{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:31:46Z","timestamp":1761921106972,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T00:00:00Z","timestamp":1674950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key Research and Development Program of China","award":["2017YFC1309800","82002995","82200659","ZR20220H002"],"award-info":[{"award-number":["2017YFC1309800","82002995","82200659","ZR20220H002"]}]},{"name":"National Natural Science Foundation","award":["2017YFC1309800","82002995","82200659","ZR20220H002"],"award-info":[{"award-number":["2017YFC1309800","82002995","82200659","ZR20220H002"]}]},{"name":"Natural Science Foundation of Shandong Province","award":["2017YFC1309800","82002995","82200659","ZR20220H002"],"award-info":[{"award-number":["2017YFC1309800","82002995","82200659","ZR20220H002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>(1) Background: As the introduction of \u201cpositive\u201d diagnostic criteria for metabolic dysfunction-associated fatty liver disease (MAFLD) does not exclude alcohol consumption, some patients originally diagnosed with alcoholic fatty liver disease (AFLD) may be diagnosed with dual- etiology fatty liver disease (AFLD&amp;MAFLD), which requires us to urgently explore the impact of the changes in this classification of AFLD on clinical manifestations. (2) Methods: Utilizing data from the Nationwide Inpatient Sample database 2016\u20132018, a total of 9269 participants with AFLD were selected. With the definition of MAFLD, these patients were further categorized into two groups: single AFLD and AFLD&amp;MAFLD. The primary outcome was the risk of comorbidities and organ failures. The secondary outcomes were the length of stay, total charges, and in-hospital all-cause mortality. (3) Results: The patients with AFLD&amp;MAFLD were older, were predominantly male, and had more comorbidities and organ failures compared to the patients with AFLD. These comorbidities included coronary atherosclerosis, myocardial infarction, cerebrovascular disease, arrhythmia, asthma, chronic obstructive pulmonary disease, and chronic kidney disease (all p values &lt; 0.05). The patients with AFLD&amp;MAFLD were more likely to develop acute and chronic heart and\/or kidney failures than those with single AFLD (all p &lt; 0.05). The length of stay and total charges of the patients in the AFLD&amp;MAFLD group were greater than the single AFLD group (p = 0.029 and p &lt; 0.001, respectively). No significant difference in all-cause mortality was observed. (4) Conclusions: The patients with AFLD&amp;MAFLD have more comorbidities and organ failures, longer hospital stays, and higher hospitalization costs than the patients with single AFLD. Hence, patients with dual-etiology fatty liver disease deserve more attention from clinical staff during treatment.<\/jats:p>","DOI":"10.3390\/diagnostics13030488","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T08:28:23Z","timestamp":1675067303000},"page":"488","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changes in Clinical Manifestations Due to AFLD Retyping Based on the New MAFLD Criteria: An Observational Study Based on the National Inpatient Sample Database"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0458-1394","authenticated-orcid":false,"given":"Xiaoshan","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruirui","family":"Xuan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingchun","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqin","family":"Wu","sequence":"additional","affiliation":[{"name":"Northern Ohio Alcohol Center, Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH 44196, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7092-508X","authenticated-orcid":false,"given":"Yiping","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zinuo","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junming","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China"},{"name":"Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Institute of Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan 250021, China"},{"name":"Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3267-9292","authenticated-orcid":false,"given":"Jiajun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital 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