Prevalence of liver fibrosis and associated risk factors in the Korean general population: a retrospective cross-sectional study

• Published in: BMJ open 2021-03, Vol.11 (3), p.e046529-e046529
• Main Authors: Nah, Eun-Hee, Cho, Seon, Kim, Suyoung, Chu, Jieun, Kwon, Eunjoo, Cho, Han-Ik
• Format: Article
• Language: English
• Subjects: Age; Bile; Biopsy; Body mass index; Cholesterol; Cross-Sectional Studies; Diabetes; Elasticity Imaging Techniques; Epidemiology; Female; Gastroenterology and Hepatology; Health promotion; Humans; Hypertension; Liver - pathology; Liver cirrhosis; Liver Cirrhosis - epidemiology; Liver Cirrhosis - pathology; Liver diseases; Male; Metabolic syndrome; Population; Prevalence; Republic of Korea - epidemiology; Retrospective Studies; Risk Factors; Ultrasonic imaging; Womens health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-046529

ObjectivesThe health burden of chronic liver disease is increasing worldwide. Its main histological consequence is liver fibrosis, and eventually cirrhosis. This process is rarely diagnosed at the pre-cirrhotic stage due to it being asymptomatic. Little is known about the prevalence of liver fibrosis and associated risk factors in the general population. The aims of this study were to determine the prevalence and distribution of liver fibrosis using magnetic resonance elastography (MRE), as well as the risk factors associated with liver fibrosis in the asymptomatic general population.Design, setting and participantsThis cross-sectional retrospective study consecutively selected subjects who underwent health check-ups including MRE at 13 health promotion centres in Korea between 2018 and 2020. Liver fibrosis was estimated using MRE with cut-off values for significant and advanced liver fibrosis of 2.90 and 3.60 kPa, respectively.Primary and secondary outcome measuresThe Χ2 test was used to compare the prevalence of liver fibrosis according to sex and age groups. Multivariable logistic regression analyses were performed to identify the factors for significant and advanced liver fibrosis.ResultsAmong the 8183 subjects, 778 (9.5%) had ≥significant fibrosis (≥2.9 kPa), which included 214 (2.6%) subjects with ≥advanced fibrosis (≥3.6 kPa). Multivariable analysis revealed that liver fibrosis was associated with age (OR=1.34, 95% CI=1.18 to 1.51), male sex (OR=3.18, 95% CI=1.97 to 5.13), diabetes (OR=2.43, 95% CI=1.8 to 3.28), HBsAg positivity (OR=3.49, 95% CI=2.55 to 4.79), abnormal liver function test (OR=1.9, 95% CI=1.49 to 2.42) and obesity (OR=1.77, 95% CI=1.35 to 2.32) (all p