P0950 - Prevalence of Fibrosis Among US Adults Unaware of Their Nonalcoholic Fatty Liver Disease: A 2017-2020 United States National Health and Nutrition Examination Surveys (NHANES) Assessment

David S. Kim, MD, Catherine Ye, MD, Mohamed Ismail, DO, Nikolaos T.. Pyrsopoulos, MD, PhD, MBA
Rutgers New Jersey Medical School, Newark, NJ

Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common form of liver disease and is becoming increasingly prevalent worldwide. However, many remain unaware of their liver condition. In this study, we investigated the prevalence of NALFD and advanced fibrosis among the United States population.

Methods: Participants from the 2017–March 2020 pre-pandemic National Health and Nutrition Examination Survey (NHANES) with interview, laboratory, and Fibroscan® results were included. participants with viral hepatitis and excessive alcohol use (≥2 or 1 drinks/day for males and females, respectively) were excluded. NAFLD as defined by controlled attenuation parameter (CAP) scores ≥248 dB/m and advanced fibrosis was defined as liver stiffness measurement (LSM) ≥ 9.6 kPa.

Results: Among 4,982 participants with no knowledge of liver disease, 44.4% of participants were identified with NAFLD by CAP. Between participants with NAFLD, participants with no knowledge of NAFLD had higher platelet counts (median 239 vs. 218), lower levels of glycohemoglobin (6.0% vs. 6.4%), aspartate aminotransferase (21.3 vs. 31.1 IU/L), alanine aminotransferase (24.1 vs. 41.4 IU/L), liver stiffness measurements (6.9 vs. 8.5 kPa), and advanced fibrosis (11.2% vs. 18.7%) than participants with knowledge of NAFLD (all P < 0.05). Univariate analysis showed lower platelet level, increased aspartate transaminase, alanine transaminase, glycosylated hemoglobin (GH), body mass index (BMI), and knowledge of NAFLD to be significantly associated with advanced fibrosis (P < 0.05). In multivariate analysis, advanced fibrosis was associated with decreased platelet count (odds ratio (OR) = 0.995; 95% confidence interval (CI), 0.992 – 0.998; P = 0.011) increased BMI (OR = 1.152; 95% CI, 1.108 – 1.198; P < 0.001), and increased GH (OR = 1.416; 95% CI, 1.238 – 1.620; P < 0.001).

Discussion: The proportion of participants with undiagnosed NAFLD in the US population is high. Although rates of advanced fibrosis were higher in participants aware of their NAFLD, participants with undiagnosed NAFLD were also associated with considerable rates of advanced fibrosis. This data highlights the importance of NAFLD screening, particularly in participants with elevated BMI or GH.


Disclosures:


David S. Kim, MD, Catherine Ye, MD, Mohamed Ismail, DO, Nikolaos T.. Pyrsopoulos, MD, PhD, MBA. P0950 - Prevalence of Fibrosis Among US Adults Unaware of Their Nonalcoholic Fatty Liver Disease: A 2017-2020 United States National Health and Nutrition Examination Surveys (NHANES) Assessment, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.