Non-resolution of non-alcoholic fatty liver disease (NAFLD) among urban, adult Sri Lankans in the general population: A prospective, cohort follow-up study

Autoři: Madunil Anuk Niriella aff001;  Anuradhani Kasturiratna aff001;  Thulani Beddage aff001;  Dileepa Senajith Ediriweera aff001;  Shamila Thivanshi De Silva aff001;  K. Ruwan Perera aff002;  Chamila Erandaka Subasinghe aff002;  S Kuleesha Kodisinghe aff002;  T. Chathura Piyaratna aff002;  Vithiya Rishikesawan aff002;  Anuradha Supun Dassanayaka aff001;  Arjuna Priyadarshin De Silva aff001;  Arunasalam Pathmeswaran aff001;  Ananda Rajitha Wickramasinghe aff001;  Norihiro Kato aff003;  Hithanadura Janaka de Silva aff001
Působiště autorů: Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka aff001;  University Medical Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka aff002;  National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article



There are few studies investigating the natural course of non-alcoholic fatty liver disease (NAFLD) in the community. We assessed resolution of NAFLD in a general population cohort of urban Sri Lankans adults.


Participants were selected by age-stratified random sampling from electoral lists. They were initially screened in 2007 and re-evaluated in 2014. On both occasions structured interview, anthropometric-measurements, liver ultrasonography, and biochemical/serological tests were performed. NAFLD was diagnosed on ultrasound criteria for fatty liver, safe-alcohol consumption (<14-units/week for men, <7-units/week for women) and absence of hepatitis B/C markers. Non-NAFLD was diagnosed on absence of any ultrasound criteria for fatty liver and safe-alcohol consumption. Resolution of NAFLD was defined as absence of ultrasound criteria for fatty liver. Changes in anthropometric indices [Weight, Body-Mass-Index (BMI), waist-circumference (WC), waist-hip ratio (WHR)], clinical [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and biochemical measurements [Triglycerides (TG), High Density Lipoprotein (HDL), Total Cholesterol (TC), HbA1c%] at baseline and follow-up were compared.


Of the 2985 original study participants, 2148 (71.9%) attended follow-up after 7 years. This included 705 who had NAFLD in 2007 and 834 who did not have NAFLD in 2007. Out of 705 who had NAFLD in 2007, 11(1.6%) changed their NAFLD status due to excess alcohol consumption. After controlling for baseline values, NAFLD patients showed significant reduction in BMI, weight, WHR, HDL and TC levels and increase in HbA1c levels compared to non-NAFLD people. Despite this, none of them had complete resolution of NAFLD.


We did not find resolution of NAFLD in this general population cohort. The observed improvements in anthropometric, clinical and biochemical measurements were inadequate for resolution of NAFLD.

Klíčová slova:

Alcohol consumption – Anthropometry – Blood pressure – Fatty liver – Cholesterol – Physical activity – Ultrasound imaging – Weight loss


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2019 Číslo 10
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