目的 探索肥胖、不良生活习惯（不进食早餐、晚睡、点外卖、久坐）对代谢相关脂肪性肝病 （metabolic associated fatty liver disease，MAFLD）肝纤维化进展的影响。方法 选取2017年7月至2018年7月 于云南大学附属医院行 FibroTouch 的就诊者进行横断面分析，根据 FibroTouch 所检测受控衰减参数值 （controlled attenuation parameter，CAP）将就诊者分为健康对照组（n = 1 731）及MAFLD 组（n = 410），再根据 FibroTouch 所检测肝硬度值（liver stiffness measurement，LSM）将 MAFLD 组患者分为无或轻度肝纤维化组 （n = 262）及进展性肝纤维化组（n = 148），运用 χ2 检验、Spearman 相关分析、二分类 logistic 回归分析不良生 活习惯对肝纤维化进展的影响。结果 健康对照组及 MAFLD 组间性别、LSM、体质量指数（body mass in⁃ dex，BMI）差异均有统计学意义（P < 0.05）；MAFLD组中年龄、LSM、BMI、CAP间存在明显相关性（P < 0.001）；无 或轻度肝纤维化组及进展性肝纤维化组间年龄、LSM、BMI、CAP、不良生活习惯差异均有统计学意 义（P < 0.05）；二分类 logistic 回归分析显示，BMI、不良生活习惯是 MAFLD 肝纤维化进展的独立危险因素 （P < 0.05）。结论 肥胖、不良生活习惯等危险因素增加了MAFLD 患者肝纤维化进展的风险。

Objective To explore the influence of obesity and bad living habits on the progression of liver fibrosis in metabolic associated fatty liver disease. Methods Patients undergoing FibroTouch in the Affiliated Hospital of Yunnan University from July 2017 to July 2018 were selected for cross⁃sectional analysis. According to the controlled attenuation parameters detected by FibroTouch，the patients were divided into healthy control group （n = 1731）and MAFLD group（n = 410），then according to the liver hardness value detected by FibroTouch， MAFLD group was divided into no or mild liver fibrosis group（n = 262）and progressive liver fibrosis group （n = 148）. Chi ⁃square test，Spearman correlation analysis and binary Logistic regression were used to analyze the influence of bad living habits on the progression of liver fibrosis. Results Statistically significant differences in gender，LSM and BMI were found between healthy control group and MAFLD group（P < 0.05）. There were significant correlations among age，LSM，BMI and CAP in MAFLD group（P < 0.001）. There were statistically significant differences in age，LSM，BMI，CAP and bad living habits between the group without or mild liver fibrosis and the group with advanced liver fibrosis （P < 0.05）. Binary Logistic regression analysis showed BMI and bad living habits were independent risk factors for progression of liver fibrosis in MAFLD（P < 0.05）. Conclusion Risk factors such as obesity and bad living habits increased the risk of liver fibrosis progression in patients with MAFLD.