The Current Status of Awareness and Influencing Factors Analysis of Metabolic-associated Fatty Liver Disease among the General Population in Multiple Regions of Yunnan

doi:10.12114/j.issn.1007-9572.2025.0095

Chinese General Practice ›› 2026, Vol. 29 ›› Issue (17): 2347-2353.DOI: 10.12114/j.issn.1007-9572.2025.0095

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The Current Status of Awareness and Influencing Factors Analysis of Metabolic-associated Fatty Liver Disease among the General Population in Multiple Regions of Yunnan

1. Department of Gastroenterology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
2. Department of Gastroenterology, Lincang People's Hospital, Lincang 675800, China
3. Department of Gastroenterology, Xishuangbanna Dai Autonomous Prefecture People's Hospital, Xishuangbanna Dai Autonomous Prefecture 666100, China
4. Department of Gastroenterology, Yingjiang People's Hospital, Dehong Dai and Jingpo Autonomous Prefecture 679300, China
5. Department of Gastroenterology, Huize County People's Hospital, Huize County, Qujing 654200, China

Received:2025-03-19 Revised:2025-07-20 Published:2026-06-15 Online:2026-05-21
Contact: MA Lanqing
About author:
HUANG Minshan, CHEN Hang and LI Liya are co-first authors

云南多地区普通人群对代谢相关脂肪性肝病的认知现状调查及影响因素研究

1．650032　云南省昆明市，昆明医科大学第一附属医院消化内科
2．675800　云南省临沧市人民医院消化内科
3．666100　云南省西双版纳傣族自治州人民医院消化内科
4．679300　云南省德宏傣族景颇族自治州盈江县人民医院消化内科
5．654200　云南省曲靖市会泽县人民医院消化内科

通讯作者: 马岚青
作者简介:
黄敏杉、陈杭和李丽娅为共同第一作者
作者贡献：
黄敏杉、陈杭和李丽娅负责数据收集、论文构思和初稿写作；杨太明、陈丽芳、李申超、任丽、王卉、李明珂、王仙梅、王达、万盈、何昱乐、周青青、李钰、李梦唯、陆丽红、罗一凡负责数据收集；马岚青负责论文构思、经费获取、监督指导。
基金资助:
国家自然科学基金资助项目(82470604); 国家临床重点专科专项(530000210000000073331); 云南省基础研究计划昆医联合专项-重点项目(202401AY070001-009)

Abstract

Abstract:

Background

With the ongoing changes in lifestyle, the prevalence of metabolic-associated fatty liver disease has been increasing year by year. However, public awareness of this condition remains insufficient. Enhancing public knowledge is essential for early prevention and intervention, highlighting the urgent need for related population-based investigations.

Objective

To investigate the current awareness of metabolic-associated fatty liver disease among the general population in multiple regions of Yunnan Province and analyze the factors affecting this awareness, providing a basis for improving public understanding of fatty liver disease.

Methods

This study collected questionnaires on knowledge related to metabolic-associated fatty liver disease from the general population in 11 regions of northeastern, southeastern, northwestern, and southwestern Yunnan Province (including Baoshan City, Dehong Dai and Jingpo Autonomous Prefecture, Honghe Hani and Yi Autonomous Prefecture, Lijiang City, Lincang City, Puer City, Wenshan Zhuang and Miao Autonomous Prefecture, Xishuangbanna Dai Autonomous Prefecture, Kunming City, Yingjiang County of Dehong Dai and Jingpo Autonomous Prefecture, and Huize County of Qujing City) through free medical consultations from June 2022 to October 2023. The questionnaire covered general information (such as residence, gender, age, ethnicity, place of residence, occupation, education level, and income) and fatty liver disease awareness (including epidemiology, causes, risk factors, diagnosis, harm, treatment, and prevention). Data were analyzed using SPSS 25.0, and logistic regression was applied to identify factors related to awareness.

Results

A total of 975 questionnaires were collected. After eliminating 12 invalid questionnaires, 963 valid questionnaires were retrieved, with an effective recovery rate of 98.77%. The overall average awareness accuracy rate was 60.36%. 78.61% (757/963) of respondents correctly recognized the symptoms of fatty liver disease. 80.48% (775/963) believed that both obese and non-obese individuals could develop fatty liver disease. 35.62% (343/963) were aware of the risk groups for fatty liver disease. 25.34% (244/963) had never been screened for fatty liver disease, with 60.25% (147/244) of these individuals having an annual income of less than 50 000 yuan. The correct rates for knowledge about fatty liver disease's causes and risk factors, diagnostic methods, dietary restrictions, preventive measures, and treatment methods were 35.62% (343/963), 1.25% (12/963), 79.13% (762/963), 57.42% (553/963), and 58.36% (562/963), respectively. 39.15% (377/963) believed that careful use of medications, health supplements, and alcohol limitation could reduce liver burden. About 90% could correctly identify the timing for medication (886/963) and medical consultation for fatty liver disease (861/963). 76.53% (737/963) had a clear understanding of the adverse prognosis of fatty liver disease. Multivariate Logistic regression analysis showed that educational attainment of primary school (OR=2.905, 95%CI=1.701-4.961), junior high school (OR=3.791, 95%CI=2.318-6.200), and senior high school (OR=2.993, 95%CI=1.868-4.795) were risk factors for low awareness of metabolism-related fatty liver disease (P<0.05); household annual income ranging from 50 000 yuan to less than 100 000 yuan (OR=0.547, 95%CI=0.375-0.796) and 100 000 yuan to less than 200 000 yuan (OR=0.629, 95%CI=0.399-0.993) were protective factors for low awareness of metabolism-related fatty liver disease (P<0.05).

Conclusion

The general public has insufficient knowledge about the causes, risk factors, treatment, and prevention of fatty liver disease, and there are significant misconceptions about the diagnosis of liver fat degeneration. Low-income groups severely neglect early screening for the disease, and low education level is independent risk factor for low fatty liver disease awareness, high household income is protective factor for low fatty liver disease awareness.

Key words: Metabolic associated fatty liver disease, Non-alcoholic fatty liver disease, General population, Awareness, Yunnan Province

摘要：

背景

随着生活方式改变，代谢相关脂肪性肝病患病率逐年上升，但公众认知仍不足。提升公众认知水平对早期预防与干预具有重要意义，亟须开展相关调查研究。

目的

调查云南省多地区普通人群对代谢相关脂肪性肝病的认知现状，并分析影响认知度的因素，为提高公众对代谢相关脂肪性肝病的正确认知提供依据。

方法

本研究于2022年6月—2023年10月通过义诊收集云南省滇东北、滇东南、滇西北、滇西南11个地区（包括保山市、德宏傣族景颇族自治州、红河哈尼族彝族自治州、丽江市、临沧市、普洱市、文山壮族苗族自治州、西双版纳傣族自治州、昆明市、德宏傣族景颇族自治州盈江县、曲靖市会泽县）普通人群关于代谢相关脂肪性肝病相关知识的调查问卷。问卷涵盖一般情况（生活地、性别、年龄、民族、居住地、职业、文化程度、收入）和代谢相关脂肪性肝病认知情况（流行病学、病因、危险因素、诊断、危害、治疗、预防）。采用SPSS 25.0进行统计，应用Logistic回归分析探讨影响认知度的相关因素。

结果

共收集975份问卷，剔除无效问卷12份，回收有效问卷963份，有效回收率为98.77%。调查对象对代谢相关脂肪性肝病的总体认知正确率为60.36%。78.61%（757/963）可以正确认知代谢相关脂肪性肝病的患病表现，80.48%（775/963）认为肥胖和非肥胖人群均会患代谢相关脂肪性肝病；35.62%（343/963）了解代谢相关脂肪性肝病的危险人群，25.34%（244/963）从未筛查过，其中60.25%（147/244）年收入<5万元；代谢相关脂肪性肝病病因及危险因素、诊断方法、饮食禁忌、预防、治疗的正确率分别为35.62%（343/963）、1.25%（12/963）、79.13%（762/963）、57.42%（553/963）、58.36%（562/963）；39.15%（377/963）认为谨慎使用药物、保健品和限酒可减轻肝脏负担；约90%能正确把握用药（886/963）和就诊时机（861/963）；76.53%（737/963）对代谢相关脂肪性肝病不良预后有清楚认知。多因素Logistic回归分析显示，文化程度为小学（OR=2.905，95%CI=1.701~4.961）、初中（OR=3.791，95%CI=2.318~6.200）、高中（OR=2.993，95%CI=1.868~4.795）是代谢相关脂肪性肝病认知度低的危险因素（P<0.05）；家庭年收入为5万元~<10万元（OR=0.547，95%CI=0.375~0.796）、10万元~<20万元（OR=0.629，95%CI=0.399~0.993）是代谢相关脂肪性肝病认知度低的保护因素（P<0.05）。

结论

公众在代谢相关脂肪性肝病病因、危险因素、治疗及预防方面认识不足，对肝脏脂肪变性的诊断存在误区。低收入群体严重忽视早期筛查，文化程度低是代谢相关脂肪性肝病认知度低的独立危险因素，家庭年收入高是代谢相关脂肪性肝病认知度低的独立保护因素。

CLC Number:

R 575.5

HUANG Minshan,CHEN Hang,LI Liya, et al. The Current Status of Awareness and Influencing Factors Analysis of Metabolic-associated Fatty Liver Disease among the General Population in Multiple Regions of Yunnan[J]. Chinese General Practice, 2026, 29(17): 2347-2353. DOI: 10.12114/j.issn.1007-9572.2025.0095.
黄敏杉,陈杭,李丽娅等. 云南多地区普通人群对代谢相关脂肪性肝病的认知现状调查及影响因素研究[J]. 中国全科医学, 2026, 29(17): 2347-2353. DOI: 10.12114/j.issn.1007-9572.2025.0095.

Figures/Tables 3

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变量	β	SE	Wald χ²值	P值	OR（95%CI）
所在地区（以滇东北为参照）				<0.001
滇东南	0.525	0.216	5.935	0.015	1.691（1.108~2.580）
滇西北	-0.114	0.228	0.252	0.615	0.892（0.571~1.394）
滇西南	-0.119	0.218	0.298	0.585	0.888（0.580~1.360）
年龄段（以≥66岁为参照）				<0.001
<18岁	-0.598	0.831	0.517	0.472	0.550（0.108~2.805）
18~25岁	-1.828	0.757	5.828	0.016	0.161（0.036~0.709）
26~35岁	-1.679	0.725	5.358	0.021	0.187（0.045~0.773）
36~45岁	-0.935	0.718	1.696	0.193	0.393（0.096~1.603）
46~55岁	-1.004	0.715	1.970	0.160	0.367（0.090~1.489）
56~65岁	-1.038	0.775	1.794	0.180	0.354（0.078~1.617）
居住地（以农村为参照）				<0.001
城镇	-0.737	0.147	25.003	<0.001	0.479（0.359~0.639）
职业（以国家机关、党群组织、企业、事业单位负责人为参照）				<0.001
专业技术人员	-0.304	0.236	1.660	0.198	0.738（0.465~1.171）
办事人员和有关人员	-0.016	0.341	0.002	0.963	0.984（0.505~1.920）
商业、服务业人员	0.318	0.266	1.426	0.232	1.374（0.815~2.316）
农、林、牧、渔、水利生产人员	1.475	0.254	33.713	<0.001	4.372（2.657~7.193）
生产、运输设备操作及有关人员	0.256	0.502	0.260	0.610	1.292（0.483~3.456）
军人	-0.997	1.092	0.833	0.361	0.369（0.043~3.138）
不便分类的其他从业人员	0.507	0.197	6.617	0.010	1.661（1.128~2.444）
文化程度（以本科及以上为参照）				<0.001
小学	1.724	0.220	61.336	<0.001	5.606（3.642~8.630）
初中	1.765	0.216	66.877	<0.001	5.843（3.827~8.920）
高中	1.344	0.215	39.036	<0.001	3.834（2.515~5.844）
专科	0.499	0.209	5.714	0.017	1.648（1.094~2.481）
年收入（以<5万元为参照）				<0.001
5万元~<10万元	-1.070	0.164	42.441	<0.001	0.343（0.249~0.473）
10万元~<20万元	-1.228	0.190	41.970	<0.001	0.293（0.202~0.425）
≥20万元	-0.780	0.287	7.395	0.007	0.458（0.261~0.804）

变量	β	SE	Wald χ²值	P值	OR（95%CI）
所在地区（以滇东北为参照）				<0.001
滇东南	0.525	0.216	5.935	0.015	1.691（1.108~2.580）
滇西北	-0.114	0.228	0.252	0.615	0.892（0.571~1.394）
滇西南	-0.119	0.218	0.298	0.585	0.888（0.580~1.360）
年龄段（以≥66岁为参照）				<0.001
<18岁	-0.598	0.831	0.517	0.472	0.550（0.108~2.805）
18~25岁	-1.828	0.757	5.828	0.016	0.161（0.036~0.709）
26~35岁	-1.679	0.725	5.358	0.021	0.187（0.045~0.773）
36~45岁	-0.935	0.718	1.696	0.193	0.393（0.096~1.603）
46~55岁	-1.004	0.715	1.970	0.160	0.367（0.090~1.489）
56~65岁	-1.038	0.775	1.794	0.180	0.354（0.078~1.617）
居住地（以农村为参照）				<0.001
城镇	-0.737	0.147	25.003	<0.001	0.479（0.359~0.639）
职业（以国家机关、党群组织、企业、事业单位负责人为参照）				<0.001
专业技术人员	-0.304	0.236	1.660	0.198	0.738（0.465~1.171）
办事人员和有关人员	-0.016	0.341	0.002	0.963	0.984（0.505~1.920）
商业、服务业人员	0.318	0.266	1.426	0.232	1.374（0.815~2.316）
农、林、牧、渔、水利生产人员	1.475	0.254	33.713	<0.001	4.372（2.657~7.193）
生产、运输设备操作及有关人员	0.256	0.502	0.260	0.610	1.292（0.483~3.456）
军人	-0.997	1.092	0.833	0.361	0.369（0.043~3.138）
不便分类的其他从业人员	0.507	0.197	6.617	0.010	1.661（1.128~2.444）
文化程度（以本科及以上为参照）				<0.001
小学	1.724	0.220	61.336	<0.001	5.606（3.642~8.630）
初中	1.765	0.216	66.877	<0.001	5.843（3.827~8.920）
高中	1.344	0.215	39.036	<0.001	3.834（2.515~5.844）
专科	0.499	0.209	5.714	0.017	1.648（1.094~2.481）
年收入（以<5万元为参照）				<0.001
5万元~<10万元	-1.070	0.164	42.441	<0.001	0.343（0.249~0.473）
10万元~<20万元	-1.228	0.190	41.970	<0.001	0.293（0.202~0.425）
≥20万元	-0.780	0.287	7.395	0.007	0.458（0.261~0.804）

变量	β	SE	Wald χ²值	P值	OR（95%CI）
文化程度（以本科及以上为参照）				<0.001
小学	1.067	0.273	15.263	<0.001	2.905（1.701~4.961）
初中	1.333	0.251	28.178	<0.001	3.791（2.318~6.200）
高中	1.096	0.240	20.787	<0.001	2.993（1.868~4.795）
专科	0.348	0.219	2.515	0.113	1.416（0.921~2.175）
家庭年收入（以<5万元为参照）				0.011
5万元~<10万元	-0.604	0.192	9.932	0.002	0.547（0.375~0.796）
10万元~<20万元	-0.463	0.232	3.964	0.046	0.629（0.399~0.993）
≥20万元	-0.079	0.322	0.060	0.807	0.924（0.491~1.738）

变量	β	SE	Wald χ²值	P值	OR（95%CI）
文化程度（以本科及以上为参照）				<0.001
小学	1.067	0.273	15.263	<0.001	2.905（1.701~4.961）
初中	1.333	0.251	28.178	<0.001	3.791（2.318~6.200）
高中	1.096	0.240	20.787	<0.001	2.993（1.868~4.795）
专科	0.348	0.219	2.515	0.113	1.416（0.921~2.175）
家庭年收入（以<5万元为参照）				0.011
5万元~<10万元	-0.604	0.192	9.932	0.002	0.547（0.375~0.796）
10万元~<20万元	-0.463	0.232	3.964	0.046	0.629（0.399~0.993）
≥20万元	-0.079	0.322	0.060	0.807	0.924（0.491~1.738）

The Current Status of Awareness and Influencing Factors Analysis of Metabolic-associated Fatty Liver Disease among the General Population in Multiple Regions of Yunnan

云南多地区普通人群对代谢相关脂肪性肝病的认知现状调查及影响因素研究

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