title: Prevalence of primary non-alcoholic fatty liver disease in a population-based study and its association with biochemical and anthropometric measures.
abstract: OBJECTIVE
  Only a few studies have assessed the epidemiology of non-alcoholic fatty liver disease (NAFLD). The aim was to evaluate the prevalence of primary NAFLD in a population-based study in Israel and to determine independent risk factors.
  
  
  METHODS
  A cross-sectional study of a subsample of the Israeli national health survey (n=352). Individuals with a known etiology for secondary NAFLD were excluded. Each participant underwent an abdominal ultrasound, biochemical tests and an anthropometric evaluation.
  
  
  RESULTS
  Three hundred and twenty-six subjects (53.4% male, mean age 50.5+/-10.3 standard deviaton [SD]) met the inclusion criteria. The prevalence of primary NAFLD was 30% (25-35% 95% confidence intervals [CI]). NAFLD was more prevalent in men than women (38% vs. 21%; P=0.001). Compared with ultrasonography, the sensitivity of serum alanine transaminase (ALT) for the diagnosis of primary NAFLD was 8.2%. Risk factors independently associated with NAFLD included male gender (odds ratios (OR)=2.8, 95% CI 1.5-5.3), abdominal obesity (OR=2.9, 95% CI 1.3-6.4), homeostasis model assessment (OR=5.8, 95% CI 2.0-17.2), hyperinsulinemia (OR=2.3, 95% CI 1.2-4.3, P=0.01) and hypertriglyceridemia (OR=2.4, 95% CI 1.3-4.5).
  
  
  CONCLUSIONS
  NAFLD is prevalent in the general Israeli population and closely related to the metabolic syndrome. The use of ALT as a marker for NAFLD seriously underestimates its prevalence.
authors.affiliation: The Liver Unit, Department of Gastroenterology, Tel Aviv, Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Shira
authors.initials: S
authors.lastname: Zelber-Sagi
authors.forename: Dorit
authors.initials: D
authors.lastname: Nitzan-Kaluski
authors.forename: Zamir
authors.initials: Z
authors.lastname: Halpern
authors.forename: Ran
authors.initials: R
authors.lastname: Oren
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000410:Alanine Transaminase