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Study co-authors Stephen Harrison, Naim Alkhouri and Samer Gawrieh suggest that current estimates of NAFLD and NASH populations in the US may be meaningfully understated.

Earlier this year, Drs. Harrison, Alkhouri, Gawrieh and seven co-authored published a paper in the Journal of Hepatology titled, "Prospective evaluation of the prevalence of non-alcoholic fatty liver disease and steatohepatitis in a large middle-aged US cohort." This study of 664 non-symptomatic patients revealed a 38% incidence of NAFLDand 14% incidence of NASH. While there were no cases of cirrhosis, 5.9% of patients demonstrated biopsy-diagnosed F2 or F3 NASH. Incidences were higher in several subgroups, notably including patients with Type 2 diabetes or obesity and Hispanic patients.

The three co-authors discuss the motivation to do this study, methods they used and key findings. More gripping were their discussion of implications and the things that surprised them. Louise Campbell and Roger Green asked more questions about the NAFLD and NASH incidence numbers, contrasted them to other US estimates and tied them to other ex-US patient populations.

The group consensus is that this issue is more pressing and prevalent than is generally reported, and that the effects of COVID-19 should make the challenge larger. This episode is a call to action to think more creatively and urgently about treating Fatty Liver disease.