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

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.