DOI: https://doi.org/10.22141/2308-2097.53.1.2019.163454

Results of the observational cross-over PRELID 2 study (2015–2016). Part 1. The prevalence of non-alcoholic fatty liver disease, the characteristics of concomitant pathology, metabolic syndrome and its individual criteria in patients seeking general pract

Yu.M. Stepanov

Abstract


Background. In Ukraine, large-scale epidemiological studies of non-alcoholic fatty liver disease (NAFLD) were not conducted. There are no statistics on the prevalence of NAFLD in Ukraine. Different information is received from specialists from different regions of the country on the prevalence of NAFLD, and there are still no clear recommendations for the treatment of this disease. The purpose of this study is to evaluate the prevalence of NAFLD among patients seeking general practitioners’ and gastroenterologists’ help in Ukraine, the presence of concomitant pathology, metabolic syndrome and its individual criteria in patients with confirmed and unconfirmed diagnosis of NAFLD. Materials and methods. The study included 5,000 patients (an average of 50 persons from 100 research centers), among them 2,450 women (49.00 %) and 2,550 men (51.00 %) with an average age of (52.83 ± 12.33) years. One hundred gastroenterological departments were selected for the study in Ukraine. The list of research centers included offices with qualified personnel, relevant mate­rials and technical equipment, and the obligatory presence of a local Ethics Committee. The study used data obtained during one regular visit of patients to the research center. During the visit, the baseline patient’s data were recorded (demographic data, medical history, anthropometric data, complaints, objective data). NAFLD was diag­nosed or excluded based on the results of laboratory and instrumental data of medical records. Results. Statistical analysis showed that the number of patients with a confirmed diagnosis of NAFLD significantly exceeds the number of patients with unconfirmed NAFLD. These data are due to the fact that doctors included in the study the patients with suspected NAFLD. In this regard, the frequency of confirmed NAFLD should be considered as a percen­tage of cases confirming the diagnosis in patients with suspected pathology. Analysis of correspondence to the criteria for NAFLD and stages of NAFLD in patients included in the study showed that 4,698 (93.96 %) persons met the criteria for the disease presence, of which non-alcoholic steatosis was diagnosed in 3,153 (62.72 %), non-alcoholic steatohepatitis — in 1,517 (30.30 %), liver cirrhosis — in 44 (0.88 %) patients. Only in 3,571 (71.42 %) cases the diagnosis was confirmed, and 1,429 (28.58 %) patients had an unconfirmed diagnosis of NAFLD. The gender factor did not affect the frequency of confirmed diagnosis of NAFLD in men (71.63 %) compared with women (71.22 %). In the presence of metabolic syndrome, the diagnosis of NAFLD is confirmed in 76.07 % of cases, with a low level of high-density lipoproteins — in 71.25 %, with hypertriglyceridemia — in 77.15 %. In this study, no association was found between the presence of menopause symptoms, the use of hormone replacement therapy in women and the frequency of confirmed NAFLD diagnosis (p > 0.05). Conclusions. The results of the study demonstrated a high prevalence of both diag­nostically confirmed and unconfirmed cases of NAFLD. A high level of NAFLD comorbidity with metabolic syndrome, overweight, obesity and dyslipidemia has been also established.


Keywords


non-alcoholic fatty liver disease; comorbidity; metabolic syndrome

References


Munteanu MA, Nagy GA, Mircea PA. Current Management of NAFLD. Clujul Med. 2016;89(1):19-23. doi: 10.15386/cjmed-539.

Massoud O, Charlton M. Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis and hepatocellular carcinoma. Clin Liver Dis. 2018 Feb;22(1):201-211. doi: 10.1016/j.cld.2017.08.014.

Cobbina E, Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab Rev. 2017 May;49(2):197-211. doi: 10.1080/03602532.2017.1293683.

Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: Practice guideline by the American association for the study of liver diseases, American college of gastroenterology, and the American gastroenterological association. Am J Gastroenterol. 2012 Jun;107(6):811-26. doi: 10.1038/ajg.2012.128.

Byrne CD, Targher G. NAFLD: a multisystem disease. J Hepatol. 2015 Apr;62(1 Suppl):S47-64. doi: 10.1016/j.jhep.2014.12.012.

Kwon YM, Oh SW, Hwang SS, Lee C, Kwon H, Chung GE.Association of nonalcoholic fatty liver disease with components of metabolic syndrome according to body mass index in Korean adults. Am J Gastroenterol. 2012 Dec;107(12):1852-8. doi: 10.1038/ajg.2012.314.

Yki-Jarvinen H. Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome. Lancet Diabetes Endocrinol. 2014 Nov;2(11):901-10. doi: 10.1016/S2213-8587(14)70032-4.

Marchesini G, Bugianesi E, Forlani G, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology. 2003 Apr;37(4):917-23. doi: 10.1053/jhep.2003.50161.

Stepanova M, Rafiq N, Younossi ZM. Components of metabolic syndrome are independent predictors of mortality in patients with chronic liver disease: a population-based study. Gut. 2010 Oct;59(10):1410-5. doi: 10.1136/gut.2010.213553.

Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology. 2012 Jun;142(7):1592-609. doi: 10.1053/j.gastro.2012.04.001.

Drapkina O, Ivashkin V. Prevalence and risk factors for non-alcoholic fatty liver disease in the Russian Federation. Collection of annotations reports of International Congress of Hepatologists. 2010;(330):138. (in Russian).

Caballería L, Pera G, Auladell MA, et al. Prevalence and factors associated with the presence of nonalcoholic fatty liver disease in an adult population in Spain. Eur J Gastroenterol Hepatol. 2010 Jan;22(1):24-32. doi: 10.1097/MEG.0b013e32832fcdf0.

Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005 Jul;42(1):44-52. doi: 10.1002/hep.20734.

Kojima S, Watanabe N, Numata M, Ogawa T, Matsuzaki S. Increase in the prevalence of fatty liver in Japan over the past 12 years: analysis of clinical background. J Gastroenterol. 2003;38(10):954-61. doi: 10.1007/s00535-003-1178-8.

Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011 Jan;140(1):124-31. doi: 10.1053/j.gastro.2010.09.038.

Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease. Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84. doi: 10.1002/hep.28431.

Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011 Aug;34(3):274-85. doi: 10.1111/j.1365-2036.2011.04724.x.




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