Frequency of Non-Alcoholic Fatty Liver Disease among the Non-Obese Population Presenting to the Gastrointestinal Outpatient Clinic

Abstract

Background: It has been reported that Asian males with BMI ≤ 23 kg/m2 have considerably higher content of fat and visceral adipose tissue as compared to their Western counterparts. Multiple studies have reported variable frequency of Non-alcoholic Fatty Liver Disease (NAFLD) in lean population. However, the data is scarce regarding the prevalence of NAFLD in the lean Asian population. Objective: To determine the frequency of NAFLD among the non-obese population presenting to our clinic Methods: This cross-sectional study included all the lean individuals with BMI< 23 kg/m2 presenting to the gastroenterology outpatient clinic from 1st November 2020 to 31st March 2022. Ultrasound abdomen was performed for the presence or absence of fatty liver which was diagnosed based on hyperechoic liver texture. The analysis of continuous variables was performed using the student t-test while the Chi-square test was applied for the analysis of categorical variables. A p-value ≤ 0.05 was considered as significant. Results: Among the 283 individuals presenting to the gastrointestinal clinic with BMI < 23 kg/m2, the majority were females [150 (53%)]. Out of 283 patients, 118(41.7%) had hypertension, 114(40.3%) had hypertriglyceridemia while 86(29.7%) patients had diabetes. On ultrasound abdomen, fatty liver was observed in 92 (32.5%) patients including 59 (64.1%) females and 33 (35.9%) males. The statistical analysis documented a significant association of NAFLD with female gender (p=0.006), hypertension (p<0.001), hypertriglyceridemia (p=0.13), high total lipids (p<0.001), and serum cholesterol levels (p=0.005). However, no statistically significant association of fatty liver was observed with body mass index (p=0.823), age (p=0.169), and diabetes (p= 0.522). Conclusion: The presence of hypertension, hypertriglyceridemia, raised total lipids and serum cholesterol levels and female gender were the factors significantly associated with the presence of fatty liver in the lean population. However, to validate our results, multicentered studies on a larger scale are required.