Prevalence and risk factors of metabolic dysfunction‐associated steatotic liver disease in south Central Uganda: A cross‐sectional survey

Author:

Enriquez Rocio1,Homsi Mahmoud1,Ssekubugu Robert2,Nabukalu Dorean2,Zeebari Zangin13,Marrone Gaetano1,Gigante Bruna4,Chang Larry W.256,Reynolds Steven J.2567,Nalugoda Fred2,Ekström Anna Mia18,Hagström Hannes910ORCID,Nordenstedt Helena111ORCID

Affiliation:

1. Department of Global Public Health Karolinska Institutet Stockholm Sweden

2. Rakai Health Sciences Program Kalisizo Uganda

3. Jönköping International Business School, Jönköping University Jönköping Sweden

4. Department of Medicine Solna, Karolinska Institutet Stockholm Sweden

5. Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA

6. Division of Infectious Diseases, Department of Medicine Johns Hopkins School of Medicine Baltimore Maryland USA

7. Laboratory of Immunoregulation, Division of Intramural Research National Institute for Allergy and Infectious Diseases, National Institutes of Health Bethesda Maryland USA

8. Department of Infectious Diseases Venhälsan, Södersjukhuset Stockholm Sweden

9. Unit of Hepatology, Division of Upper Gastrointestinal Diseases Karolinska University Hospital Stockholm Sweden

10. Department of Medicine Huddinge, Karolinska Institutet Stockholm Sweden

11. Department of Internal Medicine and Infectious Diseases Danderyd University Hospital Stockholm Sweden

Abstract

SummaryBackgroundDespite numerous risk factors and serious consequences, little is known about metabolic dysfunction‐associated steatotic liver disease (MASLD) at population level in Africa.AimThe aim of the study was to estimate the prevalence and risk factors of MASLD in people living with and without HIV in Uganda.MethodsWe collected data from 37 communities in South Central Uganda between May 2016 and May 2018. We estimated MASLD prevalence using the fatty liver index and advanced liver fibrosis using the dynamic aspartate‐to‐alanine aminotransferase ratio. We collected additional data on sociodemographics, HIV and cardiovascular disease (CVD) risk factors. We used multivariable logistic regression to determine the association between HIV, CVD risk factors and MASLD.ResultsWe included 759 people with HIV and 704 HIV‐negative participants aged 35–49. MASLD prevalence was 14% in women and 8% in men; advanced liver fibrosis prevalence was estimated to be <1%. MASLD prevalence was more common in women (15% vs. 13%) and men (9% vs. 6%) with HIV. Being female (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.4–3.3) was associated with a higher odds of MASLD after adjustment for confounders; HIV infection was borderline associated with MASLD (OR = 1.4; 95% CI: 1.0–2.0).ConclusionsIn a relatively young cohort in Uganda, 14% of women and 8% of men had MASLD. There was an indication of an association between HIV and MASLD in multivariable analysis. These data are the first to describe the population‐level burden of MASLD in sub‐Saharan Africa using data from a population‐based cohort.

Funder

National Center for Child Health and Development

National Institute of Allergy and Infectious Diseases

Vetenskapsrådet

Centers for Disease Control and Prevention

National Institute of Mental Health

Publisher

Wiley

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