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Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease ranging from simple steatosis, non-alcoholic steatohepatitis (NASH), through to advanced fibrosis and cirrhosis. We assessed the prevalence, spectrum, and determinants of NAFLD among adults in urban and rural North India....

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Autores principales: Asadullah, Md, Shivashankar, Roopa, Shalimar, Kandasamy, Devasenathipathy, Kondal, Dimple, Rautela, Garima, Peerzada, Ariba, Grover, Bhanvi, Amarchand, Ritvik, Nayak, Baibaswata, Sharma, Raju, Ramakrishnan, Lakshmy, Prabhakaran, Dorairaj, Krishnan, Anand, Tandon, Nikhil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830644/
https://www.ncbi.nlm.nih.gov/pubmed/35143562
http://dx.doi.org/10.1371/journal.pone.0263768
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author Asadullah, Md
Shivashankar, Roopa
Shalimar,
Kandasamy, Devasenathipathy
Kondal, Dimple
Rautela, Garima
Peerzada, Ariba
Grover, Bhanvi
Amarchand, Ritvik
Nayak, Baibaswata
Sharma, Raju
Ramakrishnan, Lakshmy
Prabhakaran, Dorairaj
Krishnan, Anand
Tandon, Nikhil
author_facet Asadullah, Md
Shivashankar, Roopa
Shalimar,
Kandasamy, Devasenathipathy
Kondal, Dimple
Rautela, Garima
Peerzada, Ariba
Grover, Bhanvi
Amarchand, Ritvik
Nayak, Baibaswata
Sharma, Raju
Ramakrishnan, Lakshmy
Prabhakaran, Dorairaj
Krishnan, Anand
Tandon, Nikhil
author_sort Asadullah, Md
collection PubMed
description BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease ranging from simple steatosis, non-alcoholic steatohepatitis (NASH), through to advanced fibrosis and cirrhosis. We assessed the prevalence, spectrum, and determinants of NAFLD among adults in urban and rural North India. METHODS: A representative sample of adults aged 30–60 years were recruited from urban Delhi and rural Ballabhgarh during 2017–2019. Participants underwent abdominal ultrasonography (USG) and vibration controlled transient elastography (VCTE) with FibroScan to assess fatty liver and fibrosis, respectively. We estimated the age- and sex-standardised prevalence of NAFLD and its spectrum. The factors associated with ‘ultrasound-diagnosed NAFLD’ were identified using multivariate logistic regression. RESULTS: A total of 828 urban (mean ± SD age: 45.5 ± 8.0 years; women: 52.7%) and 832 rural (mean ± SD age: 45.1 ± 7.9 years; women: 62.4%) participants were recruited. The age- and sex-standardized prevalence of ultrasound-diagnosed NAFLD was 65.7% (95%CI: 60.3–71.2) in the urban and 61.1% (55.8–66.5) in the rural areas, respectively. The prevalence of NAFLD with elevated alanine transaminase (≥40IU/L) was 23.2% (19.8–26.6), and 22.5% (19.0–26.0) and any fibrosis by liver stiffness measurement on transient elastography (≥6.9 kPa) was 16.5% (13.8–19.8) and 5.2% (3.8–6.7) in urban and rural participants, respectively. In both urban and rural areas, diabetes, central obesity and insulin resistance were significantly associated with NAFLD. CONCLUSION: NAFLD prevalence was high among rural and urban North Indian adults, including fibrosis or raised hepatic enzymes. The strong association of metabolic determinants confirms its linkage with metabolic syndrome.
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spelling pubmed-88306442022-02-11 Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population Asadullah, Md Shivashankar, Roopa Shalimar, Kandasamy, Devasenathipathy Kondal, Dimple Rautela, Garima Peerzada, Ariba Grover, Bhanvi Amarchand, Ritvik Nayak, Baibaswata Sharma, Raju Ramakrishnan, Lakshmy Prabhakaran, Dorairaj Krishnan, Anand Tandon, Nikhil PLoS One Research Article BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease ranging from simple steatosis, non-alcoholic steatohepatitis (NASH), through to advanced fibrosis and cirrhosis. We assessed the prevalence, spectrum, and determinants of NAFLD among adults in urban and rural North India. METHODS: A representative sample of adults aged 30–60 years were recruited from urban Delhi and rural Ballabhgarh during 2017–2019. Participants underwent abdominal ultrasonography (USG) and vibration controlled transient elastography (VCTE) with FibroScan to assess fatty liver and fibrosis, respectively. We estimated the age- and sex-standardised prevalence of NAFLD and its spectrum. The factors associated with ‘ultrasound-diagnosed NAFLD’ were identified using multivariate logistic regression. RESULTS: A total of 828 urban (mean ± SD age: 45.5 ± 8.0 years; women: 52.7%) and 832 rural (mean ± SD age: 45.1 ± 7.9 years; women: 62.4%) participants were recruited. The age- and sex-standardized prevalence of ultrasound-diagnosed NAFLD was 65.7% (95%CI: 60.3–71.2) in the urban and 61.1% (55.8–66.5) in the rural areas, respectively. The prevalence of NAFLD with elevated alanine transaminase (≥40IU/L) was 23.2% (19.8–26.6), and 22.5% (19.0–26.0) and any fibrosis by liver stiffness measurement on transient elastography (≥6.9 kPa) was 16.5% (13.8–19.8) and 5.2% (3.8–6.7) in urban and rural participants, respectively. In both urban and rural areas, diabetes, central obesity and insulin resistance were significantly associated with NAFLD. CONCLUSION: NAFLD prevalence was high among rural and urban North Indian adults, including fibrosis or raised hepatic enzymes. The strong association of metabolic determinants confirms its linkage with metabolic syndrome. Public Library of Science 2022-02-10 /pmc/articles/PMC8830644/ /pubmed/35143562 http://dx.doi.org/10.1371/journal.pone.0263768 Text en © 2022 Asadullah et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Asadullah, Md
Shivashankar, Roopa
Shalimar,
Kandasamy, Devasenathipathy
Kondal, Dimple
Rautela, Garima
Peerzada, Ariba
Grover, Bhanvi
Amarchand, Ritvik
Nayak, Baibaswata
Sharma, Raju
Ramakrishnan, Lakshmy
Prabhakaran, Dorairaj
Krishnan, Anand
Tandon, Nikhil
Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population
title Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population
title_full Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population
title_fullStr Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population
title_full_unstemmed Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population
title_short Rural-Urban differentials in prevalence, spectrum and determinants of Non-alcoholic Fatty Liver Disease in North Indian population
title_sort rural-urban differentials in prevalence, spectrum and determinants of non-alcoholic fatty liver disease in north indian population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830644/
https://www.ncbi.nlm.nih.gov/pubmed/35143562
http://dx.doi.org/10.1371/journal.pone.0263768
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