The growing prevalence of nonalcoholic fatty liver disease (NAFLD), determined by fatty liver index, amongst young adults in the United States. A 20-year experience

Wenhao Li, Cheng Han Ng, Jingxuan Quek, Kai En Chan, Caitlyn Tan, Rebecca Wenling Zeng, Jie Ning Yong, Hannah Tay, Darren Jun Hao Tan, Wen Hui Lim, Douglas Chee, Jinyang Ho, Nicholas W.S. Chew, Lung Yi Mak, Mohammad Shadab Siddiqui, Arun Sanyal, William Alazawi, Naim Alkouri, Mark Muthiah, Mazen Noureddin

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Aim: The Global burden of nonalcoholic fatty liver disease (NAFLD) has significantly increased recently, with its prevalence mirroring increasing obesity and diabetes. However, population-specific evidence for young adults remains limited. Herein, we provide a 20-year trend analysis of NAFLD in young adults and examine factors associated with NAFLD and major adverse cardiovascular events (MACE) prevalence. Methods: This study uses data from the United States National Health and Nutrition Examination Survey (NHANES) 1999-2018. Fatty liver was examined with the fatty liver index (FLI) and United States-FLI (US-FLI), and advanced fibrosis was examined with the fibrosis-4 index. Clustered multivariate logistic regression analysis on the year of study was applied to obtain odds ratios (OR) for the estimation of events. Results: 13.31% (95%CI: 12.71% to 13.94%) of young adults had NAFLD. The prevalence increased from 9.98% in 1999 to 19.49% in 2018, with a statistically significant trend (P < 0.001). 9.52% and 5.29% of patients have clinically significant and advanced fibrosis, respectively. In multivariate analysis, diabetes (3.48, 95%CI: 2.37 to 5.11), hypertension (2.03, 95%CI: 1.62 to 2.55), elevated body mass index (1.22, 95%CI: 1.20 to 1.23, P < 0.001) significantly increases odds of NAFLD. The largest increase in odds was related to obesity (OR: 21.61, 95%CI: 16.95 to 27.55, P < 0.001). Young adults with NAFLD had a borderline non-significant increase in the prevalence of MACE compared to individuals without NAFLD (OR: 1.603, 95%CI: 0.949 to 2.708, P = 0.078). Conclusion: The rising prevalence of NAFLD in young adults depicts the changing landscape of NAFLD and its association with a significant increase in MACE. The challenge of effective risk stratification and education of these individuals remains.

Original languageEnglish (US)
Article number19
JournalMetabolism and Target Organ Damage
Volume2
Issue number4
DOIs
StatePublished - Dec 1 2022

Keywords

  • NAFLD
  • epidemiology
  • prevalence
  • young Adults

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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