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Significant burden of NALFD with advanced fibrosis in the USA

Published ahead of print, the latest Alimentary Pharmacology & Therapeutics evaluated prevalence and predictors of hepatic fibrosis among US adults with NAFLD.

News image

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease in the US.

Understanding the epidemiology of NAFLD, with specific focus on individuals with hepatic fibrosis is important to guide healthcare resource planning.

Dr Wong and colleagues from California, USA evaluated prevalence and predictors of hepatic fibrosis among US adults with NAFLD.

The researchers performed a cross-sectional study using data from the updated 2011-2014 National Health and Nutrition Examination Survey, a national, stratified, multistage sampling survey of non-institutionalized US adults age ≥ 20.

The team assessed METAVIR F2 or greater fibrosis among individuals with NAFLD using AST to Platelet Ratio Index (APRI) score of greater than 0.7.

Prevalence of ≥F2 fibrosis was 24%
Alimentary Pharmacology & Therapeutics

METAVIR F3 or greater fibrosis was assessed using NAFLD fibrosis score (NFS) of more than 0.676 and FIB-4 score more than 3.25.

Multivariate logistic regression models evaluated for predictors of fibrosis among individuals with NAFLD.

Overall prevalence of NAFLD among US adults was 22%, representing 51.6 million adults.

Among individuals with NAFLD, the team observed a 24% prevalence of ≥F2 fibrosis, representing 12.2 million individuals.

The researchers observed a 3%-10% prevalence of ≥F3 fibrosis, representing as many as 5.0 million adults. On multivariate regression analyses, increasing age, obesity and concurrent diabetes mellitus were associated with increased risk of ≥F3 fibrosis.

Dr Wong's team concludes, "NAFLD represents a major healthcare burden among US adults with as many as 5 million adults estimated to have NAFLD with ≥F3 fibrosis."

"Age and the components of the metabolic syndrome are independently associated with higher risk of fibrosis."

Aliment Pharmacol Ther 2017: Early view DOI: 10.1111/apt.14327
02 October 2017

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