Fatty liver disease (FLD) is a chronic liver condition characterised by fat accumulation in the liver. It is also known by various related terms such as non-alcoholic fatty liver disease (NAFLD) or metabolic associated steatotic liver disease (MASLD). FLD is linked closely to being overweight or obese, as well as metabolic conditions such as diabetes. FLD is suspected to affect 40% of individuals and has become the most common liver disease worldwide.
Individuals who are ethnically South Asian tend to have higher rates of metabolic disease, as well as higher overall risk of cardiovascular disease. Majority of individuals with FLD die from cardiovascular disease and are at a much higher risk of heart attack, heart failure and stroke. However, it is not clear how:
- The COVID-19 pandemic affected the burden of FLD in England.
- How this differed based on ethnic and social deprivation.
- How a diagnosis of COVID-19 affected the relationship between FLD and short to medium-term cardiovascular outcomes in individuals with FLD, and how this relationship is impacted by ethnicity and socioeconomic determinants.
This project aims to enable us to better understand these very important questions.
The aim of this project is to investigate how COVID-19 has affected the prevalence of FLD in England; the relationship between FLD and cardiovascular disease, and how this relationship differs based on ethnicity and socioeconomic factors. This is important because South Asians experience a higher risk of cardiovascular disease compared to East Asian and Caucasian ethnic groups. South Asians are also hypothesised to have higher rates of FLD although data specific to ethnic groups is limited.
Furthermore, individuals exposed to higher social deprivation are hypothesised to have worse cardiovascular outcomes. What is currently unknown is the impact of COVID-19 on the prevalence of FLD, as well as on the relationship between FLD and cardiovascular disease in individuals from South Asian versus other ethnic groups and based on social deprivation. This research project would help to shed light on this question and may subsequently be useful in defining areas of the population to focus on for targeted prevention measures.
This work would generate new knowledge to inform the trajectory of individuals with FLD, especially the ethnic and social groups at higher risk of cardiovascular disease. These groups may benefit from greater screening and/or targeted outreach for prevention. It would also allow recommendations on the management of FLD pertaining to complications from COVID-19 and cardiovascular disease.