High prevalence of non‐alcoholic fatty liver disease among healthy male blood donors of urban India

Abstract

Background There is limited data on the community prevalence of non‐alcoholic fatty liver disease (NAFLD). The present study evaluated the prevalence of NAFLD in a large number of healthy male blood donors of urban north India. Methodology In a prospective study performed over 18 months, voluntary blood donors fulfilling the requisite blood donation criteria and consenting to participate in the study were evaluated. The study received the approval of the institute's ethics committee. Diagnosis of NAFLD was made by excluding significant alcohol intake, ultrasound showing hepatic steatosis, and exclusion of transfusion associated infections. Subjects were also evaluated for various metabolic risk factors and the presence of metabolic syndrome. Results Of 1388 subjects who consented for participation, 386 did not come for evaluation. Three females, nine (0.9%) HBsAg‐positive, and four (0.4%) anti‐HCV positive subjects were excluded. Of the 986 males evaluated with hepatobiliary ultrasound, 543(55.1%) had fatty liver on ultrasonography [15 (1.5%) alcoholic fatty liver and 528 (53.5%) NAFLD]. Among those with NAFLD, 469 (88.8%), 54 (10.2%), and 5 (0.9%) had mild, moderate, and severe hepatic steatosis, respectively. Subjects with NAFLD, when compared to those without NAFLD, had significantly higher age, BMI, waist circumference, blood pressure, total cholesterol and triglycerides, low‐density lipoprotein, and fasting plasma glucose. Multivariate regression analysis demonstrated age, BMI, waist circumference, systolic blood pressure, total cholesterol, and number of metabolic syndrome criteria as independent predictors of NAFLD. Conclusions Urban Indian healthy male blood donors have a high prevalence of NAFLD.

High potency multistrain probiotic improves liver histology in non-alcoholic fatty liver disease (NAFLD): a randomised, double-blind, proof of concept study

“…The prevalence of NAFLD is rapidly rising and is becoming a worldwide public health problem. NAFLD occurs among all ages, both the genders and various ethnic groups, and its global prevalence among the general population is ~25% with the highest prevalence seen in the Middle East and South America and the lowest in Africa 3–7…”

Prevalence and severity of non-alcoholic fatty liver disease in patients with gall stone disease

“…There is limited available literature reporting the true prevalence of NAFLD in India. The reported prevalence of NAFLD from West Bengal is 9% while it is 32% from south India with a higher prevalence of 53% in north India [4][5][6]. In the majority of these patients, NAFLD was detected incidentally on imaging which was performed for some other ailment in a patient.…”

“…Incidence of obesity, diabetes, insulin resistance, hypertension and other metabolic risk factors is increasing among Indians. The reported prevalence of NAFLD in India varies between 9-53% in general population [4][5][6]. Asian-Indians are more at risk to have NAFLD because of a higher incidence of insulin resistance even at lower BMI [7].…”

Need for hepatitis A prevention in patients with chronic liver disease in the changing epidemiological setting of India

“…For example, a study published in 2016 found that 30.7% of adults aged ≥35 years in a rural community in North India had NAFLD on ultrasonography, 36 while one published in 2019 reported that 528 (53.5%) of male blood donors (mean age 31 ± 8 years for males and 45 ± 8 for females) in an urban community in North India had NAFLD on ultrasonography. 37 Recent meta-analyses have estimated seroprevalences of HBV surface antigen (HBsAg) and anti-HCV to be 1.46% 38 and 0.44-0.88%, 39 respectively in India. Based on a population of approximately 1.38 billion, 40 this would equate to approximately 20 million people in India having chronic HBV infection and around 6-12 million having chronic HCV infection, meaning that large numbers of people are potentially at risk for FHF, which has a very high mortality rate among patients with CLD.…”

“…For example, a study published in 2016 found that 30.7% of adults aged ≥35 years in a rural community in North India had NAFLD on ultrasonography, 36 while one published in 2019 reported that 528 (53.5%) of male blood donors (mean age 31 ± 8 years for males and 45 ± 8 for females) in an urban community in North India had NAFLD on ultrasonography. 37 …”