Future Shock Fatty Liver Is Common in Young

Future Shock— Fatty liver is common in young Malaysians N BAHAR, H RAZLAN, A VIJAYANANTHA N, KL GOH Division of Gastroenterology and Hepatology, Department of Radiology, University of Malaya, Kuala Lumpur Introduction Fatty liver (FL) is a common condition in the Asia- Pacific region. Increasingly its relationship to cirrhosis and hepatocellular carcinoma has been recognized. The condition is commonly detected in middle or later years of life. As it is a rapidly emerging disease, we were anxious to know if a young Malaysian adult population was affected by it. Objective To determine the prevalence and risk factors of FL in a young Malaysian population. Materials and Methods This was a cross- sectional study carried out on consecutive university students between 18 and 30 years from University Malaya. Subjects with significant amounts of alcohol consumption and history of liver diseases were excluded. All the students were subjected to a complete demographic, anthropometric and biochemical analyses fol- lowed by an abdominal ultrasound to look for FL. Results 243 subjects were recruited: 140 (57.6%) females and 103 (42.4%) males; mean age 22.51 ± 2.57; 96 (39.5%) Malays, 94 (38.7%) Chinese, 53 (21.8%) Indians. FL was diagnosed in 25 (10.3%), commoner in males (19.2%) compared with females (3.6%) (p < 0.001). Although the prevalence among Malays (19.8%) and Indians (13.2%) were higher compared with the Chinese (6.4%), this was not statistically significant. Sub-analysis showed Malay and Indian males had inappropriately higher prevalence rates of 21.6% and 33.3%. However, this was not statistically significant compared with Chinese males because of the small numbers of subjects. However, the difference between Indian and Malay males vs females subgroups in all 3 races were statistically significant. Multivariate analysis showed predictive factors for FL were male sex [odds ratio (OR) 0.178 ; 95% confidence interval (CI) 0.05–0.61], central obesity (OR 3.65, CI 1.17–11.40), body mass index (BMI) (OR 1.42, CI 1.20– 1.68) and family history of heart disease (OR 4.81, CI 1.15–20.11). Conclusions The prevalence of FL in our young population was not high. However, sub- analysis showed subgroups: Indian and Malay males with an alarmingly high prevalence rates in excess of 20%. Male sex, central obesity, BMI and family history of heart disease were found to be independent risk factors for FL. Racial and gender predilection points to the role of genetic factors in the pathogenesis of this disease. A high prevalence among young adults portends serious metabolic problems among Indian and Malay males. This has been borne out by the high prevalence of diabetes and CVS disease in both these races. Females in general appear to have a significant lower prevalence owing to the protec- tive effects of oestrogen in the premenopausal age. Future Shock— Fatty liver is common in young Malaysians N BAHAR, H RAZLAN, A VIJAYANANTHA N, KL GOH Division of Gastroenterology and Hepatology, Department of Radiology, University of Malaya, Kuala Lumpur Introduction Fatty liver (FL) is a common condition in the Asia- Pacific region. Increasingly its relationship to cirrhosis and hepatocellular carcinoma has been recognized. The condition is commonly detected in middle or later years of life. As it is a rapidly emerging disease, we were anxious to know if a young Malaysian adult population was affected by it. Objective To determine the prevalence and risk factors of FL in a young Malaysian population. Materials and Methods This was a cross- sectional study carried out on consecutive university students between 18 and 30 years from University Malaya. Subjects with significant amounts of alcohol consumption and history of liver diseases were excluded. All the students were subjected to a complete demographic, anthropometric and biochemical analyses fol- lowed by an abdominal ultrasound to look for FL. Results 243 subjects were recruited: 140 (57.6%) females and 103 (42.4%) males; mean age 22.51 ± 2.57; 96 (39.5%) Malays, 94 (38.7%) Chinese, 53 (21.8%) Indians. FL was diagnosed in 25 (10.3%), commoner in males (19.2%) compared with females (3.6%) (p < 0.001). Although the prevalence among Malays (19.8%) and Indians (13.2%) were higher compared with the Chinese (6.4%), this was not statistically significant. Sub-analysis showed Malay and Indian males had inappropriately higher prevalence rates of 21.6% and 33.3%. However, this was not statistically significant compared with Chinese males because of the small numbers of subjects. However, the difference between Indian and Malay males vs females subgroups in all 3 races were statistically significant. Multivariate analysis showed predictive factors for FL were male sex [odds ratio (OR) 0.178 ; 95% confidence interval (CI) 0.05–0.61], central obesity (OR 3.65, CI 1.17–11.40), body mass index (BMI) (OR 1.42, CI 1.20– 1.68) and family history of heart disease (OR 4.81, CI 1.15–20.11). Conclusions The prevalence of FL in our young population was not high. However, sub- analysis showed subgroups: Indian and Malay males with an alarmingly high prevalence rates in excess of 20%. Male sex, central obesity, BMI and family history of heart disease were found to be independent risk factors for FL. Racial and gender predilection points to the role of genetic factors in the pathogenesis of this disease. A high prevalence among young adults portends serious metabolic problems among Indian and Malay males. This has been borne out by the high prevalence of diabetes and CVS disease in both these races. Females in general appear to have a significant lower prevalence owing to the protec- tive effects of oestrogen in the premenopausal age. Future Shock—Fatty liver is common in young

Malaysians

N BAHAR, H RAZLAN, A VIJAYANANTHAN, KL GOH

Division of Gastroenterology and Hepatology, Department of Radiology, University of Malaya, Kuala Lumpur

Introduction Fatty liver (FL) is a common condition in the Asia-Paciﬁc region. Increasingly its relationship to cirrhosis and hepatocellular carcinoma has been recognized. The condition is commonly detected in middle or later years of life. As it is a rapidly emerging disease, we were anxious to know if a young Malaysian adult population was affected by it.

Objective To determine the prevalence and risk factors of FL in a young

Malaysian population.

Materials and Methods This was a cross-sectional study carried out on consecutive university students between 18 and 30 years from University

Malaya. Subjects with signiﬁcant amounts of alcohol consumption and history of liver diseases were excluded. All the students were subjected to a complete demographic, anthropometric and biochemical analyses fol- lowed by an abdominal ultrasound to look for FL.

Results 243 subjects were recruited: 140 (57.6%) females and 103

(42.4%) males; mean age 22.51 ± 2.57; 96 (39.5%) Malays, 94 (38.7%) Chinese, 53 (21.8%) Indians. FL was diagnosed in 25 (10.3%), commoner in males (19.2%) compared with females (3.6%) (p < 0.001). Although the prevalence among Malays (19.8%) and Indians (13.2%) were higher compared with the Chinese (6.4%), this was not statistically signiﬁcant.

Sub-analysis showed Malay and Indian males had inappropriately higher prevalence rates of 21.6% and 33.3%. However, this was not statistically signiﬁcant compared with Chinese males because of the small numbers of subjects. However, the difference between Indian and Malay males vs females subgroups in all 3 races were statistically signiﬁcant. Multivariate analysis showed predictive factors for FL were male sex [odds ratio (OR)

0.178 ; 95% conﬁdence interval (CI) 0.05–0.61], central obesity (OR 3.65,

CI 1.17–11.40), body mass index (BMI) (OR 1.42, CI 1.20–1.68) and family history of heart disease (OR 4.81, CI 1.15–20.11).

Conclusions The prevalence of FL in our young population was not high. However, sub-analysis showed subgroups: Indian and Malay males with an alarmingly high prevalence rates in excess of 20%. Male sex, central obesity, BMI and family history of heart disease were found to be independent risk factors for FL. Racial and gender predilection points to the role of genetic factors in the pathogenesis of this disease. A high prevalence among young adults portends serious metabolic problems among Indian and Malay males. This has been borne out by the high prevalence of diabetes and CVS disease in both these races. Females in general appear to have a signiﬁcant lower prevalence owing to the protec- tive effects of oestrogen in the premenopausal age.