High prevalence of MAFLD in general population: A large cross‐sectional study calls for concerted public health action

Summary Background Metabolic associated fatty liver disease (MAFLD) is a relatively new term with limited studies done in South Asian population. Aim To determine prevalence and clinico‐epidemiological characteristics of MAFLD in general population. Methods A cross‐sectional study was conducted in randomly selected regions across Delhi, India. Data were collected on socio‐demographic particulars, health status and lifestyle factors. Anthropometric measurements, transient elastography, and laboratory investigations were carried out. Results Altogether 6146 participants (mean age: 43.1 ± 13.9 years, 48.1% males) were included. The prevalence of MAFLD was 56.4% ( n = 3468), of which lean MAFLD constituted 11.3%. Higher age (OR: 2.47; 95% CI: 2.21–2.76), low education level (OR: 1.23; 95% CI: 1.09–1.39), upper socio‐economic class (OR: 1.32; 95% CI: 1.17–1.49), and low physical activity (OR: 1.15; 95% CI: 1.03–1.28) were more common in MAFLD. The association of female sex with MAFLD differed in age groups <40 years (OR: 0.64 and 95% CI: 0.55–0.75) and >40 years (OR: 1.40 and 95% CI: 1.22–1.62) in both magnitude and direction ( p < 0.001). Liver fibrosis was present in 23% of the study population (32.2% among MAFLD group). Advanced liver fibrosis was three times more common in MAFLD group (6.2% vs 1.8%, p < 0.001). Obesity and fibrosis had a statistically significant relationship and 75.8% of the individuals with advanced stages of fibrosis had obesity. Conclusion Nearly half of study population was found to have MAFLD. Advanced hepatic fibrosis was three times more common in these subjects. Aggressive public health measures are urgently required to raise awareness and introduce interventional strategies.