Non-alcoholic fatty liver disease in a rural, physically active, low income population in Sri Lanka

M Janani Pinidiyapathirage,Shaman Rajindrajith,Norihiro Kato,Udaya Kalubowila,A Rajitha Wickremasinghe,H Janaka De Silva,Anuradha S Dassanayake

doi:10.1186/1756-0500-4-513

Abstract

BackgroundNon-alcoholic fatty liver disease (NAFLD) is recognized as a metabolic disorder largely seen in urbanized populations. The purpose of this study was to assess prevalence and risk factors for NAFLD in a rural, physically active, economically deprived population in Sri Lanka.MethodsBy visiting individual households in the community, 35-64 year old adults resident in two selected estates in the Nuwara Eliya District of Sri Lanka, were invited to participate in the study. Blood pressure and anthropometric measurements were made on all participants. Blood samples were obtained for the assay of fasting glucose, serum lipids, serum insulin and alanine aminotransferase. NAFLD was diagnosed on established ultrasound criteria for fatty liver in the absence of hepatitis B and C markers and high alcohol consumption.ResultsOf those invited, 403 (65%) participated in the study. Almost all participants were either Indian or Sri Lankan Tamils and 53% were females. Prevalence of NAFLD was 18% in this population. Twice as many males were diagnosed as having NAFLD compared to females. Male sex, high BMI, high waist circumference, high diastolic blood pressure and high plasma glucose levels were significant predictors of NAFLD.ConclusionNearly one in five people in this predominantly Indian Tamil, rural, physically active, economically deprived population had NAFLD. The condition was associated with constituent features of the metabolic syndrome. These results support studies reporting ethnic variations in disease susceptibility and suggest that genetic factors may also play a role in determining disease risk.

Highlights

Non-alcoholic fatty liver disease (NAFLD) is recognized as a metabolic disorder largely seen in urbanized populations
This study aims to determine the prevalence of NAFLD and its risk factors in the estate population of Sri Lanka, a physically active, low socio-economic population group
Male sex, higher education or income level, low or moderate levels of physical activity, BMI ≥ 25 kg/m2, WC ≥ 90 cm in males or ≥ 80 cm in females, systolic blood pressure of ≥ 130 mmHg, diastolic blood pressure of ≥ 85 mmHg, fasting plasma glucose of ≥ 5.6 mmol/L, insulin resistance and triglycerides ≥ 1.7 mmol/L were significantly associated with NAFLD (Table 2)

Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD) is recognized as a metabolic disorder largely seen in urbanized populations. The purpose of this study was to assess prevalence and risk factors for NAFLD in a rural, physically active, economically deprived population in Sri Lanka. Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common chronic liver condition in most regions worldwide. More active forms of the condition that include steatohepatitis can have significant clinical consequences related to the development of cirrhosis and its complications or co-morbid cardiovascular disease [1]. Data on NAFLD prevalence in less urbanized, socioeconomically underprivileged populations in Sri Lanka, and in most Asian countries, is not available. This study aims to determine the prevalence of NAFLD and its risk factors in the estate population of Sri Lanka, a physically active, low socio-economic population group

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