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S1-E1.1 – Fatty Liver Prevalence May Be Higher Than Previously Thought, Especially Among Type 2 Diabetes Patients

Hepatology Researcher and Key Opinion Leader Stephen Harrison discussed results of his 2021 publication in the Journal of Hepatology that reported, in a prospective random sample of 835 people with a median age of 55, NAFLD prevalence as being 37%, NASH as being 14% and advanced fibrosis as being 6% in a random asymptomatic patients. Among patient with Type 2 Diabetes, NAFLD prevalence was 70% and NASH was 35%.

NAFLD prevalence is an increasing topic of conversation and concern. Some refer to it as “the new pandemic.” The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide is a new podcast dedicated to focusing on prevalence, severity and downstream health implications for patients with Type 2 Diabetes and other metabolic diseases. This conversation centers around a segment of the first episode in the series that shared results of a prospective study estimating disease prevalence.

Fatty Liver Prevalence May Be Higher Than Previously Thought, Especially Among Type 2 Diabetes Patients

Historically, researchers derived estimates of NAFL prevalence retrospectively relying on insurance and other databases. In 2011 and again in 2021, Stephen Harrison led prospective studies to estimate NAFLD prevalence, along with NASH and advanced fibrosis, in a large sample of asymptomatic patients. He and his team also looked at key population subgroups, notably including Type 2 Diabetes patients.

The methodology for the two studies was fairly straightforward. In both cases, individuals with no history or symptoms of liver disease went to their local military hospital for a colonoscopy screen. While there, they were offered the chance to learn about the health of their livers, first through blood testing, then FibroScan and if the FibroScan suggested NASH, a liver biopsy. In both studies, the researchers found incidence of NAFLD to be in the mid-30s (38% in 2021) and NASH to be in the mid-teens (14% in 2021). Over that time, the only change was in the incidence of advanced fibrosis, which grew from 2% to 6%.

Among people with Type 2 Diabetes, the numbers were higher: 70% with NAFLD and 35% with NASH. People with Type 2 Diabetes, obesity and hypertension had a 74% NAFLD prevalence and 46% NASH prevalence.

In this conversation, Dr. Harrison shares these numbers and the other panelists, endocrinologist Ken Cusi, hepatologist Kathleen Corey, medical device Key Opinion Leader Kay Pepin and pricing and forecasting guru and co-host Roger Green. In turn, the panelists have questions of their own and comments about the severe implications of the study for patients in general, and particularly those with Type 2 Diabetes and other metabolic diseases.

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