Prevalence of Steatotic Liver Disease (MASLD, MetALD, and ALD) in the United States: NHANES 2017-2020

Markos Kalligeros; Athanasios Vassilopoulos; Stephanos Vassilopoulos; David W Victor; Eleftherios Mylonakis; Mazen Noureddin

doi:10.1016/j.cgh.2023.11.003

Prevalence of Steatotic Liver Disease (MASLD, MetALD, and ALD) in the United States: NHANES 2017-2020

Clin Gastroenterol Hepatol. 2023 Nov 8:S1542-3565(23)00914-X. doi: 10.1016/j.cgh.2023.11.003. Online ahead of print.

Authors

Markos Kalligeros¹, Athanasios Vassilopoulos¹, Stephanos Vassilopoulos¹, David W Victor², Eleftherios Mylonakis³, Mazen Noureddin⁴

Affiliations

¹ Division of Internal Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
² Division of Gastroenterology and Hepatology, Houston Methodist Hospital, Houston, Texas.
³ Houston Methodist Hospital, Houston, Texas.
⁴ Houston Research Institute, Houston, Texas. Electronic address: noureddinmd@houstonresearchinstitute.com.

PMID: 37949334
DOI: 10.1016/j.cgh.2023.11.003

Abstract

Following the Delphi consensus process, the term steatotic liver disease (SLD) was introduced to replace fatty liver disease, while the term metabolic dysfunction-associated steatotic liver disease (MASLD) emerged as the successor to the term nonalcoholic fatty liver disease (NAFLD).¹ This revised nomenclature aims to enhance precision and mitigate negative connotations and potential stigmatization, while refining comprehension and disease categorization. Concurrently, a novel category was introduced to capture individuals whose alcohol consumption exceeded the previously defined thresholds of NAFLD but remained unclassified within the existing system. This category, termed MetALD, now delineates a spectrum of conditions and is defined as a daily intake of 20 to 50 g of alcohol (or weekly 140-350 g) for females and 30 to 60 g daily for males (or weekly 210-420 g).¹ Within the MetALD spectrum, some individuals might predominantly exhibit MASLD characteristics, whereas others might be more inclined toward alcoholic liver disease (ALD).¹ In the present study, we used a US nationally representative data set to calculate the prevalence of SLD and its subcategories in the United States.