The prevalence of and the risk factors for fatty liver have not undergone a formal evaluation in a representative sample of the general population.
Dr Stefano Bellentani and colleagues therefore performed a cross-sectional study in Italy, within the context of the Dionysos Project.
| Nonalcoholic fatty liver is more likely amongst older subjects and males|
The investigators reported that of 5780 eligible persons aged 18 to 75 years, 3345 agreed to participate in the study.
The team defined subjects with suspected liver disease on the basis of elevated serum alanine aminotransferase and -glutamyl-transferase activity.
Suspected liver disease was also defined on the basis of hepatitis B surface antigen, or hepatitis C virus-RNA positivity.
The subjects were matched with randomly selected subjects of the same age and sex without suspected liver disease.
The investigators reported that 311 subjects with and 287 without suspected liver disease underwent clinical, laboratory, and anthropometrical evaluation.
Fatty liver was diagnosed by ultrasonography, and alcohol intake was assessed by using a 7-day diary.
The investigative team used multinomial logistic regression to detect risk factors for normal liver versus nonalcoholic fatty liver disease and vice versa.
The investigators found that the prevalence of nonalcoholic fatty liver disease was similar in subjects with and without suspected liver disease.
At multivariable analysis, the team observed that normal liver was more likely than nonalcoholic fatty liver disease in older subjects.
The investigators also observed that normal liver was less likely with obesity, hyperglycemia, hyperinsulinemia, hypertriglyceridemia, and systolic hypertension.
The team found that alcoholic fatty liver was more likely than nonalcoholic fatty liver disease in older subjects and males.
The team also noted that alcoholic fatty liver was more likely with elevated glutamyl-transferase and hypertriglyceridemia.
In addition, alcoholic fatty liver was observed to be less likely in the presence of obesity and hyperglycemia.
Dr Bellentani and team concluded, “Nonalcoholic fatty liver disease is highly prevalent in the general population, is not associated with suspected liver disease, but is associated with many features of the metabolic syndrome.”