Non-alcoholic fatty liver disease in a rural, physically active, low income population in Sri Lanka

Abstract

BackgroundNon-alcoholic fatty liver disease (NAFLD) is recognized as a metabolic disorder largely seen in urbanized populations. The purpose of this study was to assess prevalence and risk factors for NAFLD in a rural, physically active, economically deprived population in Sri Lanka.MethodsBy visiting individual households in the community, 35-64 year old adults resident in two selected estates in the Nuwara Eliya District of Sri Lanka, were invited to participate in the study. Blood pressure and anthropometric measurements were made on all participants. Blood samples were obtained for the assay of fasting glucose, serum lipids, serum insulin and alanine aminotransferase. NAFLD was diagnosed on established ultrasound criteria for fatty liver in the absence of hepatitis B and C markers and high alcohol consumption.ResultsOf those invited, 403 (65%) participated in the study. Almost all participants were either Indian or Sri Lankan Tamils and 53% were females. Prevalence of NAFLD was 18% in this population. Twice as many males were diagnosed as having NAFLD compared to females. Male sex, high BMI, high waist circumference, high diastolic blood pressure and high plasma glucose levels were significant predictors of NAFLD.ConclusionNearly one in five people in this predominantly Indian Tamil, rural, physically active, economically deprived population had NAFLD. The condition was associated with constituent features of the metabolic syndrome. These results support studies reporting ethnic variations in disease susceptibility and suggest that genetic factors may also play a role in determining disease risk.

Non-alcoholic Fatty Liver Disease in South Asians: A Review of the Literature

“…Another study, though conducted in an urban setting in Pakistan, noted a prevalence of 51% NAFLD in Type II diabetics 21. In a study carried out in rural Sri Lanka, NAFLD was noted to be prevalent, at 18% 22. Again, as noted in other studies, a different study in an urban setting also showed a higher prevalence of 32.6% 23.…”

Profile of patients with incidentally detected nonalcoholic fatty liver disease (IDNAFLD) in coastal eastern India

“…7,42 However, Fernandes et al, 43 and Haentjens et al 44 suggest that women especially those who are at increased risk of developing NAFLD. Spruss et al, too showed that female mice were more susceptible to NAFLD than male mice.…”

Influence of non‐alcoholic fatty liver disease on the development of diabetes mellitus

“…Parallel to rapidly increasing rates of obesity and type 2 diabetes, NAFLD is being increasingly diagnosed in the Asia‐Pacific region, and prevalence rates of 5–40% have been reported . Recent population based studies from Sri Lanka have reported a NAFLD prevalence of 32.6% in an urban community and 18% in a predominantly Indian Tamil, rural, physically active, economically deprived estate worker community . Sri Lanka is currently experiencing a surge in non‐communicable diseases as a result of the epidemiologic and demographic transitions that have interacted with lifestyle changes.…”