Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Prevalence and associated factors for non-alcoholic fatty liver disease among adults in the South Asian Region: a meta-analysis(Elsevier, 2023) Niriella, M.A.; Ediriweera, D.S.; Withanage, M.Y.; Darshika, S.; de Silva, S.T.; de Silva, H.J.BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease worldwide. We estimated the prevalence and predefined associated factors for NAFLD among South-Asian adults. METHODS: We searched PubMed and included descriptive, epidemiological studies with satisfactory methodology, reporting the prevalence of NAFLD with ultrasound. Two authors screened and extracted data independently. Gender, urban/rural settings, general population and individuals with metabolic diseases (MetD) stratified the analysis. In addition, a random-effects meta-analysis of the prevalence and effect sizes of associations of NAFLD was performed. FINDINGS: Twenty-two publications were included after the quality assurance process. The difference in the NAFLD prevalence between the general population and people with MetD was found to be statistically significant (Q = 15.8, DF = 1, P < 0.001). The pooled overall prevalence of NAFLD in the general population was 26.9% (95% CI: 18.9-35.8%) with high heterogeneity. The prevalence was similar among men and women (Q = 0.06, DF = 1, P = 0.806). The NAFLD prevalence in the rural communities was 22.6% (95% CI: 13.6-33.1%), and the prevalence in urban communities was 32.9% (95% CI: 22.8-43.8%) and the difference was not statistically significant (Q = 1.92, DF = 1, P = 0.166). The pooled overall prevalence of NAFLD in patients with MetD was 54.1% (95% CI: 44.1-63.9%) with high heterogeneity. The pooled overall prevalence of NAFLD in the non-obese population was 11.7% (95% CI: 7.0-17.3%). The pooled prevalence of non-obese NAFLD in the NAFLD population was 43.4% (95% CI: 28.1-59.4%). Meta-analysis of binary variables showed that NAFLD in the South Asian population was associated with diabetes mellitus, hypertension, dyslipidaemia, general obesity, central obesity and metabolic syndrome. Gender was not associated with NAFLD. INTERPRETATION: The overall prevalence of NAFLD among adults in South Asia is high, especially in those with MetD, and a considerable proportion is non-obese. In the South Asian population, NAFLD was associated with diabetes mellitus, hypertension, dyslipidaemia, general obesity, central obesity, and metabolic syndrome.Item Non-alcoholic fatty liver disease in the South Asian Region: A systematic review and meta-analysis(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Withanage, M.Y; Niriella, M.A.; Ediriweera, D.; de Silva, S.T.; de Silva, A.P.; de Silva, H.J.Introduction: Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease worldwide. Objectives: We estimated the overall prevalence and effect sizes of associations for NAFLD among adults in South Asia. Methods: We searched for search terms “Prevalence of NAFLD (Non-Alcoholic Fatty Liver Disease)” AND “South Asia” AND individual South Asian countries from January 2004-May 2021 in PubMed database. Strict eligibility criteria were applied. Gender, urban or rural setting, general population and individuals with metabolic diseases stratified analysis. A random-effects meta-analysis was performed. Results: Out of 158 studies, selected 25 studies from five countries (Bangladesh, India, Nepal, Pakistan and Sri Lanka) were included with 15,758 participants, of whom 4703 had NAFLD. The pooled NAFLD prevalence was 40.5% [95% CI 33.7-47.5] in overall, 26.2% [95% CI 18.7-4.4] in general population, 21.9% [95% CI 14.4-30.5] in rural communities, 32.9% [95% CI 22.8-43.8] in urban communities, 54% [95% CI 46.4-61.5] in individuals with one or more metabolic abnormalities and 11.1% [95% CI 7.1-16] among non-obese population. 41.4% of NAFLD patients were non-obese. Gender specific prevalence was similar. Prevalence of NAFLD among individuals with metabolic disease was significantly higher than the general population (p<0.0001). A significant association with NAFLD was found for metabolic syndrome, general obesity, central obesity, diabetes mellitus, dysglycemia, dyslipidemia and hypertension. Conclusions: The overall prevalence of NAFLD among adults in South Asia is high, especially in urban populations and those with metabolic abnormalities. Targeted health¬strategies should be implemented in the region to address this.