幽门螺杆菌和代谢相关脂肪肝疾病严重程度：荟萃分析
{"_":" and metabolic-associated fatty liver disease severity: a meta-analysis.","i":["Helicobacter pylori"]}
摘要(中文译文)
代谢相关脂肪性肝病（MAFLD）是全球性健康问题。观察性证据提示感染与MAFLD严重程度之间可能存在关联；然而，以严重程度为重点的数据仍不一致，且方法学异质性较大。我们检索了国际数据库PubMed、Embase和Web of Science以及中文数据库中国知网、中国科技期刊数据库（维普）和万方数据库，检索时间为2015年1月至2024年12月。纳入报告感染状态与MAFLD/非酒精性脂肪性肝病（NAFLD）严重程度的观察性研究。使用NAFLD标准的研究被认为在临床上与MAFLD具有可比性，因为这些研究开展于MAFLD术语被广泛采用之前，且纳入的是以肝脂肪变性伴代谢特征定义的脂肪性肝病人群。采用随机效应模型计算合并比值比（OR），并使用限制性最大似然估计和Hartung-Knapp校正。共纳入7项研究，包含11,168名参与者（4,980例阳性；6,188例阴性）。总体随机效应分析未显示感染与MAFLD严重程度之间存在统计学显著关联（合并OR 1.47，95%置信区间[CI]：0.83-2.59，= 0.148，= 0.1325），异质性较大（= 79.0%）。在无创评估亚组中，合并估计值为OR = 1.22（95% CI：0.95-1.57）。两项基于活检的研究显示个体估计值较高但极不精确，未被解释为存在更强关联的证据。地理分析显示仅在中国人群中存在关联（OR = 1.31，95% CI：1.15-1.49，= 0%）。当前证据未显示感染与MAFLD严重程度之间存在统计学显著的总体关联。在中国研究中观察到适度关联，但基于活检的证据仍过于不精确，不足以进行推断。在得出因果或治疗结论之前，需要进行大规模前瞻性研究，对活动性感染和MAFLD严重程度进行标准化评估。
Abstract
Metabolic-associated fatty liver disease (MAFLD) is a global health concern. Observational evidence has suggested a possible relationship between infection and MAFLD severity; however, severity-focused data remain inconsistent and methodologically heterogeneous. We searched the international databases PubMed, Embase and Web of Science and the Chinese databases China National Knowledge Infrastructure, Chinese Scientific Journal Database (VIP) and Wanfang between January 2015 and December 2024. Observational studies reporting status and MAFLD/non-alcoholic fatty liver disease (NAFLD) severity were included. Studies using NAFLD criteria were considered clinically comparable with MAFLD because they were conducted before the broad adoption of the MAFLD terminology and enrolled fatty liver disease populations defined by hepatic steatosis with metabolic features. Pooled odds ratios (ORs) were calculated using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp adjustment. Seven studies, comprising 11,168 participants (4,980 -positive; 6,188 -negative), were included. The overall random-effects analysis did not demonstrate a statistically significant association between infection and MAFLD severity (pooled OR 1.47, 95% confidence interval [CI]: 0.83-2.59, = 0.148 = 0.1325), with substantial heterogeneity ( = 79.0%). In the non-invasive assessment subgroup, the pooled estimate was OR = 1.22 (95% CI: 0.95-1.57). The two biopsy-based studies showed high but highly imprecise individual estimates and were not interpreted as evidence of a stronger association. Geographic analysis showed an association only in Chinese populations (OR = 1.31, 95% CI: 1.15-1.49, = 0%). Current evidence does not demonstrate a statistically significant overall association between infection and MAFLD severity. A modest association was observed in Chinese studies, although biopsy-based evidence remains too imprecise for inference. Large-scale prospective studies with standardized assessment of active infection and MAFLD severity are needed before causal or therapeutic conclusions can be drawn.
如何引用
AMA
Lingyun Zhang, Yuexia Zhang, Lei Qiao, Ruihan Wu, Feng He, Yuxin Guan, et al. {"_":" and metabolic-associated fatty liver disease severity: a meta-analysis.","i":["Helicobacter pylori"]}. Frontiers in medicine. 2026; doi:10.3389/fmed.2026.1821076.
APA
Lingyun Zhang, Yuexia Zhang, Lei Qiao, Ruihan Wu, Feng He, Yuxin Guan, et al (2026). {"_":" and metabolic-associated fatty liver disease severity: a meta-analysis.","i":["Helicobacter pylori"]}. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1821076
GB/T 7714
Lingyun Zhang, Yuexia Zhang, Lei Qiao, Ruihan Wu, Feng He, Yuxin Guan, et al. {"_":" and metabolic-associated fatty liver disease severity: a meta-analysis.","i":["Helicobacter pylori"]}[J]. Frontiers in medicine, 2026 doi:10.3389/fmed.2026.1821076.
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