Prevalence of Significant Hepatic Fibrosis Using Magnetic Resonance Elastography in the General, NAFLD, and Diabetic Populations

Abstract

Background: The prevalence of significant and advanced liver fibrosis in the general population has not been well characterized. Using magnetic resonance elastography (MRE), we investigated the prevalence of significant fibrosis in a general community-based cohort. Methods: The study analyzed 2,170 participants who underwent the MR chemical shift technique and MRE. We also conducted subgroup analyses for participants with non-alcoholic fatty liver disease (NAFLD), metabolic syndrome, and diabetes mellitus (DM). Findings: The prevalence of F2 (≥3.0 kPa) and F3 fibrosis (≥3.6 kPa) in the general population was 5.1% and 1.3%, respectively. The prevalence of NAFLD (>5% hepatic fat fraction) was 20.8% in the average risk population (after excluding alcohol use and viral hepatitis), and the prevalence of significant and advanced fibrosis in NAFLD participants was 7.5% and 1.1%, respectively. The prevalence of DM was 7.7% in the general population, with significant fibrosis in 13.7% and advanced fibrosis in 4.8%. In participants with fatty liver (of any etiology) plus diabetes, 27.5% had ≥F2 and 7.2% ≥F3. Multivariate analyses indicated that older age, lower platelet count, higher AST/ALT ratio, diabetes, and fatty liver were independently associated with significant fibrosis. Interpretation: In the general population, the prevalence of significant and advanced fibrosis was 5.1% and 1.3%, respectively, and increased three- to four-fold in diabetes. Funding: None. Declaration of Interest: None declared. Ethical Approval: This study was approved by the Institutional Review Board of Kangbuk Samsung Hospital (IRB No. KBSMC 2018-06-008-001), and the protocol was registered at the Clinical Research Information Service (http://cris.nih.go.kr/) with registration number KCT0003782.