none

NON-ALCOHOLIC FATTY LIVER DISEASE AND ASSOCIATED RISK FACTORS IN THE GAMBIAN CONTEXT

賈君怡(Bintou Junaidi Jallow)

指導教授 ： 辛錫璋

高雄醫學大學/醫學院/臨床醫學研究所/碩士(2011年)

摘要

none

關鍵字

none

並列摘要

SUMMARY
The Prevalence of non-alcoholic fatty liver disease (NAFLD) remains largely unknown in The Gambian population; there is great concern about the impact of this fast growing disease in this part of the world.
The aim of this study was to investigate the socio-demographics, clinical and biochemical features of Gambian subjects diagnosed with non-alcoholic fatty liver disease by Ultrasonography.
Consecutive subjects who satisfy the study criteria were enrolled from the Royal Victoria Teaching hospital at the center of health examination. All subjects consented and completed a baseline questionnaire, abdominal ultrasound scan was performed to determine radiologic evidence of fatty liver and fasting blood samples were collected for measurement of biometabolic including; fasting plasma glucose, triglycerides, cholesterol, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) body mass index (BMI),and blood pressure (BP) were also measured. Nominal logistic regression analysis was used to estimate the odds ratio for fatty liver and associated risk factors.
Three hundred subjects were enrolled and all completed the questionnaire, ultrasound, and laboratory investigation mean age 47.2years (SD = 15.9, range 18-85years) and gender ratio (F: M) of 142:158(47.3%:52.7%). The prevalence of NAFLD was 47.0%. The frequencies of obesity, and glucose intolerance were all significantly higher in subjects with NAFLD (P < 0.0001), whiles subjects with manual occupation (P=0.0025), ≥150 minutes per week of moderate aerobic activity (P= 0.0286) and vigorous aerobic activity per week (P=0.0298) tend to be protected from NAFLD.

In conclusion, our data demonstrated that subjects with fatty liver by US tend to be obese and manifest glucose intolerance before derangement of liver enzymes. We suggest that the obese, regardless of age, should undergo abdominal US, to identify subjects at risk, so they could benefit from careful follow-up and might be motivated toward lifestyle modifications that are potentially able to cure their liver disease and the extrahepatic manifestations of the metabolic syndrome. We also observered that ≥150 minutes per week of moderate aerobic intensity physical activity and vigorous-intensity physical activity per week were significantly related to outcomes. Thus, intensity may be an important dimension of physical activity to consider when counseling patients and planning interventions. Clinicians should be aware of the importance of a complete clinical evaluation for early diagnosis and treatment of liver disease, as well as the different manifestations of the metabolic syndrome.

並列關鍵字

non-alcoholic fatty liver disease (NAFLD) ； socio-demographics ； clinical and biochemical features ； Gambian subjects

參考文獻

Reference List

(1) Adams LA, Angulo P. Recent concepts in non-alcoholic fatty liver disease. Diabetic Medicine 2005;22(9):1129-33.

(2) Brunt EM. Nonalcoholic steatohepatitis. Semin Liver Dis 2004;24(1):3-20.

(3) Bugianesi E. Expanding the natural history of non-alcoholic steatohepatitis: from cryptogenic cirrhosis to hepatocellular carcinoma. Gastroenterology 2002;123:134-40.

(4) Clark JM, Diehl AM. Nonalcoholic Fatty Liver Disease. JAMA: The Journal of the American Medical Association 2003 Jun 11;289(22):3000-4.