Non-alcoholic fatty liver disease (NAFLD): have we recognized the burden?

Abstract

Non alcoholic Fatty Liver Disease (NAFLD) is the most common chronic liver disease worldwide. There is no established medical treatment for non-alcoholic staetohepatitis (NASH), the more severe progressive form of the illness. Progression of NASH to cirrhosis and hepatocellular carcinoma is well recognized. NASH is the most common cause for unexplained elevation of liver function tests in Sri Lanka. NASH is one of the most common causes for cirrhosis in Sri Lanka. This tendency is also recognized in patients with hepatocellular carcinoma in Sri Lanka. In a study involving 3000 adults from an urban Sri Lankan population north of Colombo 33% had ultrasonographic evidence of NAFLD. There was a significant association between patatin-like phospholipase domain containing 3 (PNPLA3) gene rs738409 polymorphism, and susceptibility to NAFLD in the same population. In a similar study in a physically active population from the rural estate sector from the central Sri Lanka the prevalence of NAFLD was 15%. In a follow up study involving the urban population 7 years later the prevalence of NAFLD had increased significantly to more than 60% suggesting an annual incidence of 6.6% thus illustrating the magnitude of this problem in Sri Lanka.