Prevalence of liver fibrosis and associated risk factors in the Korean general population: a retrospective cross-sectional study

Abstract

ObjectivesThe health burden of chronic liver disease is increasing worldwide. Its main histological consequence is liver fibrosis, and eventually cirrhosis. This process is rarely diagnosed at the pre-cirrhotic stage due to it being asymptomatic. Little is known about the prevalence of liver fibrosis and associated risk factors in the general population. The aims of this study were to determine the prevalence and distribution of liver fibrosis using magnetic resonance elastography (MRE), as well as the risk factors associated with liver fibrosis in the asymptomatic general population.Design, setting and participantsThis cross-sectional retrospective study consecutively selected subjects who underwent health check-ups including MRE at 13 health promotion centres in Korea between 2018 and 2020. Liver fibrosis was estimated using MRE with cut-off values for significant and advanced liver fibrosis of 2.90 and 3.60 kPa, respectively.Primary and secondary outcome measuresThe Χ2 test was used to compare the prevalence of liver fibrosis according to sex and age groups. Multivariable logistic regression analyses were performed to identify the factors for significant and advanced liver fibrosis.ResultsAmong the 8183 subjects, 778 (9.5%) had ≥significant fibrosis (≥2.9 kPa), which included 214 (2.6%) subjects with ≥advanced fibrosis (≥3.6 kPa). Multivariable analysis revealed that liver fibrosis was associated with age (OR=1.34, 95% CI=1.18 to 1.51), male sex (OR=3.18, 95% CI=1.97 to 5.13), diabetes (OR=2.43, 95% CI=1.8 to 3.28), HBsAg positivity (OR=3.49, 95% CI=2.55 to 4.79), abnormal liver function test (OR=1.9, 95% CI=1.49 to 2.42) and obesity (OR=1.77, 95% CI=1.35 to 2.32) (all p<0.001), as well as metabolic syndrome (OR=1.4, 95% CI=1.05 to 1.87) (p=0.024).ConclusionsThe prevalence of significant or more liver fibrosis was high in the Korean general population and much higher among individuals with risk factors. This suggests that screening of liver fibrosis should be considered in general population, especially among high-risk groups.

Metabolic dysfunction‐associated fatty liver disease and liver fibrosis: Prevalence and associated factors in the middle‐aged and older US population

“…We identified a high prevalence among Hispanic Americans in accordance with Watt et al 46 In addition, more than 20% of patients with diabetes had significant liver fibrosis, which was also observed in other studies. 16,48 Studies have shown that hyperglycemia in patients with diabetes could increase the severity of chronic inflammation 49 and activate the IRS1-PI3K-Akt signaling pathway to stimulate the proliferation of HSCs, whereas activated HSCs promote the overproduction and deposition of extracellular matrix during fibrogenesis. [50][51][52] Thus, early screening of liver fibrosis in aging patients with diabetes should be addressed; if positive, antifibrogenic therapies are essential to prevent further progression to irreversible stages.…”

Current situation of viral hepatitis in Egypt

“…Transient elastography is an economically attractive alternative to liver biopsy and other noninvasive diagnostic tests of liver cirrhosis 221 . A significant prevalence (22.4%) of liver fibrosis was detected using magnetic resonance elastography among Korean asymptomatic HBsAg‐positive patients 222 …”

Metabolic Syndrome: A Warning Sign of Liver Fibrosis

“… 14 Notably, in a study with Korean health checkup examinees, the prevalence rate of significant liver fibrosis (estimated using magnetic resonance elastography) was higher in subjects with MetS (15.3%) than in those with fatty liver diagnosed by ultrasonography (11.3%). 15 …”