Increased fatty liver disease awareness needed to mitigate burden among young adults

Increased awareness is needed to mitigate burden fatty liver disease and modifiable risk factors among adolescents and young adults, according to research presented at The Liver Meeting Digital Experience.

“The prevalence of fatty liver disease is potentially increasing in adolescents and young adults, what we call the AYA population, and this is due to increased rates of alcohol consumption in recent years leading to an increase in alcohol-associated fatty liver disease, or ALD, and the obesity pandemic leading to an increase in the prevalence of nonalcoholic fatty liver disease, or NAFLD,” Naim Alkhouri, MD, vice president of academic affairs and director of the Fatty Liver Program at Arizona Liver Health, said. “Previous studies that estimated the prevalence of fatty liver disease in the AYA population relied on liver enzymes or liver ultrasound with known issues in terms of sensitivity and specificity.”

To assess the prevalence and burden of alcohol-associated fatty liver disease (ALD) and nonalcoholic fatty liver disease, researchers analyzed data from the National Health and Nutrition Examination Survey database for adolescents and young adults aged 15 years to 39 years with valid FibroScan measurements. They further divided the study population by excessive alcohol consumption (males: > 2 drinks/day; females: > 1 drink/day) and generated controlled attenuation parameter scores ([CAP] 248 dB/m) to identify subjects with suspected ALD and NAFLD.

According to study results, subjects who consumed alcohol excessively were older (28.1 years vs. 26.2 years), had a higher BMI (29.2 kg/m² vs. 27.6 kg/m²), were current smokers (51% vs. 17.9%) and were more likely to be male (63.4% vs. 51.1%).

Suspected ALD was present in 42.4% of subjects (95% CI, 36.5-48.4) with suspected significant and advanced fibrosis present in 17.7% (95% CI, 13-23.6) and 9.4% (95% CI, 6.5-12.3), respectively. Among subjects without excessive alcohol consumption, 39% (95% CI, 35.6-42.4) had suspected NAFLD with suspected significant and advanced fibrosis present in 25.1% (95% CI, 21.3-29.5) and 14.4% (95% CI, 9.7-20).

“A significant percentage of adolescents and young adults in the United States are at risk for alcohol associated liver disease and nonalcoholic fatty liver disease and a subset of these subjects are at risk of significant liver fibrosis and even advanced liver fibrosis,” Alkhouri concluded. “Therefore, efforts should focus on increasing awareness of the burden of ALD and NAFLD in this population and to mitigate modifiable risk factors to prevent disease development and disease progression to potentially advanced fibrosis and cirrhosis.”