Premium
Incidence and risk factors for non‐alcoholic fatty liver disease: A 7‐year follow‐up study among urban, adult Sri Lankans
Author(s) -
Niriella Madunil A.,
Pathmeswaran Arunasalam,
De Silva Shamila T.,
Kasturiratna Anuradhani,
Perera Ruwan,
Subasinghe Chamila E.,
Kodisinghe Kuleesha,
Piyaratna Chathura,
Rishikesawan Vithiya,
Dassanayaka Anuradha S.,
De Silva Arjuna P.,
Wickramasinghe Rajitha,
Takeuchi Fumihiko,
Kato Norihiro,
Silva Hithanadura J.
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13478
Subject(s) - medicine , fatty liver , incidence (geometry) , overweight , anthropometry , cohort , population , obesity , gastroenterology , disease , environmental health , physics , optics
Background This study investigated incidence and risk factors for NAFLD among an adult cohort with 7‐year follow‐up. Methods The study population (age‐stratified random sampling, Ragama MOH area) was screened initially in 2007 (aged 35‐64 years) and re‐evaluated in 2014 (aged 42‐71 years). On both occasions assessed by structured interview, anthropometric measurements, liver ultrasound, biochemical and serological tests. NAFLD was diagnosed on ultrasound criteria, safe alcohol consumption and absence of hepatitis B/C markers. Non‐ NAFLD controls did not have any ultrasound criteria for NAFLD . An updated case–control genetic association study for 10 selected genetic variants and NAFLD was also performed. Results Out of 2985 of the original cohort, 2148 (72.0%) attended follow‐up (1238 [57.6%] women; mean‐age 59.2 [ SD ‐7.6] years) in 2014, when 1320 (61.5%) were deemed NAFLD subjects. Out of 778 who initially did not have NAFLD and were not heavy drinkers throughout follow‐up, 338 (43.4%) (221 [65.4%] women, mean‐age 57.8 [ SD ‐8.0] years) had developed NAFLD after 7‐years (annual incidence‐6.2%). Central obesity ( OR =3.82 [95%‐ CI 2.09‐6.99]), waist increase >5% ( OR =2.46 [95%‐ CI 1.20‐5.05]) overweight ( OR =3.26 [95%‐ CI 1.90‐5.60]), weight gain 5%‐10% ( OR =5.70 [95%‐ CI 2.61‐12.47]), weight gain >10% ( OR =16.94 [95%‐ CI 6.88‐41.73]), raised plasma triglycerides ( OR =1.96 [95%‐ CI 1.16‐3.29]) and diabetes ( OR =2.14 [95%‐ CI 1.13‐4.06]), independently predicted the development of incident NAFLD in multivariate analysis. The updated genetic association study (1362‐cases, 392‐controls) showed replicated association ( P =.045, 1‐tailed) with NAFLD at a candidate locus: PNPLA 3 (rs738409). Conclusions In this community cohort study, the annual incidence of NAFLD was 6.2%. Incident NAFLD was associated with general and central obesity, raised triglycerides and diabetes, and showed a tendency of association with PNPLA 3 gene polymorphisms.