Prevalence of Non-alcoholic Fatty Liver Disease in the Russian Federation: the Open, Multicenter, Prospective Study, DIREG 1

Oxana Drapkina^1, , Yulia Evsyutina¹ and Vladimir Ivashkin¹

¹Department of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University, Moscow, Russian Federation

Cite this paper

Oxana Drapkina, Yulia Evsyutina and Vladimir Ivashkin. Prevalence of Non-alcoholic Fatty Liver Disease in the Russian Federation: the Open, Multicenter, Prospective Study, DIREG 1. American Journal of Clinical Medicine Research. 2015; 3(2):31-36. doi: 10.12691/AJCMR-3-2-3

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a very serious medical and social problem that can lead to the progression of liver cirrhosis and eventually hepatic failure. There is a paucity of data regarding the prevalence and risk factors for NAFLD in the Russian Federation. Methods: The open multicenter prospective screening study, DIREG 1, involved patients aged 18–80 years who were admitted to various polyclinics for ambulatory therapeutic care (with or without apparent signs of hepatic diseases) at 208 centers in the Russian Federation from March 25th to November 26th, 2007. NAFLD was diagnosed by ultrasonography; a range of clinical and laboratory findings were also recorded for each participant. Results: A total of 30,754 outpatients were included in the screening study analysis. The prevalence of NAFLD was 27.0% (8,315/30,754), of which 80.3% had steatosis, 16.8% had steatohepatitis and 2.9% had disease at the cirrhotic stage. Most cases of NAFLD were observed in those aged 50-59 years (31.1%), 40-49 years (23.6%), and 60-69 years (18.1%). The most common risk factors associated with the NAFLD cohort vs the general screening population were dyslipidemia (75.9% vs 37.6%), arterial hypertension (69.9% vs 41.8%), and hypercholesterolemia (68.8% vs 33.5%) (all P<0.001). Conclusion: There is an urgent need to address the high prevalence of NAFLD in the Russian Federation (27%) and the large proportion of individuals with associated risk factors.

Keywords

non-alcoholic steatohepatitis, steatosis, cirrhosis, obesity, dyslipidemia

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology 2012; 142: 1592-1609.
[2]	Machado MV, Cortez-Pinto H. Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. J Hepatol 2013; 58: 1007-19.
[3]	Ratziu V, Bellentani S, Cortez-Pinto H, Day C, Marchesini G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol. 2010; 53: 372-84.
[4]	Michelotti GA, Machado MV, Diehl AM. NAFLD, NASH and liver cancer. Nat Rev Gastroenterol Hepatol. 2013;10:656-65.
[5]	Musso G, Gambino R, Cassader M, Pagano G. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med. 2011; 43: 617-49.
[6]	Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010; 363: 1341-1350.
[7]	Ghamar Chehreh ME, Vahedi M, Pourhoseingholi MA, Ashtari S, Khedmat H, Amin M, Zali MR, Alavian SM. Estimation of diagnosis and treatment costs of non-alcoholic Fatty liver disease: a two-year observation. Hepat Mon. 2013; 13: e7382.
[8]	Tolman KG, Dalpiaz AS. Treatment of non-alcoholic fatty liver disease. Ther Clin Risk Manag. 2007; 3: 1153-63.
[9]	Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011; 34: 274-85.
[10]	Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton JD, Cohen JC, Grundy SM, Hobbs HH. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004; 40: 1387-95.
[11]	Li Z, Xue J, Chen P, Chen L, Yan S, Liu L. Prevalence of nonalcoholic fatty liver disease in mainland of China: a meta-analysis of published studies. J Gastroenterol Hepatol. 2014; 29: 42-51.
[12]	Schwenger KJ, Allard JP. Clinical approaches to non-alcoholic fatty liver disease. World J Gastroenterol. 2014; 20: 1712-1723.
[13]	Leite NC, Salles GF, Araujo AL, Villela-Nogueira CA, Cardoso CR. Prevalence and associated factors of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus. Liver Int. 2009; 29: 113-9.
[14]	Mirrakhimov AE. Nonalcoholic fatty pancreatic disease and cardio-metabolic risk: is there is a place for obstructive sleep apnea? Cardiovasc Diabetol. 2014; 13: 29.
[15]	Park SH, Jeon WK, Kim SH, Kim HJ, Park DI, Cho YK, Sung IK, Sohn CI, Keum DK, Kim BI. Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol. 2006; 21: 138-43.
[16]	Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, Landt CL, Harrison SA. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011; 140: 124-31.
[17]	Fung J, Lee CK, Chan M, Seto WK, Lai CL, Yuen MF; the Hong Kong Liver Health Census Study Group. High prevalence of non-alcoholic fatty liver disease in the Chinese - results from the Hong Kong liver health census. Liver Int. 2015; 35(2): 542-9.
[18]	Blachier M, Leleu H, Peck-Radosavljevic M, Valla DC, Roudot-Thoraval F. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol. 2013; 58: 593-608.
[19]	Bertolotti M, Lonardo A, Mussi C, Baldelli E, Pellegrini E, Ballestri S, Romagnoli D, Loria P. Nonalcoholic fatty liver disease and aging: Epidemiology to management. World J Gastroenterol. 2014; 20: 14185-14204.
[20]	Noureddin M, Yates KP, Vaughn IA, Neuschwander-Tetri BA, Sanyal AJ, McCullough A, Merriman R, Hameed B, Doo E, Kleiner DE, Behling C, Loomba R; NASH CRN. Clinical and histological determinants of nonalcoholic steatohepatitis and advanced fibrosis in elderly patients. Hepatology. 2013; 58: 1644-54.
[21]	Leite NC, Villela-Nogueira CA, Cardoso CR, Salles GF. Non-alcoholic fatty liver disease and diabetes: from physiopathological interplay to diagnosis and treatment. World J Gastroenterol. 2014; 20: 8377-92.
[22]	Xu C, Yu C, Ma H, Xu L, Miao M, Li Y. Prevalence and risk factors for the development of nonalcoholic fatty liver disease in a nonobese Chinese population: the Zhejiang Zhenhai Study. Am J Gastroenterol. 2013; 108: 1299-304.