Clin Mol Hepatol.
2024 Sep;30(suppl):s199-s213. 10.3350/cmh.2024.0351.
Prevalence of clinically significant liver fibrosis in the general population: A systematic review and meta-analysis
- Affiliations
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- 1Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 2Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
- 3Department of Internal Medicine, Institute of Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
- 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- 5Yonsei Liver Center, Severance Hospital, Seoul, Korea
- 6Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 7Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- 8Department of Gastroenterology and Hepatology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
- 9Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare, Collaborating Agency, Seoul, Korea
- 10Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- KMID: 2559592
- DOI: http://doi.org/10.3350/cmh.2024.0351
Abstract
- Background/Aims
Although important, clinically significant liver fibrosis is often overlooked in the general population. We aimed to examine the prevalence of clinically significant liver fibrosis using noninvasive tests (NITs) in the general population.
Methods
We collected data from four databases (MEDLINE, Embase, Cochrane Library, and KoreaMed) from inception to June 13, 2023. Original articles reporting the prevalence of clinically significant liver fibrosis in the general population were included. The Stata metaprop function was used to obtain the pooled prevalence of liver fibrosis with NITs in the general population.
Results
We screened 6,429 articles and included 45 eligible studies that reported the prevalence of clinically significant liver fibrosis in the general population. The prevalence of advanced liver fibrosis, using the high probability cutoff of the fibrosis-4 (FIB-4) index, was 2.3% (95% confidence interval [CI], 1.2–3.7%). The prevalence of significant liver fibrosis, advanced liver fibrosis, and liver cirrhosis, assessed using vibration-controlled transient elastography (VCTE) among the general population, was 7.3% (95% CI, 5.9–8.8%), 3.5% (95% CI, 2.7–4.5), and 1.2% (95% CI, 0.8–1.8%), respectively. Region-based subgroup analysis revealed that the highest prevalence of advanced fibrosis using the high probability cutoff of the FIB-4 index was observed in the American region. Furthermore, the American region exhibited the highest prevalence of significant liver fibrosis, advanced liver fibrosis, and liver cirrhosis, using VCTE.
Conclusions
Previously undiagnosed clinically significant liver fibrosis is found in the general population through NITs. Future research is necessary to stratify the risk in the general population.
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