Non-alcoholic Fatty Liver Disease In General Population Research Articles

Machine learning classifiers for screening nonalcoholic fatty liver disease in general adults

Nonalcoholic fatty liver disease (NAFLD) is one of major causes of end-stage liver disease in the coming decades, but it shows few symptoms until it develops into cirrhosis. We aim to develop classification models with machine learning to screen NAFLD patients among general adults. This study included 14,439 adults who took health examination. We developed classification models to classify subjects with or without NAFLD using decision tree, random forest (RF), extreme gradient boosting (XGBoost) and support vector machine (SVM). The classifier with SVM was showed the best performance with the highest accuracy (0.801), positive predictive value (PPV) (0.795), F1 score (0.795), Kappa score (0.508) and area under the precision-recall curve (AUPRC) (0.712), and the second top of area under receiver operating characteristic curve (AUROC) (0.850). The second-best classifier was RF model, which was showed the highest AUROC (0.852) and the second top of accuracy (0.789), PPV (0.782), F1 score (0.782), Kappa score (0.478) and AUPRC (0.708). In conclusion, the classifier with SVM is the best one to screen NAFLD in general population based on the results from physical examination and blood testing, followed by the classifier with RF. Those classifiers have a potential to screen NAFLD in general population for physician and primary care doctors, which could benefit to NAFLD patients from early diagnosis.

Nonalcoholic Fatty Liver Disease: A New Frontier for Hepatology in Bangladesh and a Call for Action to Combat

Nonalcoholic Fatty Liver Disease (NAFLD) is the condition where fat accumulates in liver without significant ingestion of alcohol. NAFLD has become one of the most common liver conditions throughout the world. At the dawn of the history of NAFLD it was thought that NAFLD is disease of obese individual but lean patients are increasingly detected to have NAFLD. It seems that insulin resistance is central to the pathogenesis of NAFLD. In addition, oxidative stress and cytokines are important contributing factors, resulting in steatosis and progressive liver damage in genetically susceptible individuals. NAFLD varies considerably by ethnic group and Bangladeshi ethnicity is an independent risk factor for NAFLD. Prevalence of NAFLD in general population of Bangladesh is 4 - 18.4 %, which jumps up to 49.8% in diabetic patients. With the changes in socioeconomic condition and life style, aetiology of chronic liver disease is drifting from infectious to noninfectious diseases and the contribution of NAFLD is progressively increasing. Hepatitis B and hepatitis C have been the leading causes of mortality and morbidity from chronic liver disease in Bangladesh. But with increase in awareness and mass vaccination against HBV, prevalence of both the diseases has been decreasing in the country. The most alarming feature is that there is a high prevalence of NASH among the NAFLD patients. NAFLD is emerging as the largest contributor of chronic liver disease in Bangladesh. This warrants the attention of health policy makers and clinicians to explore this frontier and combat it from right now.J Bangladesh Coll Phys Surg 2017; 35(4): 184-191

Is the Non-Alcoholic Fatty Liver Disease Part of Metabolic Syndrome?

Non-alcoholic fatty liver disease (NAFLD) is caused by fatty infiltration of the liver in the absence of alcohol consumption. The incidence of NAFLD in general population is 30-40%. NAFLD is considered by some authors to be the liver manifestation of the metabolic syndrome and by other authors is considered to be a separate entity. The pathogenesis of NAFLD and metabolic syndrome seems to have common pathophysiological mechanisms, with focus on insulin resistance as a key factor. Insulin resistance seems to explain the accumulation of triglycerides in the liver, being the main pathogenetic link involved in the onset and progression of NAFLD. The natural evolution is not well known, and there is some controversy about the progression from NAFL to NASH and fibrosis. Current data on epidemiology, pathophysiology and diagnostic supports the association of non-alcoholic fatty liver disease as a possible component in the cluster of metabolic syndrome. Clinical, experimental and epidemiological studies argue that NAFLD may be the hepatic manifestation of metabolic syndrome.

Prevalence of non-alcoholic fatty liver disease: population based study

Background and aim: Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease and liver transplantation in western countries. Increasing incidence of NAFLD has been well documented from Asian countries like Japan and China. Diabetes mellitus (DM), obesity, hyperinsulinemia are predisposing factors for NAFLD. There is increase in incidence of DM, obesity and insulin resistance in India in last two decades. Hence it is logical to expect increase in incidence of NAFLD in India. There is limited data on the prevalence of NAFLD from India. Majority of data comes from hospital based studies including small number of patients. Therefore this study was planned to estimate the prevalence of NAFLD in general population. Material and methods: Residents of two Railway colonies were evaluated on history, clinical examination, anthropometric measurements, biochemical tests and abdominal ultrasound. Results: 1,168 participants were evaluated. Persons with any amount of alcohol consumption, HBs Ag positive, Anti HCV positive, persons with other known liver diseases and taking medications causing liver disease were excluded. Prevalence of NAFLD on ultrasound was 16.6%. Out of 730 subjects above the age of 20 years (341 male 384 female 389) mean age 39.08 ± 12.3 years, 4% had diabetes, 57% had central obesity. Prevalence of NAFLD based on the ultrasound above 20 years of age was 18.9%. NAFLD was more prevalent in male than female (24.6% vs 13.6%, p < 0.001). Risk factors associated with NAFLD were age more than 40 years, male gender, central obesity, high BMR > 25, elevated fasting blood sugar, raised AST and ALT. Conclusion: Prevalence of NAFLD in Indian population is comparable to the west.