Familial Clustering of Nonalcoholic Fatty Liver Disease Among the Family Members of Nonalcoholic Steatohepatitis Cirrhotic Patients

Abstract

Background and Aim: NAFLD is a multifactorial disorder. A combination of environmental, genetic and metabolic factors play role in the progression to advanced disease. Family members of NASH cirrhotic patients share some common factors and also probability of genetic predisposition, so chance of familial clustering of NAFLD is more among the family members. This study is aimed to explore the familial clustering of NAFLD among the family members of NASH cirrhotic patients and the association of insulin resistance, metabolic syndrome and genetic polymorphism with the familial clustering. Methods: This was a cross sectional observational study. Total NASH cirrhosis patient was 50 and 1st degree relative was 81. This study was conducted in Department of Hepatology, BSMMU, Dhaka. Included family members were screened for presence or absence of fatty liver by ultrasonogram. They were then divided on two groups by ultrasonographic findings. Insulin resistance, metabolic syndrome, PNPLA3 and staging of liver stiffness by fibroscan were done. Results: Among 81 family members 47 (58.02%) were found having fatty liver. This proportion is much higher than the general population. PNPLA3 polymorphism was higher (80.85%) in fatty liver group than (55.9%) without fatty liver groups. Sons (57.89%) and daughters (51.6%) were affected by fatty liver equally but frequency of genetic polymorphism was more common in daughters (77.41%). Multivariate logistic regression analysis revealed that a subject with TG > 150 mg/dl had 6.159 times increase in odds having NAFLD. A subject with PNPLA3 polymorphism had 3.33 times increase in odds having NAFLD. A subject with HOMA-IR >1.6 had 4.375 times increase in odds having NAFLD. Conclusion: This study indicates that there is a strong familial clustering of NAFLD among the family members of NASH cirrhosis patients. There is a significant association with insulin resistance, PNPLA3 polymorphism, dyslipidemia with the development of NAFLD in the family members (Figure 1 and Table 1).Table 1Pattern of Fatty Liver, PNPLA3 Polymorphism Among Family Members of NASH Cirrhotic Patients.PNPLA3Son (n-38)Daughter (n-31)Brother (n-06)Sister (n-06)Fatty liver n-22 (57.89%)Normal n-16 (42.10%)Fatty liver n-16 (51.6%)Normal n-15 (48.4%)Fatty liver n-05 (83.3%)Normal n-01 (16.7%)Fatty liver n-04 (66.7%)Normal n-02 (33.3%)C/C06 (27.27%)06 (37.5%)02 (12.5%)05 (33.3%)02 (40%)01 (100%)01 (25%)01 (50%)C/G14 (63.63%)10 (62.5%)14 (87.5%)10 (66.7%)03 (60%)03 (75%)01 (50%)G/G02 (9.09%)00 Open table in a new tab The authors have none to declare.