摘要目的:探讨血清铁蛋白（SF）与新发代谢相关脂肪性肝病（MAFLD）的相关性。方法:以2017年在天津医科大学总医院健康管理中心体检且符合入选标准的7 980例受检者作为观察队列，按性别以基线SF水平四分位数分为 Q1~ Q4组，随访各组2018—2020年健康体检时MAFLD的发病情况，比较各组MAFLD的累积发病率，用Cox比例风险回归模型分析不同SF与新发MAFLD的相关性，并按照性别、年龄、吸烟状况、体质指数（BMI）等进行分层分析。 结果:平均随访时间3.2年，共计随访25 321人年，随访期间共发生MAFLD 1 696例， Q1~ Q4组MAFLD发病密度分别为53.30、56.39、72.80及85.78/千人年。MAFLD发病密度随着基线SF水平的升高而增加，当男性和女性SF分别≥162.47和49.94 μg/L时， Q3、 Q4组MAFLD发病密度与 Q1组比较，均 P<0.001。 Q3、 Q4组MAFLD发病风险分别为 Q1组的1.173（95% CI：1.093~1.258）、1.174（95% CI：1.122~1.228）倍；采用Cox比例风险回归模型校正年龄、吸烟状况等多种混杂因素后， Q3、 Q4组MAFLD发病风险仍为 Q1组的1.092（95% CI：1.017~1.172）、1.084（95% CI：1.035~1.136）倍（均 P<0.001）。按照性别、年龄、吸烟状况、BMI等进行分层分析，男性、较低年龄组、不吸烟、高BMI人群中，高SF与MAFLD发病关联差异有统计学意义。 结论:高SF水平与MAFLD发病相关，且受性别、年龄、吸烟状况、BMI等因素影响。

abstractsObjective:To investigate the relationship between serum ferritin (SF) and metabolic associated fatty liver disease (MAFLD).Methods:A total of 7 980 adults from physical examination in Tianjin Medical University General Hospital who met selection criterion were recruited as participants. Subjects were divided into 4 groups ( Q1- Q4) according to quartiles of SF level by gender. The incidence of MAFLD in each group in 2018-2020 were observed and cumulative incidence of MAFLD was compared between each group. Cox regression model was used to analyze the correlation between different SF levels and new-onset MAFLD, and stratified analysis was performed according to factors as gender, age, smoking status and body mass index (BMI). Results:The mean follow up period was 3.2 years, and there were 25 323 person-years of follow-up, and 1 696 subjects developed MAFLD. The incidence density of MAFLD in Q1- Q4 groups were 53.30, 56.39, 72.80 and 85.78/1 000 person-years, respectively. The incidence density of MAFLD increased along with the increase of SF levels, and the differences were statistically significant ( P values between Q3, Q4 and Q1 groups were both<0.001) with SF ≥ 162.47 μg/L (male) and 49.94 μg/L (female). The risk of MAFLD were 1.173 (95% CI: 1.093-1.258) and 1.174 (95% CI: 1.122-1.228) times higher in Q3 and Q4 group than that in Q1 group ( P<0.001). After adjusting for age, smoking status and other confounding factors, the risks of MAFLD in the Q3 and Q4 groups were 1.092 (95% CI: 1.017-1.172) and 1.084 (95% CI: 1.035-1.136) times higher in Q3 and Q4 group than that in Q1 group (all P<0.001). The stratified analyses based on gender, age, smoking status, BMI and other factors indicated that high SF levels showed significant association with MAFLD risk in those with the male sex, younger age, non-smokers and higher BMI population. Conclusions:High SF levels might increase the risk of MAFLD and this positive association might be associated with gender, age, smoking status and BMI.