title: Obesity and the extent of liver damage among adult New Zealanders: findings from a national survey.
abstract: Non-alcoholic fatty liver disease (NAFLD), defined as excessive fat accumulation in hepatocytes when no other pathologic causes are present, is an increasingly common obesity-related disorder. We sought to describe the prevalence of elevated liver enzymes, a marker of liver damage, among New Zealand adults, and high-risk subgroups including those with an elevated body mass index and those with pre-diabetes or diabetes, to gain a better understanding of the burden of liver disease.
  
  
  
  A total of 4,721 New Zealanders aged 15+ years participated in a nationally representative nutrition survey. Liver enzymes, alanine transaminase (ALT) and gamma glutamyl transpeptidase (GGT) were measured in serum. Results were available for 3,035 participants, of whom 10.8% were Māori and 4.5% Pacific.
  
  
  
  Overall, the prevalence of elevated ALT and elevated GGT was 13.1% (95% confidence interval [CI]: 11.2 - 15.0) and 13.7% (95% CI: 12.0 - 15.4), respectively. Odds ratios for an elevated ALT or GGT markedly increased with increasing body mass index. Men with obesity had the highest elevated ALT prevalence (28.5%; 95% CI: 21.7-35.4), and women with diabetes had the highest elevated GGT prevalence (36.5%; 95% CI: 26.0-47.0). Adding alcohol consumption categories to each of the adjusted models did not meaningfully change any results, although for women, heavy alcohol consumption was associated with an elevated GGT (overallp= 0.03).
  
  
  
  Obesity-related liver disease is likely to increasingly burden the New Zealand health sector and contribute to health disparities unless effective obesity treatment and prevention measures are given high priority. © 2015 The Authors. Obesity Science & Practice published by John Wiley & Sons Ltd, World Obesity and The Obesity Society.
authors: Edgar Diabetes and Obesity Research, Department of Medicine University of Otago Dunedin New Zealand.
authors: K J
authors: KJ
authors: Coppell
authors: Department of Human Nutrition University of Otago Dunedin New Zealand.
authors: J C
authors: JC
authors: Miller
authors: Department of Preventive and Social Medicine University of Otago Dunedin New Zealand.
authors: A R
authors: AR
authors: Gray
authors: Gastroenterology, Department of Medicine University of Otago Dunedin New Zealand.
authors: M
authors: M
authors: Schultz
authors: Edgar Diabetes and Obesity Research, Department of Medicine University of Otago Dunedin New Zealand; Department of Human Nutrition University of Otago Dunedin New Zealand.
authors: J I
authors: JI
authors: Mann
authors: Department of Human Nutrition University of Otago Dunedin New Zealand.
authors: W R
authors: WR
authors: Parnell
keywords: Ethnic minorities; liver enzymes; non‐alcoholic fatty liver disease (NAFLD); obesity