Awareness of Non-alcoholic Fatty Liver Disease in Makkah, Saudi Arabia: A Cross-Sectional Study

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver condition characterized by excessive fat accumulation in hepatocytes, affecting individuals globally. With a prevalence of 32% among adults, NAFLD is linked to obesity, metabolic disorders, and type 2 diabetes mellitus (T2DM), yet awareness remains disproportionately low, reaching as low as 4.4% in some developed countries like the US, despite its high prevalence. In Saudi Arabia, specifically the Makkah region, data regarding public awareness are scarce. This study aims to bridge this gap by assessing NAFLD awareness and its predictors among Makkah residents.

A cross-sectional study was conducted using an electronic questionnaire (Google Forms) distributed through social media platforms, with 716 participants (aged ≥18 years) included, who are adult residents of Makkah, Saudi Arabia. The questionnaire gathered demographic information and assessed NAFLD knowledge. The survey instrument was self-constructed; while formal psychometric validation was not conducted, content validity was ensured through review by academic faculty experts. Data were analyzed using RStudio (version 4.3.1). Descriptive statistics, Pearson's chi-square, and Fisher's exact tests were utilized. Multivariable logistic regression was performed to identify significant predictors of awareness, with results reported as odds ratios (ORs) and 95% confidence intervals (CIs).

Of the 716 participants, 80% were female, and 54.1% were aged 18-25 years. Only 30.3% were aware of NAFLD, primarily through the Internet (59.9%). Awareness of symptoms was critically low (17.9%). Significant predictors included higher education (p = 0.010) and older age (p = 0.038). Notably, participants with a family history of NAFLD were 32.7 times more likely to be aware of the condition (OR = 32.7, p < 0.001).

The study reveals significant gaps in NAFLD awareness and knowledge among Makkah residents. Given that the internet is the leading source of information, we recommend launching interactive social media campaigns led by trusted healthcare professionals to provide simplified, evidence-based content. In addition, increasing local research and conducting awareness days in public places are essential steps. These practical actions will bridge the knowledge gap, support early detection, and help prevent serious liver complications.