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The prevalence of non-alcoholic fatty liver disease (NAFLD) remains high in the South Asian population, especially for individuals with metabolic disease.¹

A team, led by Madunil Anuk Niriella, Faculty of Medicine, Department of Medicine, University of Kelaniya, estimated the prevalence and predefined associated factors for NAFLD among South-Asian adults.

NAFLD

NAFLD is currently the most common chronic liver disease globally.

In the study, the investigators searched various databases for studies with descriptive, epidemiological studies with satisfactory methodology, reporting on the prevalence of NAFLD using ultrasounds.

The team also stratified gender, urban/rural settings, general population, and individuals with metabolic diseases in the analysis and performed a random-effects meta-analysis of the prevalence and effect sizes of associations of NAFLD.

Reviewing the Data

Overall there were 22 publications included in the final analysis after the quality assurance process. The difference in prevalence of the disease between the general population and people with metabolic diseases was statistically significant (Q = 15.8; DF = 1; P <0.001) and the pooled overall prevalence of NAFLD in the general population was 26.9% (95% confidence interval [CI], 18.9-35.8%) with high heterogeneity.

This prevalence was similar between men and women (Q = 0.06, DF = 1, P = 0.806).

The investigators also looked at regional trends.

Here, they found that individuals in rural communities had a NAFLD prevalence of 22.6% (95% CI, 13.6-33.1), while the prevalence in urban communities was 32.9% (95% CI, 22.8-43.8%). The difference, however, was not statistically significant (Q = 1.92, DF = 1, P = 0.166).

Similar findings were identified in comparing obesity status.

For example, the prevalence of non-obese NAFLD within the NAFLD population was 43.4% (95% CI, 28.1-59.4%).

A meta-analysis of binary variables resulted in an association between NAFLD in the South-Asian population and diabetes mellitus, hypertension, dyslipidemia, general obesity, central obesity and metabolic syndrome.

Gender on the other hand was not associated with NAFLD.

“The overall prevalence of NAFLD among adults in South Asia is high, especially in those with [metabolic disease], and a considerable proportion is non-obese,” the authors wrote. “In the South Asian population, NAFLD was associated with diabetes mellitus, hypertension, dyslipidemia, general obesity, central obesity, and metabolic syndrome.”

Fatty Liver and Obesity

The risk of developing a number of liver diseases, including non-alcoholic fatty liver disease (NAFLD) is higher for individuals who are overweight or obese.²

A team, led by Jingxuan Quek, Yong Loo Lin School of Medicine, National University of Singapore, identified the prevalence of NAFLD, non-alcoholic fatty liver (NAFL), and non-alcoholic steatohepatitis (NASH) in individuals who are overweight or obese.

The global prevalence of NAFLD is increasing globally along a parallel line with the global increase of obesity rates.

The prevalence of NAFLD in the Americas in the overweight population was 75.34% (95% CI, 67.31–81.93; I2 = 99.00%).

The results also show that clinically significant fibrosis was present in 20.27% (95% CI, 11.32–33.62; I2 = 93.00%) of overweight individuals with NAFLD and in 21.60% (95% CI, 11.47–36.92; I2 = 95.00%) of obese patients with NAFLD.

On the other hand, 6.65% (95% CI, 4.35–10.01; I2 = 58.00%) of overweight individuals with NAFLD and 6.85% (95% CI, 3.85–11.90; I2 = 90·00%) of obese individuals with NAFLD had advanced fibrosis.