Elazığ kent toplumunda nonalkolik yağlı karaciğerlerin epidemiyolojik özellikleri

Giriş ve amaç: Endüstri toplumlarında nonalkolik yağlı karaciğere sık rastlanmaktadır. Türkiye'de ise NAYK'ın epidemiyolojik verileri yetersizdir. Bu çalışma bir Doğu Anadolu genel popülasyon örneğinde ultrasonografi ile saptanmış Nonalkolik yağlı karaciğer sıklığını ve risk faktörlerini belirlemek amacıyla yapılmıştır. Gereç ve yöntem: Elazığ şehir merkezinden randomize seçilen 459 kişiye hepatobiliyer ultrasonog-rafi yapıldı. Bireylerin vücut kitle indeksleri, bel çevreleri, kan lipidleri, glukoz, hepatit serolojisi ve transaminaz seviyeleri ölçüldü. İstatistik analiz SPSS 13.0 programında ki kare, t-testi ve lojistik regresyon testleri kullanılarak yapıldı. Bulgular: Çalışmaya yaşları 18-80 arasında değişen 408 kişi katıldı. Düzenli alkol kullanan bir ve kronik viral hepatiti olan üç kişi çıkarıldıktan sonra kalan 404 kişi değerlendirildi. Nonalkolik yağlı karaciğer sıklığı kadınlarda %16.5, erkeklerde %23.7 (p

Epidemiologic features of nonalcoholic fatty liver in urban community of Elazığ

Background/aim: Nonalcoholic fatty liver disease is common in industrialized societies, but epidemiological data of nonalcoholic fatty liver disease is insufficient in Turkey. The aim of this study was to determine the prevalence of nonalcoholic fatty liver disease diagnosed by ultrasonography and the risk factors in an eastern Turkish general population. Materials and methods: A hepatobiliary ultrasonography was performed on 459 subjects randomly selected from the general population in Elazığ. Body mass index and waist circumference were calculated and serum lipids, glucose, viral serology and aminotransferases levels were measured. In statistical analysis, chi-square, t-test and logistic regression were used. Results: 408 subjects ranging in age from 18 to 80 years participated in the study. After four persons were excluded (1 for regular alcohol consumption and 3 for chronic viral hepatitis), the remaining 404 persons were evaluated. Prevalence of Nonalcoholic fatty liver disease was 16.5% in females, 23.7% in males (p<0.05), and 19.8% in all subjects. Nonalcoholic fatty liver disease was most frequent in the fifth decade, and more common in males than females under 40 years (p<0.05). There was a significant association between nonalcoholic fatty liver disease and body mass index, waist circumference, serum ALT and trigly-ceride levels. Logistic regression analysis revealed that in females, waist circumference and advanced age, and in males, waist circumference and increased ALT are independent predictors of nonalcoholic fatty liver dis¬ease. Conclusion: Nonalcoholic fatty liver disease is a common disease that affects one-fifth of the Turkish population, and it is more common in young males especially. Central obesity seems an important factor for development of nonalcoholic fatty liver disease in our country.

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  • 1.Sanyal AJ. American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease. Gastroenterology 2002; 123:1705-25.
  • 2.Bugianesi E, Leone N, Vanni E et al. Expanding the natural history of nonalcoholic steatohepatitis: From cryptogenic cirrhosis to hepatocellular carcinoma. Gastroenterology 2002; 123:134-40.
  • 3.Caldwell SH, Oelsner DH, lezzoni JC et al. Cryptogenic cirrhosis: Clinical characterization and risk factors for underlying disease. Hepatology 1999; 29: 664-9.
  • 4.Browning JD, Szczepaniak LS, Dobbins R et al. Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity. Hepatology 2004; 40: 1387-95.
  • 5.Nomura H, Kashiwagi S, Hayashi J et al.Prevalence of fatty liver in a general population of Okinawa, Japan. Jpn J Med 1988; 27:142-9.
  • 6.Bellentani S, Tiribelli C, Saccoccio G et al. Prevalence of chronic liver disease in the general population of northern Italy: the Dionysos Study. Hepatology 1994; 20:1442-9.
  • 7.Omagari K, Kadokawa Y, Masuda J etal. Fatty liver in non-alcoholic non-overweight Japanese adults: incidence and clinical characteristics. J Gastroenterol Hepatol 2002; 17:1098-105.
  • 8.Shen L, Fan JG, Shao Yetal. Prevalence of nonalcoholic fatty liver among administrative officers in Shanghai: An epidemiological survey. World J Gastroenterol 2003; 9:1106-10.
  • 9.Fang JG, Zhu J, Li XJ et al. Epidemiological survey of prevalence of fatty liver and its risk factors in a general adult population of Shanghai. Zhonghua Gan Zang Bing Za Zhi 2005; 13: 83-8. [Abstract]
  • 10.Saito Y, Yagyu K, Hattori Y , et al. A study on fatty liver in health examination participants. Nippon Eiseigaku Zasshi 1989; 44: 953-61. [Abstract]
  • 11.Singh SP, Nayak S, Swain M et al. Prevalence of nonalcoholic fatty liver disease in coastal eastern India: A preliminary ultrasonographic survey. Trop Gastroenterol 2004; 25: 76-9.
  • 12.Bedogni G, Bellentani S. Fatty liver: How frequent is it and why? Annals of Hepatology 2004; 3: 63-65
  • 13.Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: Summary of an AASLD Single Topic Conference. Hepatology 2003; 37:1202-19.
  • 14.Lonardo A. Fatty liver and nonalcoholic steatohepatitis. Where do we stand and where are we going? Dig Dis 1999; 17: 80-9.
  • 15.Marceau P, Biron S, Hould FS et al. Liver pathology and the metabolic syndrome X in severe obesity. J Clin Eridocrinol Metab 1999; 84:1513-7.
  • 16.Chitturi S, Farrell GC, George J. Non-alcoholic steatohepatitis in the Asia-Pacific region: future shock? Gastroenterol Hepatol 2004; 19:368-74,
  • 17.Ozsahin AK, Gokcel A, Sezgin N et ah Prevalence of the metabolic syndrome in a Turkish adult population. Diabetes Nutr Metab 2004; 17: 230-4.
  • 18.Tezcan S, Altintas H, Sönmez R et ah Cardiovascular risk factor levels in a lower middle-class community in Ankara, Turkey. Trop Med Int Health 2003; 8: 660-7.
  • 19.Onal AE, Erbil S, Özel S , et al. The prevalence of and risk factors for hypertension in adults living in Istanbul. Blood Press 2004; 13: 31-6.
  • 20.Erem C, Arslan C, Hacihasanoglu A et ah Prevalence of obesity and associated risk factors in a Turkish population (trabzon city, Turkey). Obes Res 2004; 12:1117-27.
  • 21.Ozdemir L, Topçu S, Nadir I et ah The prevalence of diabetes and impaired glucose tolerance in Sivas, Central Anatolia, Turkey. Diabetes Care 2005; 28: 795-8.
  • 22.Gore RM. Diffuse liver disease. In: Gore RM, Levine MS, Laufer I, eds. Textbook of gastrointestinal radiology. Philadelphia: Saunders, 1994:1968-2017.
  • 23.Yajima Y, Ohta K, Narui T et ah Ultrasonographical diagnosis of fatty liver: signifcance of the liver kidney contrast. Tohoku J Exp Med 1983; 139: 43-50.
  • 24.Falck-Ytter Y, Younossi ZM, Marchesini G et ah Clinical features and natural history of nonalcoholic steatosis syndromes. Semin Liver Dis 2001; 21:17-26.
  • 25.Lonardo A, Trande P. Are there any sex differences in fatty liver? A study of glucose metabolism and body fat distribution. J Gastroenterol Hepatol 2000; 15: 775-82.
  • 26.Bellentani S, Saccoccio G, Masutti F et ah Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med 2000; 132:112-7.
  • 27.Assy N, Kaita K, Mymin D et ah Fatty infiltration of liver in hyperlipidemic patients. Dig Dis Sci 2000; 45:1929-34.
  • 28.Loguercio C, De Girolamo V, de Sio I et ah Non-alcoholic fatty liver disease in an area of southern Italy: main clinical, histological, and pathophysiological aspects. J Hepatol 2001; 35: 568-74.
  • 29.Krai JG, Schaffner F, Pier son RNJr et ah Body fat topography as an independent predictor of fatty liver. Metabolism 1993; 42: 548-51.
  • 30.Gillum RF, Mussolino ME, Madans JH. Body fat distribution and hypertension incidence in women and men. The NHANES I Epidemiologic Follow-up Study. Int J Obes Relat Metab Disord 1998; 22: 127-34.
  • 31.Ludwig J, Viggiano TR, McGill DB et ah Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 1980; 55: 434-8.
  • 32.Diehl AM, Goodman Z, Ishak KG. Alcohollike liver disease in nonalcoholics. A clinical and histologic comparison with alcohol-induced liver injury. Gastroenterology 1988; 95:1056-62.
  • 33.Lee RG. Nonalcoholic steatohepatitis: a study of 49 patients. Hum Pathol 1989; 20: 594-8.
  • 34.Kojima S, Watanabe N, Numata M et al. Increase in the prevalence of fatty liver in Japan over the past 12 years: Analysis of clinical background. J Gastroenterol 2003; 38: 954-61.
  • 35.Garaulet M, Perez-Llamas F, Bar aza JC et al. Body fat distribution in pre-andpost-menopausal women: metabolic and anthropometric variables. JNutr Health Aging 2002; 6:123-6.
  • 36.Saruc M, Yuceyar H, Ayhan S et al. The association of hydroepiandrosterone, obesity, waist-hip ratio and insulin resistance with fatty liver in postmenopausal women: a hyperinsulinemic euglycemic insulin clamp study. Hepatogastroenterology 2003; 50: 771-4.
  • 37.Clark JM, Brancati FL, Diehl AM. The prevalence and etiology of elevated aminotransferase levels in the United States. Am J Gastroenterol 2003; 98: 960-7.
  • 38.Mathiesen UL, Franzen LE, Fry den A et al. The clinical significance of slightly to moderately increased liver transaminase values in asymptomatic patients. Scand J Gastroenterol 1999; 34: 85-91.
  • 39.Noguchi H, Tazawa Y, Nishinomiya F et al. The relationship between serum transaminase activities and fatty liver in children with simple obesity. Acta Paediatr Jpn 1995; 37: 621-5.
  • 40.Yano E, Tagawa K, Yamaoka K et al. Test validity of periodic liver function tests in a population of Japanese male bank employees. J Clin Epidemiol 2001; 54: 945-51.
  • 41.Sonsuz A, Basaranoglu M, Ozbay G. Relationship between aminotransferase levels and histopathological findings in patients with nonalcoholic steatohepatitis. Am J Gastroenterol 2000; 95:1370-1.
Akademik Gastroenteroloji Dergisi-Cover
  • ISSN: 1303-6629
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2002
  • Yayıncı: Jülide Gülay Özler
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