Screening for non-alcoholic fatty liver disease in community setting: A cohort study using controlled attenuation parameter-transient elastography

Nicha Teeratorn; Panida Piyachaturawat; Kessarin Thanapirom; Roongruedee Chaiteerakij; Kanokwan Sonsiri; Piyawat Komolmit; Pisit Tangkijvanich; Rungsun Rerknimitr; Leon Adams; Sombat Treeprasertsuk

doi:10.1002/jgh3.12252

Screening for non-alcoholic fatty liver disease in community setting: A cohort study using controlled attenuation parameter-transient elastography

JGH Open. 2019 Sep 4;4(2):245-250. doi: 10.1002/jgh3.12252. eCollection 2020 Apr.

Authors

Nicha Teeratorn^{1

2

3}, Panida Piyachaturawat^{1

2}, Kessarin Thanapirom^{1

2}, Roongruedee Chaiteerakij^{1

2}, Kanokwan Sonsiri^{1

2}, Piyawat Komolmit^{1

2}, Pisit Tangkijvanich^{2

4}, Rungsun Rerknimitr^{1

2}, Leon Adams⁵, Sombat Treeprasertsuk^{1

2

4}

Affiliations

¹ Department of Medicine, Division of Gastroenterology, Faculty of Medicine Chulalongkorn University Bangkok Thailand.
² Thai Red Cross Society Bangkok Thailand.
³ Department of Medicine Buddhachinaraj Hospital Phitsanulok Thailand.
⁴ Department of Biochemistry and Liver Research Unit, Faculty of Medicine Chulalongkorn University Bangkok Thailand.
⁵ Medical School University of Western Australia Nedlands Western Australia Australia.

Abstract

Background/aim: The global problems of chronic liver disease and non-alcoholic fatty liver disease (NAFLD) are increasing. We examined the prevalence of NAFLD and significant liver stiffness in an asymptomatic population and identified the predictors of significant fibrosis in NAFLD.

Method: We prospectively enrolled Thai subjects, aged 18-80 years, from four regions (Bangkok, Central, North, South) of Thailand from March 2013 to November 2016. All participants underwent controlled attenuation parameter (CAP) measurement for liver fat quantification and transient elastography (TE) for liver stiffness measurement (LSM). NAFLD was defined as liver fat ≥10% (CAP ≥ 306 dB/m). Of 1145 participants, 782 (68.3%) were eligible for analysis.

Result: The mean age ± standard deviation (SD) was 53.1 ± 4.6 years, and 71.6% were female. The mean ± SD values of CAP and LSM of the overall cohort were 241.9 ± 61.4 dB/m and 5.5 ± 3.8 kPa, respectively. The prevalence of NAFLD was 18.0%, whereas 5.4% of the cohort had nonobese NAFLD (BMI < 25 kg/m²), and 2.8% had lean NAFLD (BMI < 23 kg/m²). The prevalence of significant liver fibrosis (≥F2) in NAFLD subjects was 18.4%. On multivariate analysis, the degree of significant fibrosis in NAFLD was significantly associated with male gender and a history of dyslipidemia.

Conclusion: NAFLD with significant fibrosis (≥F2) is prevalent in asymptomatic populations. The predictors of significant fibrosis in NAFLD were male gender and dyslipidemia. Screening for NAFLD using CAP/TE in asymptomatic populations should be considered in hospitals with available facilities.

Keywords: community‐based; controlled attenuation parameter; liver fibrosis; non‐alcoholic fatty liver disease; transient elastography.