High prevalence of non-alcoholic fatty liver disease among healthy male blood donors of urban India

Abstract

Background: There is limited data on the community prevalence of non-alcoholic fatty liver disease (NAFLD). The present study evaluated the prevalence of NAFLD in a large number of healthy male blood donors of urban north India.

Methodology: In a prospective study performed over 18 months, voluntary blood donors fulfilling the requisite blood donation criteria and consenting to participate in the study were evaluated. The study received the approval of the institute's ethics committee. Diagnosis of NAFLD was made by excluding significant alcohol intake, ultrasound showing hepatic steatosis, and exclusion of transfusion associated infections. Subjects were also evaluated for various metabolic risk factors and the presence of metabolic syndrome.

Results: Of 1388 subjects who consented for participation, 386 did not come for evaluation. Three females, nine (0.9%) HBsAg-positive, and four (0.4%) anti-HCV positive subjects were excluded. Of the 986 males evaluated with hepatobiliary ultrasound, 543(55.1%) had fatty liver on ultrasonography [15 (1.5%) alcoholic fatty liver and 528 (53.5%) NAFLD]. Among those with NAFLD, 469 (88.8%), 54 (10.2%), and 5 (0.9%) had mild, moderate, and severe hepatic steatosis, respectively. Subjects with NAFLD, when compared to those without NAFLD, had significantly higher age, BMI, waist circumference, blood pressure, total cholesterol and triglycerides, low-density lipoprotein, and fasting plasma glucose. Multivariate regression analysis demonstrated age, BMI, waist circumference, systolic blood pressure, total cholesterol, and number of metabolic syndrome criteria as independent predictors of NAFLD.

Conclusions: Urban Indian healthy male blood donors have a high prevalence of NAFLD.

Keywords: NAFLD; NASH; fatty liver; hepatic steatosis; metabolic syndrome; non‐alcoholic steatohepatitis.

Figure 1

Showing the flow of inclusion and the work‐up performed in the subjects. Anti HCV, hepatitis C virus antibody; BMI, body mass index; DM, diabetes mellitus; HBsAg, hepatitis B surface antigen; HDL, serum high density lipoprotein; HTN, hypertension; IFG, impaired fasting glucose; LFT, liver function test; NAFLD, nonalcoholic fatty liver disease; TG, serum triglycerides; USG, ultrasound.