{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T19:24:26Z","timestamp":1747423466383,"version":"3.40.5"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Nonalcoholic steatohepatitis (NASH) has a risk of progressing to cirrhosis. The prevalence of NASH and its associated risk factors in community populations are relatively unknown. This study aimed to determine the prevalence of NASH and advanced liver fibrosis using magnetic resonance elastography (MRE), and determine those risk factors in health examinees with asymptomatic fatty liver.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>This study consecutively selected subjects who underwent health checkups at 13 health-promotion centers in 10 Korean cities between 2018 and 2020. Hepatic steatosis and stiffness were assessed using ultrasonography and MRE, respectively. Stages of liver stiffness were estimated using MRE with cutoff values for NASH and advanced liver fibrosis of 2.91 and 3.60 kPa, respectively.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The overall prevalence of NASH and advanced liver fibrosis in the subjects with fatty liver were 8.35% and 2.04%, respectively. Multivariate logistic regression analysis indicated that central obesity (OR = 5.12, 95% CI = 2.70\u20139.71), increased triglyceride (OR = 3.29, 95% CI = 1.72\u20136.29), abnormal liver function test (OR = 3.09, 95% CI = 1.66\u20135.76) (all<jats:italic>P<\/jats:italic>&lt;0.001), and decreased high-density lipoprotein cholesterol (OR = 5.18, 95% CI = 1.78\u201315.05) (<jats:italic>P<\/jats:italic>= 0.003) were associated with NASH. The main risk factor for advanced liver fibrosis was diabetes (OR = 4.46, 95% CI = 1.14\u201317.48) (<jats:italic>P<\/jats:italic>= 0.032).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>NASH or advanced liver fibrosis is found in one-tenth of health examinees with asymptomatic fatty liver. This suggests that early detection of NASH should be considered to allow early interventions such as lifestyle changes to prevent the adverse effects of NASH and its progression in health examinees with asymptomatic fatty liver.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0260477","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T18:29:11Z","timestamp":1637778551000},"page":"e0260477","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Subclinical steatohepatitis and advanced liver fibrosis in health examinees with nonalcoholic fatty liver disease (NAFLD) in 10 South Korean cities: A retrospective cross-sectional study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-4364","authenticated-orcid":true,"given":"Eun-Hee","family":"Nah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seon","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyeran","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongwon","family":"Noh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunjoo","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han-Ik","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"issue":"Suppl 1","key":"pone.0260477.ref001","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1016\/j.jhep.2014.12.012","article-title":"NAFLD: a multisystem disease","volume":"62","author":"CD Byrne","year":"2015","journal-title":"J Hepatol"},{"issue":"Suppl 1","key":"pone.0260477.ref002","doi-asserted-by":"crossref","first-page":"S163","DOI":"10.1111\/j.1440-1746.2010.06548.x","article-title":"Nonalcoholic fatty liver in Asia: Firmly entrenched and rapidly gaining ground","volume":"26","author":"S Chitturi","year":"2011","journal-title":"J Gastroenterol Hepatol"},{"issue":"1","key":"pone.0260477.ref003","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"N Chalasani","year":"2018","journal-title":"Hepatology"},{"issue":"3","key":"pone.0260477.ref004","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1002\/hep.25772","article-title":"Nonalcoholic Steatohepatitis Clinical Research Network. 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