Prevalence and risk factors of nonalcoholic fatty liver disease, high-risk nonalcoholic steatohepatitis, and fibrosis among lean United States adults: NHANES 2017-2020

Markos Kalligeros, Stephanos Vassilopoulos, Athanasios Vassilopoulos, Fadi Shehadeh, Ingrid Lazaridou, Eleftherios Mylonakis, Kittichai Promrat, Jack R. Wands

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background Nonalcoholic fatty liver disease (NAFLD) is a growing public health concern worldwide. Early detection and management of modifiable risk factors are critical to mitigating its impact. This study aimed to investigate the prevalence and risk factors of NAFLD, nonalcoholic steatohepatitis (NASH), and fibrosis among lean adults in the United States (US), using the latest National Health and Nutrition Examination Survey (NHANES) dataset from 2017-2020. Methods Using controlled attenuation parameter scores of ≥285 dB/m, we assessed the age-adjusted prevalence of lean NAFLD. To determine the age-adjusted prevalence of high-risk NASH and significant fibrosis, we used the FibroScan-aspartate aminotransferase (FAST) score (cutoffs 0.35 and 0.67) and vibration-controlled transient elastography (liver stiffness measurement ≥8 kPa). Multivariate logistic regression was used to identify potential risk factors. Results We found the age-adjusted prevalence of lean NAFLD to be 6.30%. Among lean US adults, the age-adjusted prevalence of high-risk NASH and significant fibrosis was 1.29% and 4.35%, respectively. Older age and metabolic comorbidities, such as hypertension, diabetes, and dyslipidemia were associated with NAFLD and its complications. Conclusion These findings suggest that the prevalence of NAFLD is of concern among lean individuals, particularly those aged 40 and older with metabolic comorbidities, while a targeted approach to screening and risk stratification for hepatic fibrosis upon lean NAFLD diagnosis is warranted.

Original languageEnglish (US)
Pages (from-to)670-677
Number of pages8
JournalAnnals of Gastroenterology
Volume36
Issue number6
DOIs
StatePublished - Nov 23 2023

Keywords

  • NHANES
  • Nonalcoholic fatty liver disease
  • fibrosis
  • nonalcoholic steatohepatitis

ASJC Scopus subject areas

  • Gastroenterology

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