Incidence of Non-alcoholic Fatty Liver Disease (NAFLD)/Non-alcoholic Steatohepatitis (NASH) in the Female Population of North Karnataka: A Cross-Sectional Study

Background: India is currently facing an epidemic of type 2 diabetes mellitus (T2DM) and obesity which are high-risk factors for the development of non-alcoholic fatty liver disease (NAFLD). A non-invasive tool, the vibration-controlled transient elastography (VCTE; FibroScan, Echosens, Paris, France) is used to diagnose NAFLD. Aim: To identify the prevalence, spectrum, and metabolic determinants of NAFLD in Indian adult women using liver function tests (LFT) and non-invasive FibroScan (liver stiffness measure, i.e., LSM score) of the liver through a cross-sectional population-based study in the city of Belagavi. Methods: The subjects were screened for the presence of liver disease with a detailed history, anthropometric measurements, LFTs, blood sugars, and FibroScan of the liver to assess liver steatosis and liver fibrosis. Results: The study included 2448 women with 860 (35.13%) having NAFLD (controlled attenuation parameter {CAP}≥275 dB/m) as detected by FibroScan. Nearly, 58.8% of the participants with T2DM had NAFLD. Participants with NAFLD had higher BMI and waist circumference. When univariate logistic regression was applied, those with T2DM were 14.5 times (95% CI, 4.55, 6.52) likely to have CAP≥275 dB/m. Similarly, those with higher BMI>23 mg/m2 were 1.34 (95% CI, 1.68, 2.37) times more likely to have CAP ≥275 dB/m. The risk of NAFLD increases by ~1% for every one-year increase in age. Conclusion: NAFLD in women is the most common non‑communicable disease in India; a prevalence of 35.13% was observed in the present study in women. Higher BMI, presence of metabolic risk factors, and incremental age were associated with a high risk of developing NAFLD in women.