Impact on Prevalence of the Application of NAFLD/MAFLD Criteria in Overweight and Normal Weight Patients

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. Recently, the term metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed and adapted to body mass index (BMI). This study describes the impact on prevalence of the application of both criteria in overweight and lean patients. Methods: Patients who were evaluated for liver steatosis by transient elastography were included and divided according to BMI (≥25 kg/m2 and <25 kg/m2) and classified as NAFLD or MAFLD, according to metabolic abnormalities. Differences in prevalence were evaluated applying both criteria. A multivariate analysis was performed to evaluate independent associations of metabolic abnormalities and liver steatosis in lean patients. Results: 3847 patients were included. In overweight patients (61%), the prevalence NAFLD was 63.6% and 65.3% for MAFLD (p = 0.22). In contrast, the prevalence of MAFLD was lower (7.9% vs. 18.3%, p ≤ 0.001) in lean patients. In this group, higher age, fasting glucose, triglycerides, and waist circumference showed independent association with liver steatosis. Conclusion: The application of NAFLD/MAFLD criteria did not show prevalence differences in overweight patients. With MAFLD criteria, the prevalence is lower in lean patients, but patients with high risk of progression of liver disease for steatosis were identified, according to their metabolic abnormalities.

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

“…Likewise, the metabolic dysfunction associated with MAFLD is a frequent cause of chronic liver diseases and possibly cirrhosis, liver carcinoma, and liver transplant. Therefore, clinically, three basic criteria are evaluated for diagnosis as follows: overweight or obesity, the presence of DM2, or evidence of metabolic disorders [9,28,29]. Metabolic syndrome is characterized, according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, by the presence of three to five risk factors that include elevated abdominal circumference, triglyceride, blood pressure, and fasting glycemia and reduced High-density Lipoprotein-cholesterol (HDL-c) levels (Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III final report, 2002)) [30].…”