Publication Date
1-1-2021
Journal
PLoS One
DOI
10.1371/journal.pone.0252164
PMID
34081733
PMCID
PMC8174685
PubMedCentral® Posted Date
6-3-2021
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Elasticity Imaging Techniques, Female, Humans, Hypertension, Liver, Liver Cirrhosis, Male, Metabolic Syndrome, Middle Aged, Non-alcoholic Fatty Liver Disease, Nutrition Surveys, Obesity, Physical Fitness, Sedentary Behavior, United States
Abstract
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is increasingly common in the adult population. In the United States, the overall burden of NAFLD is unknown due to challenges with population-level NAFLD detection. The purpose of this study was to estimate prevalence of NAFLD and significant NAFLD fibrosis and identify factors associated with them in the U.S.
METHODS: Data came from the 2017-2018 cycle of National Health and Nutrition Examination Survey. We defined NAFLD by controlled attenuation parameter (CAP) scores of ≥248 dB/m in absence of excessive alcohol use and viral hepatitis. We defined significant fibrosis as Vibration controlled transient elastography (VCTE) liver stiffness measurements (LSM) value ≥7.9 kPa. We calculated the adjusted odds ratio (OR) and 95% confidential intervals (CI) for associations with NAFLD and significant NAFLD fibrosis using multivariable logistic regression.
RESULTS: Overall, among 4,024 individuals aged ≥20 years included in the analysis, 56.7% had NAFLD by CAP. In comparison, when defined by elevated liver enzymes, NAFLD prevalence was 12.4%. The prevalence of significant NAFLD fibrosis by VCTE LSM was 14.5%. NAFLD prevalence increased with age, was higher among men than women and among Hispanics compared with non-Hispanic whites. Individuals who were obese, had metabolic syndrome (MetS) and type 2 diabetes were more likely to have NAFLD compared to those that who were not obese or without MetS/diabetes. Inadequate physical activity (OR = 1.57, 95% CI: 1.18-2.08) was also a factor associated with NAFLD. MetS, high waist circumstance, diabetes and hypertension were independently associated with significant NAFLD fibrosis.
CONCLUSIONS: NAFLD and significant NAFLD fibrosis are highly prevalent in U.S. general population.
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