Concomitant Prevalence of Non-Communicable Diseases among NAFLD/NASH Patients: An Experience from a Tertiary Care Hospital in Delhi

  • Aayushi Rasogi Department of Clinical Epidemiology, Institute of Liver & Biliary Sciences, New Delhi, India
  • Umesh Kapil Department of Epidemiology and Clinical Research, Institute of Liver & Biliary Sciences, New Delhi, India
Keywords: Non-communicable diseases, NAFLD, Prevalence

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) is a multisystem disease and involves extra-hepatic organs and thus have strong association with components of metabolic dysfunction. Presence of single component of the metabolic dysfunction anticipates the appearance of additional metabolic components over time. With this objective, the present study aims at assessing the proportion of various metabolic components in NAFLD/NASH patients attending tertiary care hospital. Methodology: A record review was undertaken to extract the data of NAFLD/NASH patients who were presenting to outpatient clinics or/and inpatient wards in Department of Hepatology from August 2009 to March 2020. Medical records of NAFLD/NASH patients were extracted in pre-defined format. In case several visits of the patients were reported, the first visit was considered using unique hospital Identity number. The data was analyzed in STATA version 14. p-value of <0.05 was considered to be significant. Results:
A total of 1398 patients were included in the final analysis. Mean age of patients was 54.4±11.9 years and 76% were males. The median ALT and AST was found to be 35 IU/l (IQR: 24 -56 IU/l) and 48 IU/l (IQR: 34–74 IU/l) respectively. The obesity (66.45%) and diabetes (51.86%) were found to be the most common non-communicable diseases associated with NAFLD/NASH patients.  The odds of cirrhosis (LSM≥13) was 6.13 (95%CI: 4.43 – 8.48) times among diabetics as compared to odds of non-cirrhosis (LSM≥13) among non-diabetics (p <0.001). The univariate association with obesity and hypertension was also found to be significant. Conclusion: There is higher prevalence of non-communicable diseases among NAFLD/NASH patients.

Downloads

Download data is not yet available.

References

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;64:73–84. https://doi.org/10.1002/hep.28431.

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;42:44–52. https://doi.org/10.1002/hep.20734

Das K, Das K, Mukherjee PS, Ghosh A, Ghosh S, Mridha AR, et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology 2010;51:1593–602. https://doi.org/10.1002/hep.23567.

Duseja A, Najmy S, Sachdev S, Pal A, Sharma RR, Marwah N, et al. High prevalence of non‐alcoholic fatty liver disease among healthy male blood donors of urban India. JGH Open 2019;3:133–9. https://doi.org/10.1002/jgh3.12117.

Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol 2017;15:11–20. https://doi.org/10.1038/nrgastro.2017.109.

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;64:73–84. https://doi.org/10.1002/hep.28431.

Adams LA, Lymp JF, St. Sauver J, Sanderson SO, Lindor KD, Feldstein A, et al. The Natural History of Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study. Gastroenterology 2005;129:113–21. https://doi.org/10.1053/j.gastro.2005.04.014.

Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, et al. Nonalcoholic Fatty Liver Disease: A Feature of the Metabolic Syndrome. Diabetes 2001;50:1844–50. https://doi.org/10.2337/diabetes.50.8.1844.

Younossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis. Journal of Hepatology 2019;71:793–801. https://doi.org/10.1016/j.jhep.2019.06.021.

Cortez-Pinto H, Camilo ME, Baptista A, De Oliveira AG, De Moura MC. Non-alcoholic fatty liver: another feature of the metabolicsyndrome? Clinical Nutrition 1999;18:353–8. https://doi.org/10.1016/s0261-5614(99)80015-6.

Anstee QM, Targher G, Day CP. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat Rev Gastroenterol Hepatol 2013;10:330–44. https://doi.org/10.1038/nrgastro.2013.41.

Vanni E, Bugianesi E, Kotronen A, De Minicis S, Yki-Järvinen H, Svegliati-Baroni G. From the metabolic syndrome to NAFLD or vice versa? Digestive and Liver Disease 2010;42:320–30. https://doi.org/10.1016/j.dld.2010.01.016.

Kawada T. Predictors of the Development of Metabolic Syndrome in Male Workers. Journal of Occupational & Environmental Medicine 2012;54:292–5. https://doi.org/10.1097/jom.0b013e3182492070.

Palaniappan L, Carnethon MR, Wang Y, Hanley AJG, Fortmann SP, Haffner SM, et al. Predictors of the Incident Metabolic Syndrome in Adults: The Insulin Resistance Atherosclerosis Study. Diabetes Care 2004;27:788–93. https://doi.org/10.2337/diacare.27.3.788.

Welzel TM, Graubard BI, Zeuzem S, El-Serag HB, Davila JA, McGlynn KA. Metabolic syndrome increases the risk of primary liver cancer in the United States: A study in the SEER-medicare database. Hepatology 2011;54:463–71. https://doi.org/10.1002/hep.24397.

EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Journal of Hepatology 2016;64:1388–402. https://doi.org/10.1016/j.jhep.2015.11.004.

Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology 2017;67:328–57. https://doi.org/10.1002/hep.29367.

Krajden M, McNabb G, Petric M. The Laboratory Diagnosis of Hepatitis B Virus. Canadian Journal of Infectious Diseases and Medical Microbiology 2005;16:65–72. https://doi.org/10.1155/2005/450574.

Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care [Internet]. 2006 Jan 1 [cited 2021 Jan 10];29(suppl 1):s43–8. https://care.diabetesjournals.org/content/29/suppl_1/s43.

Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension 2020;75:1334–57. https://doi.org/10.1161/hypertensionaha.120.15026.

Sanyal A, Poklepovic A, Moyneur E, Barghout V. Population-based risk factors and resource utilization for HCC: US perspective. Current Medical Research and Opinion 2010;26:2183–91. https://doi.org/10.1185/03007995.2010.506375.

El-serag HB, Tran T, Everhart JE. Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma. Gastroenterology 2004;126:460–8. https://doi.org/10.1053/j.gastro.2003.10.065.

Ruhl CE, Everhart JE. Determinants of the association of overweight with elevated serum alanine aminotransferase activity in the United States. Gastroenterology 2003;124:71–9. https://doi.org/10.1053/gast.2003.50004.

Duseja A, Najmy S, Sachdev S, Pal A, Sharma RR, Marwah N, et al. High prevalence of non‐alcoholic fatty liver disease among healthy male blood donors of urban India. JGH Open 2019;3:133–9. https://doi.org/10.1002/jgh3.12117.

Published
2021-08-30
How to Cite
Rasogi, A., & Kapil, U. (2021). Concomitant Prevalence of Non-Communicable Diseases among NAFLD/NASH Patients: An Experience from a Tertiary Care Hospital in Delhi. ournal of ealth cience and lternative edicine, 3(2), 1-6. https://doi.org/10.14456/jhsam.2021.6