Poor Awareness of Liver Disease Among Adults With NAFLD in the United States

Population‐based studies that estimate awareness of nonalcoholic fatty liver disease (NAFLD) in the United States are scant. We aimed to understand public awareness of NAFLD and its temporal trends. Our study included 11,700 adults (18+ years old) from five National Health and Nutrition Examination Surveys (2007‐2016). NAFLD was determined by the improved Fatty Liver Index for the multiethnic U.S. population (US‐FLI) in the absence of secondary causes of liver disease. Overall prevalence of NAFLD, hepatitis C virus, and hepatitis B virus were 36.6%, 1.02% and 0.35%, respectively. From 2007‐2008 to 2015‐2016, awareness of liver disease among adults with NAFLD improved from 4.4% to 6.3% (trend P = 0.026) but 4 to 10 times lower than awareness about viral hepatitis. In 2015‐2016, among adults with NAFLD, awareness of liver disease was lower among young adults (aged 18‐29 years) compared with those aged ≥ 30 years (0% vs. 6.9%) and lower among non‐Hispanic Blacks compared with other races (0.7% vs. 6.6%) (all P