Letter: significant burden of nonalcoholic fatty liver disease with advanced fibrosis in the <scp>USA</scp>: a cross‐sectional analysis of 2011‐2014 National Health and Nutrition Examination Survey

Liu, Y.; Wan, Bo; Lin, Su

doi:10.1111/apt.14850

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…This study had several advantages: (1) It was based on a national population, providing a large sample size, (2) We used ultrasonography, a widely available, noninvasive and recommended method for the diagnosis of liver steatosis (32), to diagnose NAFLD, especially in large population-based studies (33)(34)(35), while some early population-based studies used non-invasive fatty liver models (12,36). The major limitation of this study is that it is only a cross-sectional study.…”

Section: Discussionmentioning

confidence: 99%

Association between Vitamin D Status and Non-Alcoholic Fatty Liver Disease: A Population-Based Study

Liu

Wan

et al. 2019

J Nutr Sci Vitaminol

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The relationship between vitamin D levels and non-alcoholic fatty liver disease (NAFLD) remains unestablished. In this study, we aimed to explore the relationship between vitamin D levels and NAFLD based on population survey data. This cross-sectional study was conducted based on data from the National Health and Nutrition Examination Survey. Liver steatosis was diagnosed by ultrasonography. Binary logistic regression analyses were performed to determine the relationship between vitamin D status and NAFLD. A total of 9,782 participants were identified in this analysis, with 46.8% male and an average age of 44.4160.16 y old. Among them, 6,047 (61.8%) cases were without NAFLD, 1,357 (13.9%) had mild NAFLD, 1,594 (16.3%) had moderate and 784 (8.0%) had severe NAFLD. Compared to those with non-NAFLD or mild NAFLD, patients in the moderate to severe NAFLD group had higher vitamin D deficiency or insufficiency rates (12.4% vs 11.5% and 36.8% vs 33.2%, respectively). After adjustment for male gender, older age, race, BMI, history of diabetes and vitamin D intake, vitamin D levels were independently associated with the severity of NAFLD (vitamin D deficiency group OR: 1.314, 95% CI: 1.129 to 1.529, vitamin D insufficiency group OR: 1.203, 95% CI: 1.090 to 1.328). Besides that, cold season was also found to be an independent factor for NAFLD (OR: 0.896, 95% CI: 0.820 to 0.979). Lower vitamin D level is an independent risk factor for NAFLD. Vitamin D levels are inversely associated with the severity of NAFLD. Cold season increases the risk of NAFLD independently.

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Section: Discussionmentioning

confidence: 99%

Association between Vitamin D Status and Non-Alcoholic Fatty Liver Disease: A Population-Based Study

Liu

Wan

et al. 2019

J Nutr Sci Vitaminol

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“…The study population comes from the third National Health and Nutrition Examination Surveys 1988‐1994 (NHANES III), a periodic survey conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention of the United States. The reason for using an old dataset (1988‐1994) is that NHANES III is the only and the largest survey containing the results of both liver ultrasonography and biochemical examinations, and is frequently used for the study on NAFLD 11‐14 . The National Center for Health Statistics Research Ethics Review Board approved the NHANES protocol and informed consent was obtained from all subjects.…”

Section: Methodsmentioning

confidence: 99%

Comparison of MAFLD and NAFLD diagnostic criteria in real world

Lin

Huang

Wang

et al. 2020

Liver International

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404

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Background and aims Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020, the utility of which has not been tested and validated in real world. We aimed to compare the characteristics of MAFLD and non‐alcoholic fatty liver disease (NAFLD). Methods The data was retrieved from the third National Health and Nutrition Examination Surveys of the United States, which is an unbiased survey dataset and frequently used for the study of fatty liver disease. Results A total of 13 083 cases with completed ultrasonography and laboratory data were identified from the NHANES III database. MAFLD was diagnosed in 4087/13 083 (31.24%) participants, while NAFLD in 4347/13 083 (33.23%) amongst the overall population and 4347/12 045 (36.09%) in patients without alcohol intake and other liver diseases. Compared with NAFLD, MAFLD patients were significantly older, had higher BMI level, higher proportions of metabolic comorbidities (diabetes, hypertension) and higher HOMA‐IR, lipid and liver enzymes. MAFLD patients with alcohol consumption were younger than those without, and more likely to be male. They had less metabolic disorder but higher liver enzymes. There were more cases with advance fibrosis in MAFLD patients with alcohol consumption. Conclusion MAFLD definition is more practical for identifying patients with fatty liver disease with high risk of disease progression.

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“…It is the largest survey with both biochemical and liver ultrasonography (USG) examination data thus often used for the study of fatty liver disease. [12][13][14][15][16] The National Center for Health Statistics Research Ethics Review Board approved the NHANES study protocol and informed consent was obtained from all subjects for the survey. All the data in the NHANES database is anonymous and free to access online via https://www.cdc.gov/nchs/nhanes/about_ nhanes.htm This dataset has adequate clinical information allowing us to calculate the non-invasive fibrosis scores validated to be used in patients with NAFLD, ie, FIB-4 (fibrosis-4 index) or NFS (NAFLD fibrosis score).…”

Section: Study Populationmentioning

confidence: 99%

MAFLD Criteria Guide the Subtyping of Patients with Fatty Liver Disease

Huang¹,

Ou²,

Wang³

et al. 2021

RMHP

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Background and Aims: Metabolic associated fatty liver disease (MAFLD) is diagnosed in patients with hepatic steatosis when they have the following three metabolic conditions: obesity/overweight, diabetes and metabolic dysregulation, either alone or in combination. There is no clarity whether subtypes of MAFLD diagnosed by different metabolic conditions carry different levels of risk for intra-and extra-hepatic organs. This study aims to depict the characteristics of these subtypes in a large population. Methods: The data were retrieved from the third National Health and Nutrition Examination Surveys of the United States. The clinical and biochemical features in different MAFLD subtypes were compared. The outcome of interest was significant and advanced fibrosis. Results: Out of 4,087 (31.24%) participants with MAFLD, 1,165 (28.51%) were diagnosed by single metabolic condition, 2,053 (50.23%) by two conditions, and 869 (21.26%) by all three metabolic conditions. With increasing numbers of metabolic conditions, participants tended to be older, were more likely to be female, and had more severe renal impairment and liver fibrosis (P<0.05). MAFLD patients with a lower number of metabolic conditions were more likely to have excessive alcohol consumption. Among MAFLD with single metabolic condition, those diagnosed by diabetes alone had the highest proportion of advanced fibrosis identified by non-invasive fibrosis models (P<0.05). Conclusion: More metabolic conditions upon the diagnosis of MALFD indicate higher risk of fibrosis. Patients with MAFLD diagnosed by diabetes alone are more likely to have advanced hepatic fibrosis than those with other metabolic conditions alone. Individualized management is required for MAFLD with different subtypes.

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Letter: significant burden of nonalcoholic fatty liver disease with advanced fibrosis in the USA: a cross‐sectional analysis of 2011‐2014 National Health and Nutrition Examination Survey

Abstract: Linked Content This article is linked to Wong et al and Wong papers. To view these articles visit https://doi.org/10.1111/apt.14327 and https://doi.org/10.1111/apt.14909.

Cited by 6 publications

References 5 publications

Association between Vitamin D Status and Non-Alcoholic Fatty Liver Disease: A Population-Based Study

Association between Vitamin D Status and Non-Alcoholic Fatty Liver Disease: A Population-Based Study

Comparison of MAFLD and NAFLD diagnostic criteria in real world

MAFLD Criteria Guide the Subtyping of Patients with Fatty Liver Disease

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