Abstract
Introduction:
Metabolic-associated fatty liver disease (MAFLD) is a rapidly growing public health concern due to its association with metabolic disorders and liver-related complications. There is paucity of data on the burden of MAFLD in Tanzania. The aim of this study was to assess the prevalence and associated factors of MAFLD among adult participants in Dodoma, Tanzania, who are critical for designing preventive strategies. We evaluated the associations between MAFLD and several factors, including age, sex, lifestyle, type 2 diabetes, hypertension, dyslipidemia and obesity.
Methods
A total of 351 adult participants were recruited from October 2023 to March 2024 at tertiary hospitals. The diagnosis of MAFLD was established based on evidence of steatohepatitis on imaging plus any one of five cardiometabolic risk factors, such as overweight or obesity (BMI ≥ 25 kg/m2), diabetes mellitus type 2, hypertension, dyslipidemia, and metabolic syndrome (combination of three or more of the above). Demographic, clinical, and metabolic marker data were collected and analyzed to identify potential risk factors associated with MAFLD. The chi-squared test was used to analyze categorical data. Logistic regression analysis was used to check for associated factors; significance was defined as a p value < 0.05. The UDOM research and publication committee approved the study, and informed consent was obtained from the participants and in-participants aged older than 18 years with metabolic conditions.
Results
A total of 351 participants were recruited, of whom 53% were females, and the median age was 62 (IQR 52–70) years, with most of the participants residing in urban areas (242, 68.9%). The study prevalence of MAFLD was 21.9%. Significant fibrosis was defined as a FIB-4 index ≥ 1.3 in 14% of MAFLD patients who were found to have advanced fibrosis. Diabetes mellitus (OR: 3.9; 95% CI (2.1–7.2, p < 0.000), dyslipidemia (OR: 2.3; 95% CI 1.2–4.7, p = 0.013), central obesity (OR: 2.0; 95% CI (1.1–3.7; p = 0.016), lifestyle factors (OR: 2.6; 95% CI (1.4–4.8; p = 0.001), smoking (OR: 2.6; 95% CI (1.4–4.8; p = 0.001) and lack of exercise (OR: 2.3; 95% CI (1.2–4.2; p = 0.005)) were independently associated with MAFLD.
Conclusion
This study revealed a significant frequency of MAFLD and significant associations with established risk factors such as diabetes, smoking, alcohol consumption, lack of exercise, central obesity, and dyslipidemia. These findings highlight the importance of early identification and management of these risk factors to prevent MAFLD and its associated complications. Future research should focus on understanding causal mechanisms and evaluating interventions for preventing MAFLD development in at-risk populations attending tertiary hospitals.