CHANGING TRENDS IN AETIOLOGY OF LIVER DISEASES IN IMMIGRANTS IN SOUTHERN ITALY: FATTY LIVER, AN OBSERVATIONAL RETROSPECTIVE STUDY

Abstract

The rate of migration in Italy is constantly growing with immigrants making up about 8.7% of the country's population and 4.8% in our district (Foggia-Puglia, Southern Italy) (1). These are people who are both already resident in Italy for one or more generations, and new arrivals. Migrants in our geographical area mainly come from Eastern Europe, Sub-Saharan Africa, Middle-East and South Asia. Such a high number of immigrants result in a minor change in the epidemiological pattern of diseases with an increase in certain infections, which are imported or contracted in our country such as HIV, TB and viral hepatitis (2), but can also include cancers, cardio-cerebrovascular and autoimmune diseases (3-4). Other major health concerns mainly include metabolic syndrome (5), as well as problems related to social discomfort such as alcoholism (6). The incidences of hyperlipidaemia, obesity and diabetes mellitus amongst immigrants, has increased signicantly over the years due to social and economic progression, and lifestyle changes, which in some cases are due to high-fat and highsugar diets and a lack of physical exercise (5-7). One of the most common clinical problems is fatty liver (FL): a metabolic disorder characterized by an excessive accumulation of triglycerides in hepatocytes that can be induced by multiple causes. Chronic alcohol intake is certainly one of the main causes (ALD), while another important reason is NAFLD (Non-Alcoholic Fatty Liver Disease), which represents the hepatic component of metabolic syndrome (8). FL has now become a major cause of liver related morbidity and mortality, with an incidence of around 20-25% worldwide. It is present mainly in native populations of developed countries, but its prevalence is also increasing amongst immigrants (8-10).