Non-alcoholic fatty liver disease in Malaysia: a demographic, anthropometric, metabolic and histological study.
OBJECTIVE
Nonalcoholic fatty liver disease (NAFLD) is increasing rapidly in the Asia-Pacific region. There has been a paucity of studies from the region. The aims of this study were to define the demographic, anthropometric, metabolic and histological characteristics of patients with NAFLD in our local population and to determine independent predictors of severe liver fibrosis.


METHODS
Patients with persistently raised liver enzymes and/or fatty liver detected on ultrasonography with exclusion of other liver disorders were prospectively recruited. Their insulin resistance was assessed using the homeostasis model assessment of insulin resistance score. A liver biopsy was performed in all cases for grading (for steatohepatitis) and staging (for fibrosis) of NAFLD. Independent risk factors for fibrosis were determined using multiple logistic regression analysis.


RESULTS
Seventy-five patients were recruited: 39 men (52%) and 36 women (48%). The mean age of the patients was 47.0+/-12.2 years. Of these, 58 patients (77.3%) were centrally obese, 29 patients (38.7%) were diabetic and 15 patients (20.0%) had impaired glucose tolerance. Insulin resistance was diagnosed in 62 out of 64 (96.9%) patients. Benign steatosis, nonalcoholic steatohepatitis and cirrhosis were diagnosed in three (4.3%), 59 (84.3%) and eight (11.4%) of 70 patients, respectively. Significant independent predictors of liver fibrosis were; male sex (P=0.019, OR=5.55, CI=1.33-23.18) and Indian race (P=0.013, OR=8.21, CI=1.56-43.16).


CONCLUSIONS
The full histological spectrum of NAFLD was seen in our patients. The majority of patients were insulin resistant, centrally obese and either diabetic or had impaired glucose tolerance. The predictors of severe liver fibrosis were male sex and Indian race.
Malik
Abdul
A
Division of Gastroenterology, Faculty of Medicine, University of Malaya Medical Center, Kuala Lumpur, Malaysia.
Cheah
Phaik-Leng
PL
Hilmi
Ida Normiha
IN
Chan
Siew Pheng
SP
Goh
Khean-Lee
KL
D001707:Biopsy, Needle; D001824:Body Constitution; D005234:Fatty Liver / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008296:Malaysia; D008297:Male; D008875:Middle Aged
D008055:Lipids