios (HRs) and 95% CI of death. RESULTS: The prevalence of MAFLD and NAFLD was 31.5% and 27.3%, respectively. After a median follow-up of 12.7 years, MAFLD and NAFLD both were associated with increased mortality, especially in men younger than 40 years, with HR (95% CI) of 1.51 (1.19-1.93) and 1.37 (1.06-1.78), respectively. The MAFLD-only group had higher mortality than the NAFLD-only in males 60 years or older (adjusted HR = 1.43; 95% CI, 1.00-2.03) and lower risk in males aged 40 to 59 years (adjusted HR = 0.65; 95% CI, 0.48-0.90). MAFLD with overweight/obesity-only decreased, but those with diabetes and/or metabolic dysregulation increased the risk of death. MAFLD with positive hepatitis B surface antigen and/or excessive alcohol consumption further increased the risk of death, especially in men younger than 40 years (HR = 9.86; 95% CI, 2.44-39.98). CONCLUSION: MAFLD was associated with increased all-cause mortality among the Chinese population, which was different according to the status of overweight/obesity, diabetes, other metabolic indicators, and second causes. MAFLD patients should be managed by metabolic indicators and second causes to fulfill precise treatment and management.

[Effects of Jinhuang Yidan Granule on the bile compositions of primary bile duct pigment calculus patients].

OBJECTIVE: To study the effects of Jinhuang Yidan Granule (JYD) on the bile compositions of primary bile duct pigment calculus patients. METHODS: Sixty-six patients with primary bile duct pigment calculus were randomly assigned to the control group (who took no Chinese medicine) and the JYD group (who took JYD). The bile from T-tube during the operation, 3, 10, and 40 days after medication were examined. The contents of bile acids, bilirubin (conjugated bilirubin, mono-conjugated bilirubin), glucoprotein, calcium ion, beta-glucuronidase, superoxide radical anion, and other components were detected and compared. RESULTS: Three days after taking JYD, the total bile acids increased, the total bilirubin and beta-glucuronidase decreased, showing statistical significance when compared with the control group (P < 0.05). In the JYD group, the total bile acid increased, the total bilirubin, the conjugated bilirubin, the mono-conjugated bilirubin, glucoprotein, calcium ion, beta-glucuronidase, superoxide radical anions decreased 10 and 40 days after medication, showing statistical significance when compared with the control group (P < 0.05, P < 0.01). The level of the total bile acid increased, the levels of the total bilirubin, the conjugated bilirubin, the mono-conjugated bilirubin, glucoprotein, calcium ion, beta-glucuronidase, superoxide radical anions decreased after 40-day medication in the two groups, showing statistical significance when compared with the peri-operative indices of the same group (P < 0 05, P < 0.01). CONCLUSIONS: JYD could significantly improve the pathologic bile compositions of the bile duct calculus, improve the environment of the biliary tract, showing certain preventive and therapeutic effects on bile pigment calculus of the primary bile duct calculus. Better effects may be obtained by long-term taking.