title: A comparison of the cardiometabolic profile of black South Africans with suspected non-alcoholic fatty liver disease (NAFLD) and excessive alcohol use.
abstract: Excessive alcohol use and non-alcoholic fatty liver disease (NAFLD) are putative cardiovascular disease risk factors. In order to ease the identification of these conditions on primary health care level, we aimed to determine and compare the demographic and cardiometabolic characteristics of excessive alcohol users and those with suspected NAFLD in black South Africans. In the Prospective Urban Rural Epidemiology study (North West Province, South Africa, N = 2021, collected in 2005) we selected 338 participants, namely: 1) alcohol users (N = 143) reporting 'yes' to alcohol intake, with high gamma-glutamyl transferase (GGT) ≥80 U/L and a percentage carbohydrate deficient transferrin (%CDT) ≥2%; 2) non-alcohol users (N = 127) self-reporting 'no' to alcohol intake with GGT ≤30 U/L and %CDT ≤2%; and 3) NAFLD group (N = 68) who were non-drinkers with GGT levels ≥60 U/L and %CDT ≤ 2%. The demographics indicated that the alcohol users were mostly men (73%) with a body mass index (BMI) of 19.8 (15.2-27.3) kg/m(2), 90% of which were smokers. Systolic blood pressure (SBP) of alcohol users significantly correlated with high-density lipoprotein cholesterol (HDL-C) (β = 0.24; p = 0.003) and waist circumference (WC) (β = 0.22; p = 0.006). Non-alcohol users were mostly women (84%) with a BMI of 26.0 (18.0-39.2) kg/m(2) and blood pressure in this group related positively with triglycerides. The NAFLD group were also mostly women (72%) with a comparatively larger WC (p < 0.001) and an adverse metabolic profile (total cholesterol: 5.55 ± 1.69 mmol/L; glycosylated hemoglobin: 6.03 (4.70-9.40) %). Diastolic blood pressure in the NAFLD group associated positively with WC (β = 0.27; p = 0.018). We therefore found disparate gender and cardiometabolic profiles of black South Africans with suspected NAFLD and excessive alcohol use. The described profiles may aid health care practitioners in low resource settings when using these crude screening measures of gender, obesity indices (and self-reported alcohol use) to identify individuals at risk.
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Department of Physiology, University of Limpopo (Medunsa), Pretoria, Gauteng 0001, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa.
authors.forename: Mandlenkosi Caswell
authors.initials: MC
authors.lastname: Zatu
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa.
authors.forename: Johannes Marthinus
authors.initials: JM
authors.lastname: van Rooyen
authors.affiliation: Centre for Human Metabonomics, North-West University, Potchefstroom, North West Province 2520, South Africa.
authors.forename: Du Toit
authors.initials: du T
authors.lastname: Loots
authors.affiliation: Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, North West Province 2520, South Africa.
authors.forename: Minrie
authors.initials: M
authors.lastname: Greeff
authors.affiliation: Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, North West Province 2520, South Africa; Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North West University, South Africa. Electronic address: Alta.Schutte@nwu.ac.za.
authors.forename: Aletta Elisabeth
authors.initials: AE
authors.lastname: Schutte
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000097:blood* / Q000208:ethnology*; D044383:Black People / Q000208:ethnology*; D001794:Blood Pressure / Q000502:physiology*; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000208:ethnology*; D011446:Prospective Studies; D013019:South Africa / Q000208:ethnology
chemical_list: D008076:Cholesterol, HDL
keywords: Blood pressure; Cardiovascular disease; High-density lipoprotein cholesterol; Hypertension; Low socio economic status; Non-alcoholic steatohepatitis