J Clin Exp Hepatol. 2015 Dec;5(4):295-302. doi: 10.1016/j.jceh.2015.09.001. Epub 2015 Sep 08.
Risk Factors Associated With Non-Alcoholic Fatty Liver Disease in Indians: A Case-Control Study.
Journal of clinical and experimental hepatology
Shivaram P Singh, Ayaskanta Singh, Debasis Misra, Bijay Misra, Girish K Pati, Manas K Panigrahi, Sanjib K Kar, Pallavi Bhuyan, Kaumudee Pattnaik, Chudamani Meher, Omprakash Agrawal, Niranjan Rout, Manoroma Swain, Palok Aich
Affiliations
Affiliations
- Department of Gastroenterology, S.C.B. Medical College, Cuttack 753007, India.
- Department of Pathology, S.C.B. Medical College, Cuttack 753007, India.
- Department of Radiology, Beam Diagnostics Centre, Bajrakabati Road, Cuttack 753001, India.
- Department of Oncopathology, A.H. Regional Cancer Center, Cuttack 753001, India.
- Department of Biochemistry, S.C.B. Medical College, Cuttack 753007, India.
- National Institute of Science Education & Research (NISER), Jatni, Khurdha 752050, India.
PMID: 26900270
PMCID: PMC4723647 DOI: 10.1016/j.jceh.2015.09.001
Abstract
BACKGROUND/AIMS: NAFLD has today emerged as the leading cause of liver disorder. There is scanty data on risk factors associated with NAFLD emanating from India. The present study was conducted to identify the risk factors associated with NAFLD.
METHODS: 464 consecutive NAFLD patients and 181 control patients were subjected to detailed questionnaire regarding their lifestyle and dietary risk factors. Anthropometric measurements were obtained and biochemical assays were done. Comparison of different variables was made between NAFLD patients and controls using principal component analysis (PCA).
RESULTS: NAFLD patients had higher BMI [26.25 ± 3.80 vs 21.46 ± 3.08 kg/m(2), P = 0.000], waist-hip ratio [0.96 ± 0.12 vs 0.90 ± 0.08, P = 0.000] and waist-height ratio [0.57 ± 0.09 vs 0.50 ± 0.06, P = 0.000] compared to controls. Fasting blood sugar [101.88 ± 31.57 vs 90.87 ± 10.74 mg/dl] and triglyceride levels [196.16 ± 102.66 vs 133.20 ± 58.37 mg/dl] were significantly higher in NAFLD group. HOMA-IR was also higher in NAFLD group [2.53 ± 2.57 vs 1.16 ± 0.58, P = 0.000]. Majority (90.2%) of NAFLD patients were sedentary. Family history of metabolic syndrome (MS) was positively correlated with NAFLD. Dietary risk factors associated with NAFLD were non-vegetarian diet [35% vs 23%, P = 0.002], fried food [35% vs 9%, P = 0.000], spicy foods [51% vs 15%, P = 0.001] and tea [55% vs 39%, P = 0.001]. Diabetes, hypertension, snoring and sleep apnoea syndrome were common factors in NAFLD. On multivariate PCA, waist/height ratio and BMI were significantly higher in the NAFLD patients.
CONCLUSION: The risk factors associated with NAFLD are sedentary lifestyle, obesity family history of MS, consumption of meat/fish, spicy foods, fried foods and tea. Other risk factors associated with NAFLD included snoring and MS.
Keywords: ALT, Alanine Transaminase; AST, Aspartate Transaminase; BMI, Body Mass Index; FBG, fasting blood glucose; HC, hip circumference; HCC, hepatocellular carcinoma; HDL, high-density lipoprotein; HOMA, Homeostatic Model Assessment; HOMA-B, beta-cell function; IR, insulin resistance; MS, Metabolic syndrome; NAFLD, Non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; PCA, Principal Component Analysis; SD, standard deviation; WC, waist circumference; anthropometry; diet; fatty liver; lifestyle; metabolic syndrome
References
- J Gastroenterol Hepatol. 2009 Jul;24(7):1284-8 - PubMed
- Hepatology. 2012 Sep;56(3):943-51 - PubMed
- Diabetes Res Clin Pract. 2009 Apr;84(1):84-91 - PubMed
- Dig Dis Sci. 2007 Sep;52(9):2368-74 - PubMed
- J Hepatol. 2007 Nov;47(5):711-7 - PubMed
- World J Gastroenterol. 2006 Jun 7;12(21):3400-5 - PubMed
- Lancet. 2005 Jan 1-7;365(9453):36-42 - PubMed
- Gastroenterology. 2002 Jul;123(1):134-40 - PubMed
- Semin Liver Dis. 2001;21(1):27-41 - PubMed
- J Nutr. 2008 Aug;138(8):1452-5 - PubMed
- Indian J Med Res. 2009 Mar;129(3):285-92 - PubMed
- Hepatology. 2008 Dec;48(6):1791-8 - PubMed
- Ann Hepatol. 2007 Jul-Sep;6(3):161-3 - PubMed
- N Engl J Med. 2002 Apr 18;346(16):1221-31 - PubMed
- Trop Gastroenterol. 2004 Apr-Jun;25(2):76-9 - PubMed
- BMC Gastroenterol. 2012 Feb 16;12:16 - PubMed
- Hepatology. 2003 Apr;37(4):909-16 - PubMed
- Proc Natl Acad Sci U S A. 2006 Nov 28;103(48):18273-7 - PubMed
- Int J Mol Med. 2013 Nov;32(5):989-94 - PubMed
- Obes Rev. 2013 May;14(5):417-31 - PubMed
- Gastroenterology. 2006 Jun;130(7):2023-30 - PubMed
- Hepatology. 2006 Feb;43(2 Suppl 1):S99-S112 - PubMed
- Gastroenterology. 2002 Sep;123(3):745-50 - PubMed
- Can J Gastroenterol. 2008 Oct;22(10 ):811-6 - PubMed
- J Hepatol. 2008 Jun;48(6):993-9 - PubMed
- World J Gastroenterol. 2007 Jan 28;13(4):649-50 - PubMed
- Behav Res Methods. 2007 May;39(2):175-91 - PubMed
- Nutrition. 2007 Jan;23(1):46-52 - PubMed
- J Hepatol. 2009 Nov;51(5):918-24 - PubMed
- Diabetologia. 1985 Jul;28(7):412-9 - PubMed
Publication Types