title: Prevalence and factors associated with the presence of nonalcoholic fatty liver disease in an adult population in Spain.
abstract: OBJECTIVE
  The prevalence of nonalcoholic fatty liver disease (NAFLD) is unknown in Spain. The purpose of detecting NAFLD patients is to determine the associated factors and prevent its evolution to more severe forms. The aim of this study is to determine the prevalence and factors associated with NAFLD.
  
  
  METHODS
  This is a multicentre, cross-sectional, populational study. Individuals between 15 and 85 years of age were randomly selected from 25 primary healthcare centres in the province of Barcelona, Spain. Clinical histories were reviewed, and anamnesis, physical examination, blood analysis and hepatic echography were performed. Individuals with an alcohol intake greater than 30 g/day in men and greater than 20 g/day in women or with known liver disease were excluded.
  
  
  RESULTS
  Seven hundred and sixty-six individuals with a mean age of 53+/-14 years (range 17-83, 42.2% men) were included in the study. One hundred and ninety-eight individuals presented NAFLD with echographic criteria (prevalence 25.8, 33.4% men and 20.3% women P<0.001). On multivariate analysis, the following were associated with NAFLD: male sex [odds ratio (OR): 2.34, 95% confidence interval (95% CI): 1.57-3.49], age (OR: 1.04 per year, 95% CI: 1.02-1.05), metabolic syndrome (OR: 2.19, 95% CI: 1.29-3.72), insulin resistance (OR: 6.00, 95% CI: 3.43-10.5) and alanine aminotransferase (OR: 4.21, 95% CI: 2.23-7.95). Of the individuals who consumed alcohol, 29.4% consumed alcohol within the inclusion criteria, with a mean of 9.17+/-6.75 standard beverage units per week. Moderate alcohol intake was not related to NAFLD, although a possible protector effect was found with the quantity consumed among the drinkers who did not consume excessive amounts of alcohol (OR: 0.93 per standard beverage units, 95% CI: 0.88-0.98).
  
  
  CONCLUSIONS
  NAFLD prevalence in our population is very high. Male sex, age, metabolic syndrome, insulin resistance and alanine aminotransferase are the factors associated with NAFLD. Furthermore, studies should be carried out with respect to the controversial effect of alcohol on NAFLD.
authors.affiliation: Primary Healthcare Centre Premià de Mar, Primary Healthcare Research Support Unit Metropolitana Nord. IDIAP Jordi Gol, Barcelona, Spain. lcaballeria.bnm.ics@gencat.net
authors.forename: Llorenç
authors.initials: L
authors.lastname: Caballería
authors.forename: Guillem
authors.initials: G
authors.lastname: Pera
authors.forename: Maria Antònia
authors.initials: MA
authors.lastname: Auladell
authors.forename: Pere
authors.initials: P
authors.lastname: Torán
authors.forename: Laura
authors.initials: L
authors.lastname: Muñoz
authors.forename: Dolores
authors.initials: D
authors.lastname: Miranda
authors.forename: Alba
authors.initials: A
authors.lastname: Alumà
authors.forename: José Dario
authors.initials: JD
authors.lastname: Casas
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez
authors.forename: Dolors
authors.initials: D
authors.lastname: Gil
authors.forename: Josep
authors.initials: J
authors.lastname: Aubà
authors.forename: Albert
authors.initials: A
authors.lastname: Tibau
authors.forename: Santiago
authors.initials: S
authors.lastname: Canut
authors.forename: Jesús
authors.initials: J
authors.lastname: Bernad
authors.forename: Miren Maite
authors.initials: MM
authors.lastname: Aizpurua
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D004812:Epidemiologic Methods; D005234:Fatty Liver / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000410:Alanine Transaminase