Prevalence and severity of nonalcoholic fatty liver disease by transient elastography: Genetic and metabolic risk factors in a general population. (7th May 2018)

• Record Type: Journal Article
• Authors: Petta, Salvatore; Di Marco, Vito; Pipitone, Rosaria Maria; Grimaudo, Stefania; Buscemi, Carola; Craxì, Antonio; Buscemi, Silvio
• Is Part Of: Liver international. Volume 38:Number 11(2018)
• Page Start: 2060
• Page End: 2068
• Publication Date: 2018-05-07
• Subjects: controlled attenuation parameter -- fibrosis -- general population -- liver stiffness measurement -- patatin like phospholipase domain containing 3 -- steatosis -- stiffness -- transient elastography -- transmembrane 6 superfamily 2; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13743
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background & Aims: The worldwide spread of obesity is leading to a dramatic increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) and its complications. We aimed to evaluate both prevalence and factors associated with NAFLD in a general population in a Mediterranean area. Methods: We considered 890 consecutive individuals included in the community‐based ABCD (Alimentazione, Benessere Cardiovascolare e Diabete) study (ISRCTN15840340). Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were measured with FibroScan. Participants were genotyped for PNPLA3 rs738409 and TM6SF2 rs58542926 variants. Results: The prevalence of NAFLD in the cohort was 48%. NAFLD participants exhibited elevated LSM values, suggesting advanced fibrosis (6.5% of cases). Both NAFLD and advanced fibrosis were independently associated with traditional risk factors (NAFLD: age >50 years, obesity, hypertension, elevated ALT and low HDL‐cholesterol serum concentrations. Advanced fibrosis: IFG/diabetes, elevated ALT serum concentrations). A high prevalence (>60%) of NAFLD was found in obese people, while it varied widely in non‐obese people according to the presence of metabolic risk factors. PNPLA3 G variant (OR = 1.33, 95% C.I. = 1.01‐1.8; P < .05) was independently associated with NAFLD. Prevalence of advanced fibrosis (high LSM values) ranged from 3.4% (no risk factors) to 60% (presence of all risk factors). TM6SF2 T variant (OR = 3.06, 95% C.I. = 1.08‐8.65, P < .05) was independently associated with advanced fibrosis (high LSM values). Conclusions: In a cohort of a general population, the prevalence of NAFLD was very high, and among NAFLD patients a significant proportion had advanced fibrosis (high LSM values). Apart from traditional risk factors, genetic factors may have a significant role that needs to be further investigated.