Study: Metabolic-associated fatty liver disease is increasing among U.S. adults

Reviewed by Megan Craig, M.Sc.Jun 17 2023

The percent of metabolic-associated fatty liver disease (MAFLD), the leading global cause of liver disease, is increasing in U.S. adults, according to a study presented Friday at ENDO 2023, the Endocrine Society's annual meeting in Chicago, Ill.

Mexican Americans consistently had the highest percentage of MAFLD, especially in 2018, although the prevalence of increase was higher among Whites, the study found.

MAFLD, previously known as non-alcoholic fatty liver disease (NAFLD), is fast becoming the most common indication for liver transplantation. It is a risk factor for cardiovascular disease, type 2 diabetes and a common type of liver cancer. If untreated, MAFLD can lead to liver cancer and liver failure.

"MAFLD affects Hispanics at a higher prevalence relative to Blacks and Whites. This racial/ethnic disparity is a public health concern," said researcher Theodore C. Friedman, M.D., Ph.D., Chair of the Department of Internal Medicine at Charles R. Drew University of Medicine & Science in Los Angeles, Calif. "Overall, the increase in MAFLD is concerning, as this condition can lead to liver failure and cardiovascular diseases and has an important health disparity."

The researchers analyzed data for 32,726 participants from the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2018. "We found that overall, both MAFLD and obesity increased with time, with the increase in MAFLD greater than the increase in obesity," Friedman said.

The percent of people with MAFLD increased from 16% in 1988 to 37% in 2018 (a 131% increase) while the percent of obesity rose from 23% in 1988 to 40% in 2018 (a 74% increase). The prevalence of MAFLD increased faster than the prevalence of obesity, suggesting that the increase in the other risk factors such as diabetes and hypertension may also contribute to the increase in the prevalence of MAFLD."

Magda Shaheen, M.D., Ph.D., M.P.H., M.S., study's first author, Charles R. Drew University of Medicine & Science

Among Mexican Americans, the percent of MAFLD was higher at all times compared to the overall population. The percent increase of MAFLD in 2018 relative to 1988 was 133% among Whites, 61% among Mexican Americans and 56% among Blacks.

"In summary, MAFLD is increasing with time and more efforts are needed to control this epidemic," Shaheen said.