[Natural history and risk factors of metabolic associated fatty liver disease in Chinese cohorts].

Metabolic associated fatty liver disease (MAFLD) has become the most common chronic liver disease in China, yet a comprehensive review of the natural history of disease progression and its risk factors is still lacking. This review evaluates integrated natural history characteristics and key risk factors from Chinese cohort studies of MAFLD. In the MAFLD cohorts, the incidence rate of liver fibrosis progression was 19.2%-38.4% over 3-6 years. The hepatocellular carcinoma incidence rate was 0-2.7% over 6-11 years. The all-cause mortality rate was 2.0%-12.0% over 4.6-10 years. Diabetes and abnormal blood glucose were strong predictors of disease progression, and overweight and obesity, hypertension, and age were other risk factors. The article suggests that MAFLD can progress rapidly in certain Chinese cohorts, with multiple risk factors driving the course of the disease. Future large-scale prospective studies are necessary to clarify the mechanisms and optimize intervention strategies.