Prevalence and Risk Factors of Metabolic-Associated Fatty Liver Disease in the Korean Air Force

INTRODUCTION: This study investigated the prevalence and risk factors of metabolic-associated fatty liver disease (MAFLD) in the Korean Air Force population (2020–2022), comparing nonpilot and pilot groups.

METHODS: Participants over 40 yr were classified into MAFLD or non-MAFLD groups. MAFLD was defined as hepatic steatosis on ultrasonography plus one of the following: overweight/obesity, type II diabetes, or metabolic deregulations. Variables analyzed included body mass index (BMI), alanine aminotransferase (ALT), uric acid, fasting plasma glucose, lipid profile, triglycerides, albumin, and exercise habits.

RESULTS: Among 1044 participants (667 pilots, 377 nonpilots), MAFLD prevalence was 30.3%, significantly lower in pilots (27.7%) than in nonpilots (34.7%). For nonpilots, BMI [odds ratio (OR) = 3.41], diabetes (OR = 8.32), and ALT (OR = 1.91) were significant factors, although the small sample size limited broader conclusions. Among pilots, BMI (OR = 3.77), uric acid (OR = 1.83), ALT (OR = 1.98), triglycerides (OR = 1.50), and dyslipidemia (OR = 7.97) were strongly associated with MAFLD. Uric acid levels had a greater association with MAFLD in pilots compared to nonpilots.

DISCUSSION: This study highlights the distinct prevalence and risk factors of MAFLD in pilots vs. nonpilots. Uric acid, in particular, emerged as a significant risk factor for pilots, suggesting its potential use for targeted risk assessment in this group. The findings underscore the importance of tailored preventive strategies for MAFLD in occupational groups.

Song DH, Ku B. Prevalence and risk factors of metabolic-associated fatty liver disease in the Korean Air Force. Aerosp Med Hum Perform. 2025; 96(10):894–902.