Prevalence of and risk factors for non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt

Abstract

ObjectiveLimited literature has examined the epidemiology of non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt, a country with one of the highest obesity rates globally. We assessed the prevalence of steatosis and fibrosis among college students in Egypt.DesignIn this cross-sectional study, we recruited students unaware of having fatty liver via a call-for-participation at a private university in the Dakahlia governorate of Egypt. Primary outcomes were the prevalence of steatosis as determined by the controlled attenuation parameter component of transient elastography and fibrosis as determined by the liver stiffness measurement component of transient elastography. Secondary outcomes were clinical parameters and socioeconomic factors associated with the presence and severity of steatosis and fibrosis.ResultsOf 132 participants evaluated for the study, 120 (91%) were included (median (IQR) age, 20 (19–21) years; 65 (54.2%) female). A total of 38 participants (31.6%) had steatosis, among whom 22 (57.9%) had S3 (severe) steatosis. There was a higher risk for steatosis in persons with overweight (adjusted OR 9.67, 95% CI (2.94 to 31.7, p<0.0001) and obesity (adjusted OR 13.87, 95% CI 4.41 to 43.6, p<0.0001) compared with lean persons. Moreover, higher level of parental education was associated with progressing steatosis stages (S1–S3). Six (5%) participants had transient elastography values equivalent to F2–F3 fibrosis (four with F2 fibrosis (≥7.9 kPa), and two with F3 fibrosis (≥8.8 kPa)).ConclusionIn this cohort of college students in Egypt, around 1 in 3 had steatosis, and 1 in 20 had moderate-to-advanced fibrosis, an established risk factor for hepatic and extrahepatic morbidity and mortality. These data underscore the urgency to address the silent epidemic of NAFLD among young adults in the Middle East-North Africa region.

Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes

“…The prevalence of NAFLD among apparently healthy young Egyptian adults aged 19–21 year was studied by Tomah et al who concluded that fatty liver was present in 31.6% of them [ 24 ].…”

Dietary Acid Load (DAL), Glycated Hemoglobin A1c (HbA1c), and Metabolic Syndrome (MeS) Mediate the Association of the Adherence to the Dietary Approaches to Stopping Hypertension (DASH) and Mediterranean Diet (MeD) With Nonalcoholic Fatty Liver Disease

“…Second, whole grain consumption can reduce the risk of dyslipidemia, CVD, and diabetes ( 37 , 80 , 104 ). Another feature of the MeD is low consumption of red and processed meat, including SFAs and cholesterol, which has been linked to NAFLD development in case-control and cross-sectional studies ( 11 , 105 ).…”

“…NAFLD is a multifactorial disease that involves many risk factors related to lifestyle and diet, including metabolic syndrome (MeS), obesity, type 2 diabetes mellitus, dyslipidemia, and insulin resistance (4,10). Indeed, several studies have demonstrated that obesity, diabetes, and MeS increase NAFLD risk (11)(12)(13).…”

Role of microRNA in non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH): a comprehensive review

“…1,4,5 NAFLD is a benign condition; however, it may progress toward more serious diseases, including non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and ultimately, hepatocellular carcinoma (HCC) and cardiovascular disease mortality. 4,[7][8][9] The condition is thought to affect 25% of adults worldwide. 4,9,10 MicroRNAs (miRNAs) are small, noncoding RNAs comprising 18-25 nucleotides that alter gene expression by interfering at the post-transcriptional level.…”