Conference Papers
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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
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Item Genetic variants of NAFLD in an urban Sri Lankan community(Wiley Blackwell Scientific Publications, 2013) Niriella, M.A.; Kasturiratne, A.; Akiyama, K.; Takeuchi, F.; Isono, M.; Dassanayake, A.S.; de Silva, A.P.; Wickremasinghe, A.R.; Kato, N.; de Silva, H.J.OBJECTIVE: Recently, genome-wide association studies (GWAS) have successfully identified loci associated with susceptibility to non-alcoholic fatty liver disease (NAFLD) in populations of European descent. No large-scale genetic studies have been performed thus far in South Asian populations. Therefore, as part of a community-based cohort study in an urban adult population of Sri Lankans, we investigated associations of genetic variants with NAFLD, diagnosed on established ultrasound criteria, and its related phenotypes. METHODS: We selected 10 single nucleotide polymorphisms (SNPs), all previously reported to be associated with NAFLD in populations of European and/or South Asian ancestry, for a case-control replication study. They included loci derived from GWAS [PNPLA3 (rs738409), LYPLAL1 (rs12137855), GCKR (rs780094), PPP1R3B (rs4240624) and NCAN (rs2228603)] plus those from candidate gene studies [APOC3 (rs2854117 and rs2854116), ADIPOR2 (rs767870) and STAT3 (rs6503695 and rs9891119)]. Genotype data of 2988 participants were used for the analysis. RESULTS: A significant NAFLD association was observed for PNPLA3 (rs738409) [OR = 1.25, 95% CI 1.08–1.44, P = 0.003)]; rs738409 was also associated with a trend towards lower serum triglycerides APOC3 variants were significantly (P = 7.3–7.5 × 10–8) associated with higher triglycerides, but not with NAFLD (OR = 0.86). Apart from SNP–lipid associations previously reported at the GCKR, PPP1R3B and NCAN loci, there were no other prominent associations. CONCLUSION: Our data confirm that the PNPLA3 gene variant is significantly associated with NAFLD in the general Sri Lankan population but could not replicate previously reported disease associations at other loci, reinforcing the importance of further large-scale study on genetic variants in diverse populations to better understand the pathophysiology of NAFLD.Item Prevalence and risk factors for metabolic syndrome among aging adults in an urban Sri Lankan population(Sri Lanka Medical Association, 2015) Kasturiratne, K.T.A.A.; Niriella, M.A.; de Silva, S.T.; Perera, K.R.; Subasinghe, S.K.C.E.; Kodisinghe, S.K.; Piyaratna, T.A.C.L.; Vithiya, K.; Kottachchi, D.; Ranawaka, U.K.; Jayasinghe, C.; Rajindrajith, S.; Dassanayake, A.S.; de Silva, A.P.; Pathmeswaran, A.; de Silva, H.J.INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is assumed to be of high prevalence in the Asian region. However, its community prevalence and risk factors in South Asia is poorly studied. We determined the prevalence and risk factors for MetS among adults in an urban Sri Lankan population. METHOD: The study population consisted of 42-71 year old adults, selected by stratified random sampling from the Ragama Medical Officer of Health area. MetS was defined by the International Diabetic Federation criteria with ethnic specific cutoffs. Anthropometric measurements, blood pressure (BP) and body fat distribution estimates were made. Glycosylated hemoglobin, fasting serum lipids, serum alanine aminotransferase (ALT) and serum creatinine (SCr) with estimated glomerular filtration rate (eGFR) were determined. CKD was defined as GFR<60ml/min/1.72m2 (KDIGO/KDOQI classification), USS abdomen was performed to detect fatty liver and non-alcoholic fatty liver disease (NAFLD) was diagnosed on safe alcohol consumption (< 14 units/week for men, < 7 units/week for females) and absence of hepatitis B and C markers. RESULTS: 2155 (1244 [57.7%] women, mean age 59.2 years [SD, 7.7]) participated. 1014 (47.1%) [mean age 59.2 years (SD, 7.7), 256 (28.1%) men; 758 (60.9%) women] had MetS. On multivariate analysis female gender, abnormal total body fat and abnormal visceral fat level (>10%) and presence of NAFLD were independently associated with MetS. Age 65 or more, raised ALT and CKD were not associated with MetS. CONCLUSION: The prevalence of MetS among adults in this aging urban Sri Lankan community was high and is independently associated with female gender, abnormal body fat distribution and presence NAFLD.Item Alanine Transaminase (ALT) levels in normal adult Sri Lankans(American Gastroenterological Association(AGA) Institute, Published by Elsevier Inc., 2009) Niriella, M.A.; Dassanayake, A.S.; Kalubowila, K.; Kalubowila, U.; de Silva, A.P.; Wickremasinghe, A.R.; Kato, N.; Makaya, M.; de Silva, H.J.BACKGROUND : Alanine transaminase (ALT) levels are widely used in screening for liver disease.The upper limit of normal (ULN) of ALT (males 30 IU/l, females 19 IU/l) have been definedfor western populations. Normal levels have not been established for Asian populations. OBJECTIVES: To establish levels of ALT for a normal, adult Sri Lankan population METHODS: This study was part of a community based investigation - Ragama Health Study (RHS). The study population consisted of 35-64 year old adults, selected using stratified random sampling. Consenting adults were screened by a structured interview, liver ultrasound and collection of 10 ml venous blood. The “normal” population was defined as those not using potentially hepatotoxic drugs, safe alcohol consumption (14 units/week for males, 7 units/week for females), absence of fatty liver, and being HBsAg and anti-HCVab negative. ALT levels were estimated by a kit using the Bergmeyer method. The 95th percentile of the ALT levels was taken as the ULN. RESULTS: 3012 subjects participated in the study. The ALT level (U/l) among 831 normal males (mean 36, median 30, SD 20, ULN 68) was significantly higher than that of the 885 normal females (mean 29, median 25, SD 13, ULN 53) (p<0.001,Student's t-test ). CONCLUSION: The ULN for ALT levels of a “normal” Sri Lankan population was higher than observed in western populations. The levels were higher in males. ULN for ALT may need to be redefined for different population groups.