title: Perceptions of non-alcoholic fatty liver disease - an Asian community-based study.
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and is closely related to metabolic syndrome and its risk factors. Worldwide, epidemiological studies have reported NAFLD prevalence rates of 5% to 30% depending on geographical variations. While epidemiological data suggest a progressively increasing prevalence of metabolic risk factors in Singapore, there are limited data about NAFLD per se in the community. We aim to explore the prevalence and perceptions of NAFLD in Singapore.
  
  
  METHODS
  Attendees at a gastroenterology public forum were enrolled in a cross-sectional observational study evaluating demographic, anthropometric and clinical information. The diagnosis of NAFLD was based on sonographic criteria. Metabolic syndrome was defined according to International Diabetes Federation guidelines. Perceptions of NAFLD were explored using a self-administered survey questionnaire.
  
  
  RESULTS
  A total of 227 subjects were recruited, with NAFLD being diagnosed in 40% of the cohort. Relative to those without NAFLD, subjects with NAFLD had higher male preponderance, older age, higher body mass index, waist circumference and more metabolic syndrome (all P < 0.05). Although 71.2% subjects had heard about NAFLD before, only 25.4% of them felt that they were at risk of NAFLD. Comparable responses were observed in subjects with no metabolic risk factors relative to subjects with one or more metabolic risk factors (P > 0.05). Of note, 75.6% of subjects with one or more metabolic risk factors did not think that they were at risk of NAFLD.
  
  
  CONCLUSIONS
  Our study suggests a significant local prevalence of NAFLD in the community including non-obese individuals. Considering the tendency to underestimate risk of NAFLD, enhanced public education about NAFLD is warranted to improve understanding.
authors.affiliation: Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore, Duke-NUS Graduate Medical School, Singapore and george.goh.b.b@sgh.com.sg.
authors.forename: George B B
authors.initials: GB
authors.lastname: Goh
authors.affiliation: Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore.
authors.forename: Clarence
authors.initials: C
authors.lastname: Kwan
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: Sze Ying
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: Nanda Kk
authors.initials: NK
authors.lastname: Venkatanarasimha
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: Rafidah
authors.initials: R
authors.lastname: Abu-Bakar
authors.affiliation: Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore.
authors.forename: Thinesh L
authors.initials: TL
authors.lastname: Krishnamoorthy
authors.affiliation: Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore.
authors.forename: Hang Hock
authors.initials: HH
authors.lastname: Shim
authors.affiliation: Duke-NUS Graduate Medical School, Singapore and Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: Kiang Hiong
authors.initials: KH
authors.lastname: Tay
authors.affiliation: Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore, Duke-NUS Graduate Medical School, Singapore and.
authors.forename: Wan Cheng
authors.initials: WC
authors.lastname: Chow
keywords: Singapore; epidemiology; non-alcoholic fatty liver disease; perceptions