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Incidence and risk factors for Non-Alcoholic Fatty Liver Disease in an urban, adult Sri Lankan population – a community cohort follow-up study

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dc.contributor.author Niriella, M. en_US
dc.contributor.author Kasturiratne, A. en_US
dc.contributor.author de Silva, S. en_US
dc.contributor.author Perera, R. en_US
dc.contributor.author Subasinghe, C. en_US
dc.contributor.author Kodisinghe, K. en_US
dc.contributor.author Priyantha, C. en_US
dc.contributor.author Rishikeshavan, V. en_US
dc.contributor.author Dassanayake, A. en_US
dc.contributor.author de Silva, A. en_US
dc.contributor.author Pathmeswaran, A. en_US
dc.contributor.author Kato, N. en_US
dc.contributor.author de Silva, H.J. en_US
dc.date.accessioned 2015-12-24T15:23:10Z en_US
dc.date.available 2015-12-24T15:23:10Z en_US
dc.date.issued 2015 en_US
dc.identifier.citation European Gastroenterology Journal. 2015; 3(5) Suppl: 25-26 en_US
dc.identifier.issn 2050-6406 (Print) en_US
dc.identifier.issn 2050-6414 (Electronic) en_US
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/10954 en_US
dc.description Oral Presentation Abstract (OP074), 23rd United European Gastroenterology Week, October 2015, Barcelona, Spain en_US
dc.description.abstract INTRODUCTION: We previously reported a community prevalence of 33% for NAFLD in an urban, adult Sri Lankan population. We also found a significant association between patatin-like phospholipase domain containing 3 (PNPLA3) gene rs738409 polymorphism, and susceptibility to NAFLD in the same population, after testing 10 selected single nucleotide polymorphisms (SNPs) in a case control study. AIMS & METHODS: The aim of this study was to assess the incidence and risk factors for NAFLD in this population after seven years of follow-up. The study population consisted of 42-71-year-old adults, originally selected by age stratified random sampling from electoral lists from Ragama, Sri Lanka. The target population was screened initially in 2007 and subsequently invited back for re-evaluation in 2014. On both occasions they were assessed using a structured interview, clinical and anthropometric measurements, liver ultrasound, and biochemical and serological tests. NAFLD was diagnosed on established ultrasound criteria for fatty liver (two out of three criteria: increased echogenecity of the liver compared to kidney and spleen, obliteration of the vascular architecture of the liver and deep attenuation of the ultrasonic signal), safe alcohol consumption (Asian standards: 514 units/week for men, 57 units/week for females) and absence of hepatitis B and C markers. Non-NAFLD controls were defined as subjects who did not have any of the ultrasound criteria for NAFLD. We also performed an updated case-control study to investigate associations of selected genetic variants with incident NAFLD [SNPs: PNPLA3 (rs738409), LYPLAL1 (rs12137855), GCKR (rs780094), PPP1R3B (rs4240624) and NCAN (rs2228603), APOC3 (rs2854117 and rs2854116), ADIPOR2 (rs767870) and STAT3 (rs6503695 and rs9891119)]. RESULTS: Of the 2985 original study participants, 2155 (72.2%) (1244 women and 911 men; mean age 59.2 years [SD, 7.7]) participated in the follow-up assessment. 1322 [mean age 58.9 years (SD, 7.6), 483 (53.0%) men and 839 (67.4%) women] had NAFLD. Out of 795 [466 (58.6%) women] participants who did not have NAFLD in the original study, 365 [226 (61.9%) women, mean age 58.6 years (SD, 7.9)] had developed NAFLD after 7 years, giving an annual incidence rate 6.6%. On multivariate analysis, increased waist circumference [OR 1.96(1.30 – 2.97), p=0.001], BMI4 23 kg/m2 [OR 2.93(1.99 – 4.30), p50.001] and raised plasma triglycerides (TG) [OR 1.49(1.03 – 2.13), p=0.03] were independently predictive of incident NAFLD in this cohort, while raised BP and reduced HDL, were not. In the updated association study involving 1310 cases and 427 controls, we found borderline association with NAFLD at two of the 10 candidate loci: rs4240624 at PPP1R3B and rs738409 at PNPLA3 (one-tailed P=0.044 and 0.033, respectively). CONCLUSION: In this community cohort follow-up study in an urban, adult population in Sri Lanka, the annual incidence of NAFLD was 6.6%. Incident NAFLD was associated with features of the metabolic syndrome, and showed tendency of association at PNPLA3 and PPP1R3B gene polymorphisms. Disclosure of Interest: None declared en_US
dc.language.iso en en_US
dc.publisher Sage Publishing en_US
dc.subject Non-alcoholic Fatty Liver Disease en_US
dc.subject Non-alcoholic Fatty Liver Disease-epidemiology en
dc.subject Prevalence en_US
dc.subject Sri Lanka-epidemiology en_US
dc.subject Urban Population en_US
dc.subject Case-Control Studies en_US
dc.subject Risk Factors en
dc.subject Adult en
dc.subject Follow-Up Studies en
dc.subject Cohort Studies en
dc.title Incidence and risk factors for Non-Alcoholic Fatty Liver Disease in an urban, adult Sri Lankan population – a community cohort follow-up study en_US
dc.type Conference Abstract en_US
dc.creator.corporateauthor United European Gastroenterology (Learned institution) en


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