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Background and Aims: Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020, the utility of which has not been tested and validated in real world. We aimed to compare the characteristics of MAFLD and non-alcoholic fatty liver disease (NAFLD)., Methods: The data was retrieved from the third National Health and Nutrition Examination Surveys of the United States, which is an unbiased survey dataset and frequently used for the study of fatty liver disease., Results: A total of 13 083 cases with completed ultrasonography and laboratory data were identified from the NHANES III database. MAFLD was diagnosed in 4087/13 083 (31.24%) participants, while NAFLD in 4347/13 083 (33.23%) amongst the overall population and 4347/12 045 (36.09%) in patients without alcohol intake and other liver diseases. Compared with NAFLD, MAFLD patients were significantly older, had higher BMI level, higher proportions of metabolic comorbidities (diabetes, hypertension) and higher HOMA-IR, lipid and liver enzymes. MAFLD patients with alcohol consumption were younger than those without, and more likely to be male. They had less metabolic disorder but higher liver enzymes. There were more cases with advance fibrosis in MAFLD patients with alcohol consumption., Conclusion: MAFLD definition is more practical for identifying patients with fatty liver disease with high risk of disease progression., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Previous studies have suggested that Toxoplasma gondii (T. gondii) infection might be associated with fatty liver disease. However, the relationship between non-alcoholic fatty liver disease (NAFLD) and T. gondii infection has not been investigated in a large population. We aimed to study the relationship between those two diseases using a population-based dataset from the United States., Methods: The data were collected from the third National Health and Nutrition Examination Survey (NHANES III) between 1988 and 1994. Statistical analysis was applied to compare the prevalence of NAFLD in anti-T. gondii antibody-positive participants with antibody-negative ones., Results: A total of 9465 persons with a mean age of 44.33 ± 16.21 years, 46.9% of which were males, were included in the final analysis. Their mean BMI was 27.60 ± 5.96 kg/m 2 . A total of 2520 participants (26.62%) were positive for the T. gondii antibody. There was an increasing trend of seroprevalence of T. gondii with age (P for trend < 0.001). The incidence of NAFLD in the seropositive group was higher than that in the seronegative group (27.10% vs 23.40%, p < 0.001). In addition to this, metabolic biomarkers, including serum lipid, fasting blood-glucose, and uric acid were also significantly higher in the seropositive group. However, multivariate analysis revealed that T. gondii infection was not an independent risk factor for NAFLD. Age was independently correlated with both the prevalence of T. gondii and NAFLD., Conclusions: Patients with T. gondii infection may have a higher prevalence of NAFLD. Age may have an effect on the increase of NAFLD in the T. gondii seropositive population.