Epidemiology of non alcoholic fatty liver disease (NAFLD)

epidemiology

With the rapid rise in sedentary life style, metabolic syndrome and obesity, prevalence of NAFLD amongst the general population has increased considerably.

• worldwide prevalence of NAFLD is thought to be 20% in the general population and up to 70% in patients with type 2 diabetes mellitus (1)
• the community-based Framingham heart study population has reported a prevalence of 17% (19% in men and 15% in women) with the prevalence approaching 90% in patients considering bariatric surgery (2)
• NAFLD is the most common cause of chronically elevated LFTs in the United States in both diabetic and nondiabetic individuals
• with respect to patients with NAFLD, 60-95% are obese, 28-55% have type 2 diabetes, and 20-92% have hyperlipidemia (3)

Prevalence of NAFLD

• increases with age
• is higher in men than in women
  • in a study of 26,527 subjects undergoing medical checkups, the prevalence of NAFLD was 31% in men and 16% in women
• in hispanic individuals is significantly higher and in non-hispanic blacks is significantly lower when compared to non-hispanic whites (4).

Prevalence of NAFLD in High Risk Groups

• patients with severe obesity undergoing bariatric surgery
  • the prevalence of NAFLD can exceed 90%
  • up to 5% of patients may have unsuspected cirrhosis
• type 2 diabetes mellitus patients
  • ultrasonographic studies have reported a 69% prevalence of NAFLD in type 2 diabetes patients
• dyslipidemia
  • the prevalence of NAFLD was estimated to be 50% in patients attending lipid clinics

Reference:

• (1) Sattar N, Forrest E, Preiss D. Non-alcoholic fatty liver disease. BMJ. 2014;349:g4596
• (2) Wilkins T et al. Nonalcoholic fatty liver disease: diagnosis and management. Am Fam Physician. 2013;88(1):35-42.
• (3) Harris EH.Elevated Liver Function Tests in Type 2 Diabetes.Clinical Diabetes 2005; 23:115-119
• (4) Chalasani N et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):2005-23