title: Nonalcoholic fatty liver disease in Brazil. Clinical and histological profile.
abstract: BACKGROUND
  The epidemiology and clinical characteristics of nonalcoholic fatty liver disease (NAFLD) in South America are not well known. Brazil is a largest country in this part of the world and the present study aimed to contribute with this information.
  
  
  METHODS
  This descriptive study included patients from medical centers around Brazil, who had diagnosis of NAFLD. They were selected from chart review and also prospectively in Hepatology out-clinics. Patients with history of alcohol intake and others liver diseases were excluded. Histological diagnosis included: steatosis or steatohepatitis (steatosis, ballooning of hepatocytes or fibrosis). The criteria to perform a liver biopsy was ALT or AST > 1.5 x normal levels.
  
  
  RESULTS
  A total of 1280 patients from 16 Brazilian centers and all five regions were included. The mean age was 49.68 ± 13.59 years; 53.3% were males and 85% were asymptomatic. Hyperlipidemia was observed in 66.8% cases, obesity in 44.7%, overweight in 44.4%, diabetes in 22.7%, and toxins exposure in 10%. Metabolic syndrome was observed in 41.3% cases. Elevated levels of ALT, AST and GGT were observed in 55.8%, 42.2% and 63.1% cases, respectively. Liver biopsy performed in 437 cases showed: isolate steatosis in 42% cases, steatohepatitis in 58% and 27% of them also presented fibrosis. Cirrhosis was observed in 15.4% and hepatocellular carcinoma in 0.7%.
  
  
  CONCLUSIONS
  NAFLD in Brazil is more frequent in asymptomatic males; steatohepatitis with fibrosis and cirrhosis were a significant diagnosis. The genetic predisposition and lifestyle should be influenced in the spectrum; however these findings deserve a future investigation.
authors.affiliation: Brazilian Group for the Study of the NAFLD-Sociedade Brasileira de Hepatologia, Brazil. hpcotrim@ufba.br
authors.forename: Helma P
authors.initials: HP
authors.lastname: Cotrim
authors.forename: Edison R
authors.initials: ER
authors.lastname: Parise
authors.forename: Claudia P M S
authors.initials: CP
authors.lastname: Oliveira
authors.forename: Natalhie
authors.initials: N
authors.lastname: Leite
authors.forename: Ana
authors.initials: A
authors.lastname: Martinelli
authors.forename: João
authors.initials: J
authors.lastname: Galizzi
authors.forename: Rita de Cássia
authors.initials: Rde C
authors.lastname: Silva
authors.forename: Angelo
authors.initials: A
authors.lastname: Mattos
authors.forename: Leila
authors.initials: L
authors.lastname: Pereira
authors.forename: Waldir
authors.initials: W
authors.lastname: Amorim
authors.forename: Claúdia
authors.initials: C
authors.lastname: Ivantes
authors.forename: Francisco
authors.initials: F
authors.lastname: Souza
authors.forename: Marcelo
authors.initials: M
authors.lastname: Costa
authors.forename: Lizomar
authors.initials: L
authors.lastname: Maia
authors.forename: Mário
authors.initials: M
authors.lastname: Pessoa
authors.forename: Frederico
authors.initials: F
authors.lastname: Oliveira
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D001938:Brazil / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000473:pathology; D004796:Clinical Enzyme Tests; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000473:pathology*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D011446:Prospective Studies; D012189:Retrospective Studies; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase