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Fibrosis stages worsening in alcoholic fatty liver disease cases

Although the prevalence of alcoholic fatty liver disease among U.S. adults remained stable between 2001 and 2016, the prevalence of those with stage 2 or higher fibrosis increased significantly, according to a study published in JAMA.

“This is a particularly concerning observation given that developing fibrosis is the strongest predictor of progression to cirrhosis, liver cancer, and death,” Terrence Wong, MD, from Highland Hospital in Oakland, California, and colleagues wrote. “While studies evaluating national [alcoholic liver disease (ALD)] prevalence are lacking, existing studies have demonstrated increasing burden of ALD in population subsets.”

Using the 2001 to 2016 National Health and Nutrition Examination Survey data set, Wong and colleagues found that 4.3% of the 34,423 respondents had alcoholic fatty liver disease (AFLD) with the highest prevalence in men (60.6%) and non-Hispanic white individuals (63%).

AFLD remained stable during this period (4.3% to 4.7%). However, the prevalence of AFLD with stage 2 or higher fibrosis increased from 0.6% to 1.5% (P < .001) and AFLD with stage 3 or higher increased from 0.1% to 0.2% (P = .045).

Changes in prevalence did not differ by sex, age, or race or ethnicity.

“The increasing prevalence of U.S. adults with AFLD with stage 2 or greater fibrosis and AFLD with stage 3 or greater fibrosis is concerning and emphasizes the need for greater awareness of unhealthy alcohol use and need for early prevention and intervention efforts,” Wong and colleagues concluded. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.