Nonobese Population in A Developing Country Has A High Prevalence of Nonalcoholic Fatty Liver and Significant Liver Disease

作者：Kausik Das, Kshaunish Das, Partha Sarathi Mukherjee, Alip Ghosh, Sumantra Ghosh, Asit Ranjan Mridha, Tapan Dhibar, Bhaskar Bhattacharya, Dilip Kumar Bhattacharya, Byomkesh Manna, Gopal Krishna Dhali, Amal Kumar Santra, Abhijit Chowdhury · 发表于：Hepatology · 年份：2010 · DOI：10.1002/hep.23567 · 被引用次数：472 · 研究领域：Liver Disease Diagnosis and Treatment、Diabetes, Cardiovascular Risks, and Lipoproteins、Alcohol Consumption and Health Effects

UNLABELLED: There is a paucity of community-based epidemiological data on nonalcoholic fatty liver (NAFL) among nonaffluent populations in developing countries. Available studies are radiological and/or biochemical and lack histological assessment, limiting their strength. We conducted a prospective epidemiological study comprising a 1:3 subsample of all adult (>18 years) inhabitants of a rural administrative unit of West Bengal, India. Subjects positive for hepatitis B virus and/or hepatitis C virus infection and consuming any amount of alcohol were excluded. Diagnosis of NAFL was by dual radiological screening protocol consisting of ultrasonographic and computed tomographic examination of the liver. Transient elastographic examination and liver biopsy were performed in a subset to identify significant liver disease. The risk factors of having NAFL were analyzed. A total of 1,911 individuals were analyzed, 7% of whom were overweight and 11% of whom had abdominal obesity. The prevalence of NAFL, NAFL with elevated alanine aminotransferase, and cryptogenic cirrhosis was 8.7%, 2.3%, and 0.2%, respectively. Seventy-five percent of NAFL subjects had a body mass index (BMI) <25 kg/m(2), and 54% were neither overweight nor had abdominal obesity. The subjects with the highest risk of having NAFL were those with a BMI >25 kg/m(2) (odds ratio 4.3, 95% confidence interval 1.6-11.5). Abdominal obesity, dysglycemia (fasting plasma glucose >100 mg/dL or elevated homeostatic model assessme...