title: Non-alcoholic fatty liver disease in a rural, physically active, low income population in Sri Lanka.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is recognized as a metabolic disorder largely seen in urbanized populations. The purpose of this study was to assess prevalence and risk factors for NAFLD in a rural, physically active, economically deprived population in Sri Lanka.
  
  
  METHODS
  By visiting individual households in the community, 35-64 year old adults resident in two selected estates in the Nuwara Eliya District of Sri Lanka, were invited to participate in the study. Blood pressure and anthropometric measurements were made on all participants. Blood samples were obtained for the assay of fasting glucose, serum lipids, serum insulin and alanine aminotransferase. NAFLD was diagnosed on established ultrasound criteria for fatty liver in the absence of hepatitis B and C markers and high alcohol consumption.
  
  
  RESULTS
  Of those invited, 403 (65%) participated in the study. Almost all participants were either Indian or Sri Lankan Tamils and 53% were females. Prevalence of NAFLD was 18% in this population. Twice as many males were diagnosed as having NAFLD compared to females. Male sex, high BMI, high waist circumference, high diastolic blood pressure and high plasma glucose levels were significant predictors of NAFLD.
  
  
  CONCLUSIONS
  Nearly one in five people in this predominantly Indian Tamil, rural, physically active, economically deprived population had NAFLD. The condition was associated with constituent features of the metabolic syndrome. These results support studies reporting ethnic variations in disease susceptibility and suggest that genetic factors may also play a role in determining disease risk.
authors: Faculty of Medicine, University of Kelaniya, P O Box 6, Ragama 11010, Sri Lanka. jananicm@yahoo.com.
authors: M Janani
authors: MJ
authors: Pinidiyapathirage
authors: Anuradha S
authors: AS
authors: Dassanayake
authors: Shaman
authors: S
authors: Rajindrajith
authors: Udaya
authors: U
authors: Kalubowila
authors: Norihiro
authors: N
authors: Kato
authors: A Rajitha
authors: AR
authors: Wickremasinghe
authors: H Janaka
authors: HJ
authors: de Silva