Prevalence of NAFLD, MAFLD and associated advanced fibrosis in the contemporary United States population

Data are limited on the epidemiological implications of the recent change in terminology from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD). We therefore performed a cross-sectional study of adults recruited in the 2017-2018 National Health and Nutrition Examination Survey, a representative sample of the general US population. The prevalence of NAFLD and MAFLD based on controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) obtained through vibration-controlled transient elastography (VCTE) were 37.1% (95% CI 34.0-40.4) and 39.1% (95% CI 36.3-42.1), respectively, with higher rates among Hispanic individuals. Agreement between the two definitions was high (Cohen's kappa 0.92). Patients with NAFLD and MAFLD also showed similar risk of advanced liver fibrosis (7.5% and 7.4% respectively). Our results suggest that the recent change in diagnostic criteria did not affect the prevalence of the condition in the general United States population.

Automated summary

Limited data are available on the epidemiological implications of renaming NAFLD to MAFLD. A cross-sectional study using NHANES data found similar prevalence rates of NAFLD and MAFLD in the general US population, with a high agreement between the two definitions and higher rates among Hispanic individuals. Additionally, patients with either NAFLD or MAFLD showed similar risk of advanced liver fibrosis.