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Non‐alcoholic fatty liver disease in Malaysia: A demographic, anthropometric, metabolic and histological study
Author(s) -
MALIK Abdul,
CHEAH PhaikLeng,
HILMI Ida Normiha,
CHAN Siew Pheng,
GOH KheanLee
Publication year - 2007
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1443-9573.2007.00286.x
Subject(s) - medicine , fatty liver , anthropometry , disease , alcoholic fatty liver , alcoholic liver disease , gastroenterology , physiology , cirrhosis
BACKGROUND AND OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is increasing rapidly in the Asia–Pacific region. There has been a paucity of studies from the region. The aims of this study were to define the demographic, anthropometric, metabolic and histological characteristics of patients with NAFLD in our local population and to determine independent predictors of severe liver fibrosis. METHODS: Patients with persistently raised liver enzymes and/or fatty liver detected on ultrasonography with exclusion of other liver disorders were prospectively recruited. Their insulin resistance was assessed using the homeostasis model assessment of insulin resistance score. A liver biopsy was performed in all cases for grading (for steatohepatitis) and staging (for fibrosis) of NAFLD. Independent risk factors for fibrosis were determined using multiple logistic regression analysis. RESULTS: Seventy‐five patients were recruited: 39 men (52%) and 36 women (48%). The mean age of the patients was 47.0 ± 12.2 years. Of these, 58 patients (77.3%) were centrally obese, 29 patients (38.7%) were diabetic and 15 patients (20.0%) had impaired glucose tolerance. Insulin resistance was diagnosed in 62 out of 64 (96.9%) patients. Benign steatosis, nonalcoholic steatohepatitis and cirrhosis were diagnosed in three (4.3%), 59 (84.3%) and eight (11.4%) of 70 patients, respectively. Significant independent predictors of liver fibrosis were; male sex ( P = 0.019, OR = 5.55, CI = 1.33–23.18) and Indian race ( P = 0.013, OR = 8.21, CI = 1.56–43.16). CONCLUSIONS: The full histological spectrum of NAFLD was seen in our patients. The majority of patients were insulin resistant, centrally obese and either diabetic or had impaired glucose tolerance. The predictors of severe liver fibrosis were male sex and Indian race.