A substantial minority of middle-aged adults have liver fibrosis

Reviewed by Emily Henderson, B.Sc.Nov 9 2020

A substantial minority of participants from the Framingham Heart Study, (nearly nine percent), had potentially clinically significant liver fibrosis (scarring). This the first study of this size and scale done in the United States.

Before this study, we did not know how common asymptomatic liver fibrosis (scarring) was among adults living in the community."

Michelle T. Long, MD, MSc, corresponding author, assistant professor of medicine at Boston University School of Medicine (BUSM)

More than 3,000 middle-aged Framingham Heart Study participants (over a three-year period) underwent a test called a Fibroscan© or vibration-controlled transient elastography that quantifies how much fat is in the liver and also measures the stiffness of the liver. Liver stiffness correlates with the degree of liver scarring.

"We found that liver fibrosis was associated with more adverse cardiometabolic risk factors, even after accounting for liver fat which is a known risk factor for cardiometabolic disease. In particular, we observed that approximately one-quarter of the participants with diabetes had evidence of possibly clinically significant liver fibrosis," explained Long, who also is a hepatologist at Boston Medical Center.

According to the researchers, these findings support the consideration of screening for liver fibrosis in high-risk groups, though additional studies are needed to determine the benefits/costs of screening. "Liver biopsy is the gold standard for diagnosing liver fibrosis; however, new non-invasive tests exist that can quickly and painlessly help doctors determine if you are at risk for having clinically significant liver fibrosis."

If liver fibrosis is identified early, before cirrhosis is established, it is treatable. Long believes greater recognition of and awareness of liver fibrosis as a consequence of nonalcoholic fatty liver disease will hopefully allow more patients to receive treatment to prevent complications of advanced liver disease.

These findings appear online in the journal Hepatology.