Advanced Fibrosis Is Common Among Patients With NAFLD

Non-alcoholic fatty liver disease (NAFLD) affects as many as 51.6 million US adults age 20 years or older, of whom approximately 12.2 million also have advanced hepatic fibrosis, according to a new analysis. Factors associated with a higher risk of advanced fibrosis include age, obesity, and concurrent diabetes.

It is well known that NAFLD is a leading cause of chronic liver disease in the United States. Therefore, understanding the epidemiology of NAFLD and focusing on individuals with hepatic fibrosis is a crucial component of health care resource planning.
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For their analysis, the researchers evaluated data from the updated 2011-2014 National Health and Nutrition Examination Survey, which assessed non-institutionalized adults age 20 years or older in the United States.

An Aspartate Aminotransferase to Platelet Ratio Index (APRI) score of higher than 0.7 was used to assess METAVIR F2 or greater fibrosis among individuals with NAFLD, while an NAFLD fibrosis score (NFS) of higher than 0.676 and an FIB-4 score of higher than 3.25 were used to assess METAVIR F3 or greater fibrosis. Predictors of fibrosis among individuals with NAFLD were investigated via multivariate logistic regression models.

Results indicated that 51.6 million (21.9%) US adults had NAFLD, of whom 12.2 million (23.8%) had F2 or higher fibrosis, and 5 million (2.3%-9.7%) had F3 or higher fibrosis. Multivariate regression analyses showed that age, obesity, and concurrent diabetes had each been associated with an increased risk of F3 or higher fibrosis.

“NAFLD represents a major healthcare burden among US adults with as many as 5 million adults estimated to have NAFLD with [F3 or higher] fibrosis,” the researchers concluded. “Age and the components of the metabolic syndrome are independently associated with higher risk of fibrosis.”

—Christina Vogt

Reference:

Wong RJ, Liu B, Bhuket T. Significant burden of nonalcoholic fatty liver disease with advanced fibrosis in the US: a cross-sectional analysis of 2011-2014 National Health and Nutrition Examination Survey [Published online September 15, 2017]. Alimentary Pharmacol Ther. doi:10.1111/apt.14327.