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. 2024 Nov 11;73(12):2045-2053.
doi: 10.1136/gutjnl-2024-332917.

Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA

Alexander H Yang  1 , Monica A Tincopa  1 , Federica Tavaglione  1   2 , Veeral H Ajmera  1 , Lisa M Richards  1 , Maral Amangurbanova  1 , Christian Butcher  1 , Christie Hernandez  1 , Egbert Madamba  1 , Seema Singh  1 , Ricki Bettencourt  1 , Bernd Schnabl  3 , Claude B Sirlin  4 , Rohit Loomba  5   6
Affiliations

Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA

Alexander H Yang et al. Gut. .

Abstract

Background: There are limited prospective data among overweight and obese individuals on the prevalence of advanced fibrosis, and cirrhosis using advanced MRI-based methods in the USA. The aim of this study was to fill that gap in knowledge by prospectively determining the MRI-based prevalence of steatotic liver disease (SLD) and its subcategories, advanced fibrosis and cirrhosis among overweight and obese individuals residing in the USA.

Methods: This is a cross-sectional analysis of prospectively enrolled overweight or obese adults aged 40-75 years from primary care and community-based settings in Southern California. Participants were classified as having SLD if MRI proton density fat fraction ≥5%, and subclassified as metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD) and alcohol-related liver disease (ALD) consistently with the new nomenclature guidance per AASLD-EASL-ALEH. Advanced fibrosis and cirrhosis were defined as magnetic resonance elastography (MRE) ≥3.63 kPa and MRE ≥4.67 kPa, respectively.

Results: The cohort included 539 participants with mean (±SD) age of 51.5 (±13.1) years and body mass index of 32.6 (±6.2) kg/m2, respectively. The prevalence of SLD, advanced fibrosis and cirrhosis was 75%, 10.8% and 4.5%, respectively. The prevalence of MASLD, MetALD and ALD was 67.3%, 4.8% and 2.6%, respectively. There was no difference in prevalence of advanced fibrosis and cirrhosis among subcategories.

Conclusions: Using advanced MRI methods among community-dwelling overweight and obese adults, the prevalence of cirrhosis was 4.5%. Most common SLD subcategory was MASLD with 67% of individuals, whereas MetALD and ALD were less common. Systematic screening for advanced fibrosis among overweight/obese adults may be considered.

Keywords: FIBROSIS; LIVER CIRRHOSIS; NONALCOHOLIC STEATOHEPATITIS; OBESITY.

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Conflict of interest statement

Competing interests: RL serves as a consultant to Aardvark Therapeutics, Altimmune, Arrowhead Pharmaceuticals, AstraZeneca, Cascade Pharmaceuticals, Eli Lilly, Gilead, Glympse bio, Inipharma, Intercept, Inventiva, Ionis, Janssen Inc, Lipidio, Madrigal, Neurobo, Novo Nordisk, Merck, Pfizer, Sagimet, 89 bio, Takeda, Terns Pharmaceuticals and Viking Therapeutics. In addition, his institution received research grants from Arrowhead Pharmaceuticals, Astrazeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Eli Lilly, Galectin Therapeutics, Gilead, Intercept, Hanmi, Intercept, Inventiva, Ionis, Janssen, Madrigal Pharmaceuticals, Merck, Novo Nordisk, Pfizer, Sonic Incytes and Terns Pharmaceuticals. Cofounder of LipoNexus Inc. CBS reports payment to institution for non-federal research grants from ACR, Bayer, Foundation of NIH, GE, Gilead, Pfizer, Philips, Siemens, V Foundation; payment to institution for lab service agreements from OrsoBio, Enanta, Gilead, ICON, Intercept, Nusirt, Shire, Synageva, Takeda; payment to institution for institutional consulting from BMS, Exact Sciences, IBM-Watson, Pfizer; payment to self for personal consulting from Altimmune, Ascelia Pharma, Blade, Boehringer, Epigenomics, Guerbet, and Livivos; payment to self for royalties and/or honoraria from Medscape and Wolters Kluwer; ownership of stock options in Livivos; unpaid advisory board position in Quantix Bio; executive position for Livivos (Chief Medical Officer, unsalaried position with stock options and stock) through 28 June 2023; Principal Scientific Advisor to Livivos (unsalaried position with stock options and stock) since 28 June 2023; support for attending meetings and/or travel from Fundacion Santa Fe, Congreso Argentino de Diagnóstico por Imágenes, Stanford, Jornada Paulista de Radiologia and Ascelia Pharma; member (no payment) of Data Safety Monitoring board for National Cancer Institute funded Early Detection Research Network; equipment loans to institution from GE and Siemens. BS has been consulting for Ferring Research Institute, HOST Therabiomics, Intercept Pharmaceuticals, Mabwell Therapeutics, Patara Pharmaceuticals, Surrozen and Takeda. B.S.’s institution UC San Diego has received research support from Axial Biotherapeutics, BiomX, ChromoLogic, CymaBay Therapeutics, NGM Biopharmaceuticals, Prodigy Biotech and Synlogic Operating Company. BS is the founder of Nterica Bio. UC San Diego has filed several patents with BS as inventor.

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