Metabolism-related fatty liver disease is on the rise among American adults

The percentage of metabolic-associated fatty liver disease (MAFLD), a global cause of liver disease, is increasing among American adults, according to a study presented Friday at ENDO 2023, the Endocrine Society’s annual meeting in Chicago.

Mexican Americans continued to have the highest percentage of MAFLD, especially in 2018, although the increase was greater among whites, the study found.

MAFLD, formerly known as non-alcoholic fatty liver disease (NAFLD), is rapidly 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 left untreated, MAFLD can lead to liver cancer and liver failure.

“MAFLD affects Hispanics at higher rates compared to blacks and whites. This racial/ethnic disparity is a public health concern,” researcher Theodore C. Friedman, MD, Ph.D., chair of the Department of Internal Medicine at the Charles R. True University of Medicine & Science in Los Angeles, California. “Overall, the increase in MAFLD is of concern because the condition can lead to liver failure and cardiovascular disease and constitutes an important health disparity.”

Researchers analyzed data for 32,726 participants in the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2018. “Overall, we found that both MAFLD and obesity increased over time, and the increase in MAFLD was greater than the increase in obesity,” Friedman said.

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


Magda Shaheen, MD, Ph.D., MPH, MS, first author of the study, Charles R. Drew University of Medicine and Science

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

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“In short, MAFLD is increasing over time and more efforts are needed to control this epidemic,” Shaheen said.

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