NAFLD affects 1 in 5 young adults in the UK

  • Abeysekera KWM & al.
  • Lancet Gastroenterol Hepatol
  • 15 Jan 2020

  • curated by Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • Nonalcoholic fatty liver disease (NAFLD) is highly prevalent among young adults in the UK.
  • Obesity was strong predictor.
  • Commentary praises study, criticizes lack of data collected on NAFLD risk factors, calls for early primary-prevention efforts.

Why this matters

  • Globally, 1 in 4 adults is thought to have NAFLD, but the prevalence in younger adults was not known.
  • NAFLD can lead to carcinoma, cirrhosis, and liver failure.

Key results

  • Mean age, 24.0 years.
  • Prevalences:
    • Steatosis: 20.7% (95% CI, 19.4%-22.0%).
      • Severe (S3) in 48.3%.
    • Fibrosis of F2 or higher (n=3600): 2.7% (95% CI, 2.2%-3.2%).
  • Predictors of higher disease grade/stage:
    • Steatosis grade: elevated BMI, higher waist-to-height ratio, elevated liver enzymes, elevated cholesterol measures, metabolic syndrome, but not harmful alcohol intake. 
    • Fibrosis stage: higher controlled attenuation parameter score, elevated BMI, higher waist-to-height ratio, combination of harmful alcohol consumption and steatosis.

Study design

  • Population-based study of participants in prospective birth cohort Avon Longitudinal Study of Parents and Children (ALSPAC) (n=3768).
  • Participants underwent transient elastography with FibroScan.
  • Outcome: prevalence of steatosis, fibrosis.
  • Funding: Medical Research Council UK; other charities.

Limitations

  • Transient elastography does not accurately detect F1 fibrosis.
  • Researchers did not assess most NAFLD risk factors, e.g., childhood obesity, physical activity, sugar intake.