Personal and Societal Burden of NAFLD

Anne Hogan is a Graduate Student in Food Science and Human Nutrition at the University of Illinois at Urbana Champaign

Non-Alcoholic Fatty Liver Disease (NAFLD) is becoming a major health concern in the US. As the issue continues to grow, it is essential to understand the major causes and risks of NAFLD and the burden the disease places on individuals and the public.

What is NAFLD?

NAFLD is a condition where fat has accumulated in the liver. Risk factors for NAFLD include:

Obesity
Type 2 Diabetes
High blood pressure (or hypertension)
High amounts of fat in the blood

In many cases, people with NAFLD do not show symptoms and do not know they have it unless they are screened. However, if the disease continues to progress, more severe conditions such as inflammation, permanent scarring of the liver, and other chronic health conditions can develop (Johns Hopkins, 2022).

NAFLD in the US:

It is estimated that 30% of the US population has NAFLD. This percentage is expected to increase as the rates of the risk factors continue to grow. In the US, rising rates of NAFLD also mean a likely increase in chronic liver disease and cardiovascular disease (Cotter & Rinella, 2020). This concerning trend also presents a major burden for individuals affected by the disease.

The Personal Cost:

Individuals living with NAFLD can see significant increases in their healthcare costs after the initial diagnosis. NAFLD patients have over twice as many healthcare visits as non-NAFLD patients and pay about 17% more in annual healthcare costs (Cotter et al., 2020).

Over time, patients with NAFLD can pay 80% more in healthcare costs than non-NAFLD patients with similar demographics and comorbidities, even with health insurance. Most of these costs are incurred when patients undergo screening tests to treat and manage the disease, which can include any of the following:

Cross-sectional imaging (such as a CT or MRI)
Ultrasounds
Liver biopsies
Lab studies
Elastography

While NAFLD has major impacts on health and wellness, simply managing the condition presents the additional stress of a significant financial burden for patients and their families (Allen et al., 2018).

Summary:

Non-Alcoholic Fatty Liver Disease is a condition that is expected to affect an increasing number of people as the risk factors for the disease continue to grow. While the overall health risks of NAFLD are very serious, patients also face major increases in the cost of their care because of the numerous medical tests and outpatient visits needed to diagnose and manage the disease. Understanding NAFLD’s heavy burden on patients and their families is instrumental in providing the most effective, patient-centered care.

References:

Allen, A.M., Van Houten, H.K., Sangaralingham, L.R., Talwalkar, J.A., & McCoy, R.G. (2018). Healthcare cost and utilization in nonalcoholic fatty liver disease: Real-world data from a large US claims database. Hepatology, 68(6), 2230–2238. DOI: 10.1002/hep.30094.
Cotter, T.G., Dong, L., Holmen, J., Gilroy, R., Krong, J., & Charlton, M. (2020). Nonalcoholic fatty liver disease: Impact on healthcare resource utilization, liver transplantation and mortality in a large, integrated healthcare system. Journal of Gastroenterology, 55, 722–730. DOI: https://doi-org.proxy2.library.illinois.edu/10.1007/s00535-020-01684-w.
Cotter, T.G., Rinella, M. (2020). Nonalcoholic fatty liver disease 2020: The state of the disease. Gastroenterology, 158(7), 185 –1864. DOI: https://doi.org/10.1053/j.gastro.2020.01.052.
Johns Hopkins Medicine (2022). Nonalcoholic fatty liver disease. https://www.hopkinsmedicine.org/health/conditions-and-diseases/nonalcoholic-fatty-liver-disease

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