{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:07:08Z","timestamp":1777878428886,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Chronic Disease"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Metabolic associated fatty liver disease (MAFLD) stands as the leading cause of chronic liver disease globally. Notably, individuals with metabolic risk factors, such as diabetes and obesity, exhibit a staggering prevalence of MAFLD, with estimates reaching up to 70%. However, despite its widespread occurrence, there\u2019s a noticeable gap in understanding and awareness about MAFLD among these high-risk groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The main objective of this study was to assess the awareness and prevalence of MAFLD among diabetic patients who regularly receive secondary care focusing particularly on how multiethnic backgrounds and associated lifestyle preferences influence these health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with type 2 diabetes (T2D) who regularly attend Lambeth Diabetes Intermediate Care Team clinics were invited to undergo MAFLD screening using FibroScan. Those who agreed to participate were provided with structured questionnaires on diet, physical activity, and MAFLD knowledge by a hepatologist. For each participant, anthropometric data, medical history, liver stiffness measurement, and controlled attenuation parameter (CAP) were documented. Steatosis was identified with a CAP value of \u2a7e275\u2009dB\/m, and advanced fibrosis was flagged at values of \u2a7e8\u2009kPa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The FibroScan data was valid in 96.4% (215), 53.5% (115\/215) had steatosis and 26.2% (58\/215) had liver fibrosis in this multiethnic high-risk group. Awareness of MAFLD was notably low at 30.9%. Alarmingly, 69% of patients diagnosed with liver fibrosis were unfamiliar with the condition. Additionally, understanding of MAFLD showed variation among different ethnic groups with highest levels were demonstrated in the Caucasian\/White population (46%). Majority (96%) of these subjects were receiving specific lifestyle advice from healthcare professionals due to metabolic conditions and comorbidities. However, most patients preferred diets that were rich in carbohydrates (65.8%) and only 43% subjects performed moderate exercise daily highlighting lack of understanding regarding MAFLD and lifestyle management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There\u2019s a pressing need for increased awareness of MAFLD, especially in multiethnic high-risk groups. Additionally, the development of cost-effective strategies to stratify risk is essential to address this growing health concern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406223241264539","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T03:07:02Z","timestamp":1722395222000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Lack of awareness and ethnic polarity is a major cause of metabolic associated fatty liver disease in high-risk diabetes population in South London"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1089-1949","authenticated-orcid":false,"given":"Saima","family":"Ajaz","sequence":"first","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, Denmark Hill, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Chamley","sequence":"additional","affiliation":[{"name":"North Wood Group Practice Clinical Lead, Lambeth Diabetes Intermediate Care Team, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Lok","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riham","family":"Soliman","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reece","family":"Khan","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Ahir","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique","family":"Curtis","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Fernanda","family":"Guerra-Veloz","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Institute of Liver Disease, Kings College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"bibr1-20406223241264539","unstructured":"British Liver Trust. Statistics. British liver trust, https:\/\/britishlivertrust.org.uk\/information-and-support\/statistics\/ (n.d. accessed 21 April 2024)."},{"key":"bibr2-20406223241264539","volume":"384","author":"Lancet Commission","year":"2014","journal-title":"Lancet"},{"key":"bibr3-20406223241264539","unstructured":"Office for Health Improvement and Disparities. Liver disease profiles: July 2023 Update, https:\/\/www.gov.uk\/government\/statistics\/liver-disease-profiles-july-2023-update (2023, accessed 25 April 2024)."},{"key":"bibr4-20406223241264539","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v15.i2.123"},{"key":"bibr5-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00003-1"},{"key":"bibr6-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32228"},{"key":"bibr7-20406223241264539","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.50.8.1844"},{"key":"bibr8-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2019.12.002"},{"key":"bibr9-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241858"},{"key":"bibr10-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.01.052"},{"key":"bibr11-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29466"},{"key":"bibr12-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05700-9"},{"key":"bibr13-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32500"},{"key":"bibr14-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.10.029"},{"key":"bibr15-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-015-1302-9"},{"key":"bibr16-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.025"},{"key":"bibr17-20406223241264539","unstructured":"NHS digital health report: Health state life expectancies by national deprivation deciles, England: 2017 to 2019. (2021, accessed 25 March 2024)."},{"key":"bibr18-20406223241264539","unstructured":"Urban Health. Health inequity in Lambeth, https:\/\/urbanhealth.org.uk\/insights\/reports\/health-inequity-in-lambeth (2022, accessed 27 March 2024)."},{"key":"bibr19-20406223241264539","unstructured":"Lambeth Council. State of the Borough 2022 report, https:\/\/www.lambeth.gov.uk\/sites\/default\/files\/2022-07\/state-of-the-borough-2022-report.pdf (2022)."},{"key":"bibr20-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1831"},{"key":"bibr21-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000323"},{"key":"bibr22-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00754-7"},{"key":"bibr23-20406223241264539","first-page":"1853","volume":"71","author":"Eslam M","year":"2020","journal-title":"Hepatology"},{"key":"bibr24-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.08.024"},{"key":"bibr25-20406223241264539","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-021-01612-z"},{"key":"bibr26-20406223241264539","unstructured":"Pacific physical activity and sedentary behaviour guidelines for everyone\n                      . Manila: World Health Organization Regional Office for the Western Pacific. (2023, accessed 25 April 2024)."}],"container-title":["Therapeutic Advances in Chronic Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20406223241264539","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20406223241264539","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20406223241264539","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:20:01Z","timestamp":1777591201000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20406223241264539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":26,"alternative-id":["10.1177\/20406223241264539"],"URL":"https:\/\/doi.org\/10.1177\/20406223241264539","relation":{},"ISSN":["2040-6223","2040-6231"],"issn-type":[{"value":"2040-6223","type":"print"},{"value":"2040-6231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"20406223241264539"}}