High prevalence of MAFLD in general population: A large cross‐sectional study calls for concerted public health action

Abstract

SummaryBackgroundMetabolic associated fatty liver disease (MAFLD) is a relatively new term with limited studies done in South Asian population.AimTo determine prevalence and clinico‐epidemiological characteristics of MAFLD in general population.MethodsA cross‐sectional study was conducted in randomly selected regions across Delhi, India. Data were collected on socio‐demographic particulars, health status and lifestyle factors. Anthropometric measurements, transient elastography, and laboratory investigations were carried out.ResultsAltogether 6146 participants (mean age: 43.1 ± 13.9 years, 48.1% males) were included. The prevalence of MAFLD was 56.4% (n = 3468), of which lean MAFLD constituted 11.3%. Higher age (OR: 2.47; 95% CI: 2.21–2.76), low education level (OR: 1.23; 95% CI: 1.09–1.39), upper socio‐economic class (OR: 1.32; 95% CI: 1.17–1.49), and low physical activity (OR: 1.15; 95% CI: 1.03–1.28) were more common in MAFLD. The association of female sex with MAFLD differed in age groups <40 years (OR: 0.64 and 95% CI: 0.55–0.75) and >40 years (OR: 1.40 and 95% CI: 1.22–1.62) in both magnitude and direction (p < 0.001). Liver fibrosis was present in 23% of the study population (32.2% among MAFLD group). Advanced liver fibrosis was three times more common in MAFLD group (6.2% vs 1.8%, p < 0.001). Obesity and fibrosis had a statistically significant relationship and 75.8% of the individuals with advanced stages of fibrosis had obesity.ConclusionNearly half of study population was found to have MAFLD. Advanced hepatic fibrosis was three times more common in these subjects. Aggressive public health measures are urgently required to raise awareness and introduce interventional strategies.

Associations between metabolic dysfunction-associated fatty liver disease, chronic kidney disease, and abdominal obesity: a national retrospective cohort study

“…In the research conducted by Dao et al, there was a higher prevalence of obesity MAFLD in females than males (62.6% vs. 47.6%; p < 0.001) 25 . Previous research has demonstrated that there were significantly more females than males with MAFLD in age subgroups older than 40 years and there was a sharp rise in the prevalence of MAFLD in perimenopausal and postmenopausal women 26 , 27 , a period during which the decrease in oestrogen levels can lead to fat redistribution and lead to metabolic disorders, including MAFLD 28 . Furthermore, abdominal obesity in women is a well-documented risk factor for polycystic ovary syndrome(PCOS) while a number of studies have suggested the close correlation between PCOS and NAFLD 29 .…”

Underlying Mechanisms behind the Brain–Gut–Liver Axis and Metabolic-Associated Fatty Liver Disease (MAFLD): An Update

“…Therefore, the indissociation between obesity, DM2, metabolic syndrome, MAFLD, and the brain-gut-liver axis is undeniable. This complex and not fully understood relationship is closely linked to the risk of hepatic fibrosis, which is aggravated with advancing age [36,37].…”