Risk factors for Non-Alcoholic Fatty Liver disease among the patients admitted to a Teaching Hospital in Sri Lanka: Case Control study

Abstract

Background: The burden of Non-Alcoholic Fatty Liver Disease (NAFLD) was rising globally. It is the disease condition where there is an increased fat deposition (≥5%) in the hepatic cells. The objective of this study was to determine the risk factors for NAFLD among the patients admitted to a Teaching Hospital in Sri Lanka.Methods: A case control study was conducted among the 106 cases with NAFLD and 212 unmatched hospital-based controls without having NAFLD. A case was defined based on the presence of fatty liver, according to the diagnostic ultrasonographic criteria. Three factors were used in diagnosing a patient with NAFLD. They include, increase echogenicity of the liver compared to kidney and spleen, obliteration of vascular architecture and deep attenuation of ultrasonic signals. Presence of at least two out of the above was considered as NAFLD. The data was collected by using an interviewer-administered questionnaire. The risk factors were determined by performing a multiple logistic regression and the results were expressed as adjusted odds ratios (AOR) and 95 % confidence interval (95% CI).Results: Risk factors for NAFLD include consumption of fast food ≥2 time per week (AOR=9.34, 95% CI= 4.47-19.5), infrequent coffee consumption (AOR=2.78, 95% CI= 1.32-5.88), family history of liver disease (AOR=12.2, 95% CI= 2.16-67.9), methotrexate usage (AOR=32.0, 95% CI=1.45-tet707.3), inadequate physical activity (AOR=8.10, 95% CI= 4.04-16.3), having a high BMI value more ≥23Kg/m2 (AOR=6.17, 95% CI=2.93-13.0) and being a Sinhalese (AOR=12.7, 95% CI=2.03-79.3).Conclusion: Most of the risk factors were modifiable such as inadequate physical activity, overweight, infrequent coffee consumption and frequent consumption of fast-food. Primary preventive strategies for those modifiable risk factors should be implemented to prevent NAFLD.