Abstract
Background: Studies attempted to estimate MASLD-related advanced fibrosis (AF) and cirrhosis (MC) prevalence utilized tests with low positive predictive value (PPV) which overestimates prevalence. AGILE3 + and 4 scores were developed to increase the PPV of both; respectively. In this study, we used these scores to assess the prevalence of AF and MC. Methods: Participants aged ≥ 18 years with VCTE exam in the NHANES 2017–2018 cycle were included. We excluded pregnant women, patients with excessive alcohol intake, hepatitis B/C, and ALT or AST > 500 IU/L. MASLD was defined with CAP score > 248 dB/m. MASLD subjects with AGILE 3 + score of ≥ 0.68 and AGILE 4 score of ≥ 0.57 were considered to have advanced fibrosis and cirrhosis; respectively. AGILE 3 + of 0.45–0.67 and AGILE 4 of 0.25–0.57 were grey zone, whereas AGILE 3 + < 0.45 and AGILE 4 < 0.25 were considered a rule-out. Results: 1244 subjects were included in the final analysis. The Median age was 53 (51.4–54.6) years, 55.6% were male, median BMI was 33.8 kg/m2 and 41.1% had T2DM. Based on AGILE 3+, 80.3% of the MASLD population were at low risk for AF and 11.5% were in grey zone. The prevalence of AF due to MASLD was 8.1% corresponding to 4.5 million Americans. Based on AGILE 4 score, 96.5% of the MASLD population were at low risk for cirrhosis and 2.4% were in the grey zone. The prevalence of MASLD-cirrhosis was 1.1% corresponding to 610,000 Americans. Conclusion: Our results suggest that approximately 4.5 million people in the U.S. have AF and 0.6 million have cirrhosis due to MASLD.
Original language | English (US) |
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Article number | 218 |
Journal | BMC Gastroenterology |
Volume | 24 |
Issue number | 1 |
DOIs | |
State | Published - Jul 8 2024 |
Keywords
- AGILE
- Advanced fibrosis
- Cirrhosis
- Elastography
- MASLD
- NHANES
- Severity of Illness Index
- Predictive Value of Tests
- Prevalence
- Nutrition Surveys
- Humans
- Middle Aged
- Male
- Fatty Liver/epidemiology
- United States/epidemiology
- Liver Cirrhosis/epidemiology
- Female
- Adult
ASJC Scopus subject areas
- Gastroenterology