2023-06-20 17:00:03
In very strong progression, especially in the United States, MAFLD is a liver disease associated with a risk of cardiovascular disease, cirrhosis and liver cancer. In France, 18% of the population would be affected…
A liver disease, particularly insidious, worries the American medical profession. According a study presented on June 16 at ENDO 2023, the annual meeting of the Endocrine Society in Chicago, the percentage of people with MAFLDalso known as non-alcoholic fatty liver disease (NAFLD) would have gone from 16% in 1988 to 37% in 2018, i.e. an increase of 131%. MAFLD is the acronym of “Metabolic Associated Fatty Liver Disease” which designates in French hepatic steatosis – therefore an accumulation of fat in the cells of the liver – associated with a metabolic disorder such as overweight, obesity, diabetes or metabolic syndrome (high waistline, high blood pressure, bad cholesterol…). It is fast becoming the most common indication of liver cell transplantation. After analyzing data from almost 33 000 participants (from the National Health and Nutrition Survey cohort) from 1988 to 2018, the researchers showed that in 20 years, the number of MAFLD cases increased by 133% among White Americans, 61% among Americans of Mexican or Hispanic origin and 56% among Black Americans. “The prevalence of MAFLD has increased faster than the prevalence of obesitysuggesting that other risk factors such as diabetes and high blood pressure may also contribute to increased prevalence of MAFLD“, underlined Magda Shaheen of the University of Medicine and Sciences Charles R. Drew, author of the study. In France, no global epidemiological data is available, apart from modeling studies which estimate at 18% the number of adults with MAFLD in France, indicates theINSERM.
MAFLD should not be confused with NASH
Diseases associated with MAFLD © J Clin Transl Hepatol. 2022 Apr 28; 10(2): 329–338
The increase in MAFLD is very worrying insofar as she is underdiagnosed (only 1/4 of people would be diagnosed) and that it represents a risk factor for cardiovascular disease, cirrhosis and therefore liver cancer. She might also promote the appearance of other pathologies such as Multiple Sclerosis, chronic kidney disease, polycystic ovary syndrome (PCOS), obstructive sleep apnea, osteoporosis or certain cognitive disorders, including depression, lists an April 2022 study published in the Journal of Clinical and Translational Hepatology. To date, there is no recognized drug treatment, although various studies are in progress on drugs once morest hepatic steatosis of metabolic origin. Only the modification of the hygiene of life with weight loss and increased physical activity considerably improves the disease, even in the early stages, to cure it. The recommendations of l’European Association for the Study of the Liver propose fairly strict monitoring by non-invasive blood tests : every 2 or 3 years for patients with MAFLD without a risk factor for progression. MAFLD should not be confused with NASHwhich is also non-alcoholic fatty liver disease, but which is accompanied byinflammation of liver cells. As recalled by Practitioner’s Review “MAFLD is a generally slow-progressing disease, the mechanism of which is still poorly understood. NASH represents the aggressive form of MAFLD : compared to patients with simple MAFLD, patients with NASH have a higher fibrosis progression rate, progress more quickly to cirrhosis, develop more hepatic complications and have higher mortality“.
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