| Abstract: | BACKGROUND AIMS: A recent panel of international experts proposed the disease acronym metabolic (dysfunction) associated fatty liver disease (MAFLD) in lieu of non-alcoholic fatty liver disease (NAFLD). We aimed to estimate the burden of and risk factors for NAFLD and MAFLD, and to examine the concordance between definitions in a Veterans population. METHODS: We conducted a cross-sectional study among randomly selected patients within primary care at the Houston VA. Participants completed a survey, provided blood, and underwent Fibroscan. In the absence of heavy alcohol, HCV and HBV, a CAP median ≥290 dB/m was used to define NAFLD, while MAFLD was defined as CAP median ≥290 dB/m and either BMI ≥25 kg/m2 or diabetes, or 2 or more of the following: hypertension, high triglycerides, low HDL cholesterol, and high LDL cholesterol. RESULTS: The mean age of participants was 50.9 years, 55.4% were women, 42.8% white, and 43.8% Black. The prevalence of NAFLD was 40.6% (82/202). All 82 NAFLD patients had a BMI ≥25 and therefore met our criteria for MAFLD (i.e., 100% concordance). Compared with patients with no metabolic trait, patients with ≥3 traits 48-fold (adjusted OR, 47.6; 95% CI, 11.3-200) higher risk of NAFLD/MAFLD. Overall, 19 participants (9.4% of the total, 15.9% of NAFLD) had at least moderate fibrosis. CONCLUSIONS: NAFLD was present in 40% of veterans registered in primary care; 9.4% of Veterans had at least moderate hepatic fibrosis, with most having concurrent NAFLD. There was perfect concordance between NAFLD and the alternative MAFLD definition. |
