Assessment of Risk Factors for Non-Alcoholic Fatty Liver Disease (NAFLD): Assessment of Risk Factors for NAFLD

Zahid   Hussain; Muhammad Aslam Rind; Maria  Nazir; Muhammad Saleem

doi:10.54393/pjhs.v4i05.773

Authors

Zahid Hussain Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Muhammad Aslam Rind Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Maria Nazir Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Muhammad Saleem Department of Medicine, Peoples University of Medical and Health Sciences, Nawab shah, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i05.773

Keywords:

Non-Alcoholic Fatty Liver Disease (NAFLD), Smoking, Hypertension, Obesity

Abstract

The most frequent cause of chronic liver disease globally is non-alcoholic fatty liver disease (NAFLD). Potential risk factors for NAFLD have not received enough attention in Pakistan even though NAFLD has received substantial research. Objective: To assess risk factors for Non-alcoholic fatty liver disease. This study was conducted at the Department of Medicine Liaquat University, Hospital Jamshoro from 7^t^h September 2020 to 6^t^h March 2021. Methods: This research was cross-sectional. The study recruited a total of 195 patients via nonprobability sequential sampling. The ultrasound of all the patients was done by a sonologist for detecting NAFLD. Results: The stratification of NAFLD according to smoking, hypertension, obesity, hyperlipidaemia, uncontrolled diabetes mellitus, vitamin D deficiency was done. The statistical significance was observed for NAFLD in accordance with smoking, (p=0.00), hypertension (p=0.04), obesity (p=0.04), hyperlipidaemia (p=0.03), uncontrolled diabetes mellitus (p=0.04), vitamin D deficiency (p=0.04). Conclusions: This study has shown that the percentage of NAFLD was highest in age group (40-49 years). Males were more affected as compared to females. Smokers, hypertensives, hyperlipidemics and diabetics were more prone to develop NAFLD.

References

Bedossa P. Current histological classification of NAFLD: strength and limitations. Hepatology International. 2013 Dec; 7: 765-70. doi: 10.1007/s12072-013-9446-z DOI: https://doi.org/10.1007/s12072-013-9446-z

Estes C, Razavi H, Loomba R, Younossi Z, Sanyal AJ. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018 Jan ;67(1): 123-33. doi: 10.1002/hep.29466. DOI: https://doi.org/10.1002/hep.29466

Younossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. Journal of Hepatology. 2019 Oct; 71(4): 793-801. doi: 10.1016/j.jhep.2019.06.021. DOI: https://doi.org/10.1016/j.jhep.2019.06.021

Dai W, Ye L, Liu A, Wen SW, Deng J, Wu X, et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: A meta-analysis. Medicine (Baltimore). 2017 Sep; 96(39): e8179. doi: 10.1097/MD.0000000000008179. DOI: https://doi.org/10.1097/MD.0000000000008179

Almobarak AO, Barakat S, Suliman EA, Elmadhoun WM, Mohamed NA, Abobaker IO, et al. Prevalence of and predictive factors for nonalcoholic fatty liver disease in Sudanese individuals with type 2 diabetes: Is metabolic syndrome the culprit?. Arab Journal of Gastroenterology. 2015 Jun; 16(2): 54-8. doi: 10.1016/j.ajg.2015.06.001. DOI: https://doi.org/10.1016/j.ajg.2015.06.001

Herath HM, Kodikara I, Weerarathna TP, Liyanage G. Prevalence and associations of non-alcoholic fatty liver disease (NAFLD) in Sri Lankan patients with type 2 diabetes: A single center study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019 Jan; 13(1): 246-50. doi: 10.1016/j.dsx.2018.09.002. DOI: https://doi.org/10.1016/j.dsx.2018.09.002

Lonardo A, Ballestri S, Guaraldi G, Nascimbeni F, Romagnoli D, Zona S, et al. Fatty liver is associated with an increased risk of diabetes and cardiovascular disease-Evidence from three different disease models: NAFLD, HCV and HIV. World Journal of Gastroenterology. 2016 Nov; 22(44): 9674-9693. doi: 10.3748/wjg.v22.i44.9674. DOI: https://doi.org/10.3748/wjg.v22.i44.9674

Targher G. Is it time for non-alcoholic fatty liver disease screening in patients with type 2 diabetes mellitus? Hepatobiliary Surgery and Nutrition. 2020 Apr; 9(2): 239. doi: 10.5005/jp-journals-10018-1288. DOI: https://doi.org/10.21037/hbsn.2019.10.21

Butt AS, Hamid S, Haider Z, Sharif F, Salih M, Awan S, et al. Nonalcoholic fatty liver diseases among recently diagnosed patients with diabetes mellitus and risk factors. Euroasian Journal of Hepato-Gastroenterology. 2019 Jan; 9(1): 9. doi: 10.5005/jp-journals-10018-1288. DOI: https://doi.org/10.5005/jp-journals-10018-1288

Shah AS, Khan S, Rahim H, Chishti KA, Khan AG. Prevalence of non-alcoholic fatty liver and Non-alcoholic Steatohepatitis in Peshawar Cantonment, Khyber Pakhtunkhwa, Pakistan. Pakistan Journal of Pharmaceutical Sciences. 2018 Jan; 31(1): 193-9.

Jimba S, Nakagami T, Takahashi M, Wakamatsu T, Hirota Y, Iwamoto Y, et al. Prevalence of non-alcoholic fatty liver disease and its association with impaired glucose metabolism in Japanese adults. Diabetic Medicine. 2005 Sep; 22(9): 1141-5. doi: 10.1111/j.1464-5491.2005.01582.x. DOI: https://doi.org/10.1111/j.1464-5491.2005.01582.x

Bedogni G, Miglioli L, Masutti F. Prevalence of and risk factors for non-alcoholic fatty liver disease: the Diaonysos nutrition and liver study. Hepatology. 2005 Jul; 42(1): 44-52. doi: 10.1002/hep.20734. DOI: https://doi.org/10.1002/hep.20734

Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. Jama. 2002 Jan; 287(3): 356-9. doi: 10.1001/jama.287.3.356. DOI: https://doi.org/10.1001/jama.287.3.356

Luxmi S, Sattar RA, Ara J. Association of non-alcoholic fatty liver with type 2 diabetes mellitus. JLUMHS 2008;188-193. doi: 10.22442/jlumhs.08730174. DOI: https://doi.org/10.22442/jlumhs.08730174

Collantes R, Ong JP, Younossi ZM. Nonalcoholic fatty liver disease and the epidemic of obesity. Cleveland Clinic Journal of Medicine. 2004 Aug; 71(8): 657-64. doi: 10.3949/ccjm.71.8.657. DOI: https://doi.org/10.3949/ccjm.71.8.657

Byron D and Minuk GY. Clinical hepatology: Profile of an urban, hospital‐based practic. Hepatology. 1996 Oct; 24(4): 813-5. doi: 10.1002/hep.510240410. DOI: https://doi.org/10.1002/hep.510240410

Okamoto M, Miyake T, Kitai K, Furukawa S, Yamamoto S, Senba H, et al. Cigarette smoking is a risk factor for the onset of fatty liver disease in nondrinkers: a longitudinal cohort study. PloS One. 2018 Apr; 13(4): e0195147. doi: 10.1371/journal.pone.0195147. DOI: https://doi.org/10.1371/journal.pone.0195147

Yang D, Lan J, Cen J, Han Y, Hu H. Association Between Hypertension and New-Onset Non-Alcoholic Fatty Liver Disease in Chinese Non-Obese People: A Longitudinal Cohort Study. Diabetes, Metabolic Syndrome and Obesity. 2023 Dec; 16: 345-63. doi: 10.2147/DMSO.S396011. DOI: https://doi.org/10.2147/DMSO.S396011

Ong JP, Elariny H, Collantes R, Younoszai A, Chandhoke V, Reines HD, et al. Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. Obesity surgery. 2005 Mar; 15(3): 310-5. doi: 10.1381/0960892053576820. DOI: https://doi.org/10.1381/0960892053576820

Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic, and clinical implications. Hepatology. 2010 Feb; 51(2): 679-89. doi: 10.1002/hep.23280. DOI: https://doi.org/10.1002/hep.23280

Zhang QQ and Lu LG. Nonalcoholic fatty liver disease: dyslipidemia, risk for cardiovascular complications, and treatment strategy. Journal of Clinical and Translational Hepatology. 2015 Mar; 3(1): 78. doi: 10.14218/JCTH.2014.00037. DOI: https://doi.org/10.14218/JCTH.2014.00037

Mantovani A, Byrne CD, Bonora E, Targher G. Nonalcoholic fatty liver disease and risk of incident type 2 diabetes: a meta-analysis. Diabetes Care. 2018 Feb; 41(2): 372-82. doi: 10.2337/dc17-1902. doi: 10.2337/dc17-1902. DOI: https://doi.org/10.2337/dc17-1902

Fon Tacer K and Rozman D. Nonalcoholic Fatty liver disease: focus on lipoprotein and lipid deregulation. Journal of Lipids. 2011 Oct; 2011: 1-14. doi: 10.1155/2011/783976. DOI: https://doi.org/10.1155/2011/783976

Silverman JF, O'Brien KF, Long S. Liver pathology in morbid obese patients with and without diabetes. American Journal of Gastroenterology.1990 Oct; 85(10): 1349-55.

Godoy-Matos AF, Silva Júnior WS, Valerio CM. NAFLD as a continuum: from obesity to metabolic syndrome and diabetes. Diabetology & Metabolic Syndrome. 2020 Dec; 12(1): 1-20. doi: 10.1186/s13098-020-00570-y. DOI: https://doi.org/10.1186/s13098-020-00570-y