Prevalence of advanced hepatic fibrosis and comorbidity in metabolic dysfunction‐associated fatty liver disease in Korea

Background & Aims There are several reports on the prevalence of metabolic dysfunction‐associated fatty liver disease (MAFLD). However, the prevalence of advanced hepatic fibrosis in MAFLD is largely unknown. We aimed to evaluate the prevalence of advanced fibrosis in MAFLD. Methods A total of 6775 subjects from nationwide 13 health check‐up centres were included in this cross‐sectional study. Fatty liver was evaluated using ultrasonography. Significant (≥F2) and advanced (≥F3) hepatic fibrosis were defined by MRE thresholds of 3.0 kPa (range: 2.99–3.65 kPa) and 3.6 kPa (range: 3.4–3.9 kPa) respectively. The sex‐ and age‐standardized prevalence of MAFLD and hepatic fibrosis was estimated. Results The sex‐ and age‐standardized prevalence of MAFLD was 33.9%. The prevalence of obesity (BMI ≥25 kg/m2) in MAFLD was 71.1%, and 79.0% of obese subjects had MAFLD. The prevalence of diabetes in MAFLD was 13.3%, and 73.6% of subjects with diabetes had MAFLD. The sex‐ and age‐standardized prevalence of significant (≥F2) and advanced hepatic fibrosis (≥F3) amongst MAFLD was 9.7% (range: 3.0–9.8%) and 3.0% (range: 2.6–4.6%) respectively. The prevalence of advanced hepatic fibrosis in overweight/obese (group I), lean (group II) and diabetic (group III) MAFLD was 2.3%, 3.1% and 9.5% respectively. Conclusion The sex‐ and age‐standardized prevalence of advanced fibrosis was 3.0% (range: 2.6–4.6%) in subjects with MAFLD.