11/07/2024, 14:20 Hepatology

June 2024 - Volume 79 - Issue 6

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Original Articles: Steatohepatitis

Prevalence, distribution, and hepatic fibrosis burden of the

different subtypes of steatotic liver disease in primary care
settings
Lee, Chul-min1; Yoon, Eileen L.2,3; Kim, Mimi1; Kang, Bo-Kyeong1; Cho, Seon4; Nah, Eun-Hee4; Jun, Dae Won2,3

Author Information

1Department of Radiology, Hanyang University College of Medicine, Seoul, Korea

2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea

3Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea

4Department of Laboratory Medicine, Health Promotion Research Institute, Seoul, Korea

Abbreviations: ALD, alcohol-associated liver disease; MASLD, metabolic dysfunction–associated steatotic liver
disease; MetALD, metabolic dysfunction and alcohol associated steatotic liver disease; MRE, magnetic resonance
elastography; MRI-PDFF, magnetic resonance imaging proton density fat fraction.

Correspondence Dae Won Jun, Department of Internal Medicine, Hanyang Institute of Bioscience and
Biotechnology Gastroenterology, Hanyang University College of Medicine. Email: noshin@hanyang.ac.kr

Supplemental Digital Content is available for this article. Direct URL citations are provided in the HTML and PDF
versions of this article on the journal's website,www.hepjournal.com.

Hepatology 79(6):p 1393-1400, June 2024. | DOI: 10.1097/HEP.0000000000000664

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Abstract
Background and Aim:

In relation to the new umbrella terminology for steatotic liver disease (SLD), we aimed to elucidate the prevalence,
distribution, and clinical characteristics of the SLD subgroups in the primary care setting.

Approach and Results:

We retrospectively collected data from 2535 individuals who underwent magnetic resonance elastography and MRI
proton density fat fraction during health checkups in 5 primary care health promotion clinics. We evaluated the
presence of cardiometabolic risk factors according to predefined criteria and divided all the participants according
to the new SLD classification. The prevalence of SLD was 39.13% in the total cohort, and 95.77% of the SLD cases
had metabolic dysfunction (one or more cardiometabolic risk factors). The prevalence of metabolic dysfunction–
associated steatotic liver disease (MASLD) was 29.51%, with those of metabolic dysfunction and alcohol associated
steatotic liver disease (MetALD) and alcohol-associated liver disease (ALD) at 7.89% and 0.39%, respectively.
According to the old criteria, the prevalence of NAFLD was 29.11%, and 95.80% of the NAFLD cases fulfilled the
new criteria for MASLD. The distribution of SLD subtypes was highest for MASLD, at 75.40%, followed by MetALD
at 20.06%, cryptogenic SLD at 3.33%, and ALD at 1.01%. The MetALD group had a significantly higher mean
magnetic resonance elastography than the MASLD or ALD group.

Conclusion:
Almost all the patients with NAFLD met the new criteria for MASLD. The fibrosis burden of the MetALD group was
higher than those of the MASLD and ALD groups.

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