LAUSR

BACKGROUND AND AIMS Clinical and public health implications of the recent re-defining of non-alcoholic fatty liver (NAFLD) to metabolic associated fatty liver (MAFLD) remain unclear. We sought to determine the prevalence and compare MAFLD to NAFLD in a well-defined cohort. METHODS A cross-sectional study was conducted in regional Victoria with participants from randomly selected households. Demographic and health-related clinical and laboratory data were obtained. Fatty liver was defined as a Fatty Liver Index (FLI)≥ 60 with MAFLD defined according to recent international expert consensus. RESULTS 722 participants were included. Mean age was 59.3±16 years and 55.3% were women with a median BMI 27.8 kg/m2 . Most (75.2%) participants were overweight or obese. MAFLD was present in 341 participants giving an unadjusted prevalence of 47.2% compared to a NAFLD prevalence of 38.7%. 59 (17.5%) participants met the criteria of MAFLD but not NAFLD. The increased prevalence of MAFLD in this cohort was primarily driven by dual aetiology of fatty liver. All participants classified as NAFLD met the new definition of MAFLD. Compared to NAFLD subjects, participants with MAFLD had higher ALT (26.0 [14.0] U/L vs 30.0 [23] U/L, p = 0.024) but there were no differences in non-invasive markers for steatosis or fibrosis. CONCLUSION MAFLD is a highly prevalent condition within this large community cohort. Application of the MAFLD definition increased prevalence of fatty liver disease by including people with dual aetiologies of liver disease.