Perceptions of non-alcoholic fatty liver disease–an Asian community-based study

Background and Aims:Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease and is closely related to metabolic syndrome and its risk factors.Worldwide,epidemiological studies have reported NAFLD prevalence rates of 5%to 30%depending on geographical variations.While epidemiological data suggest a progressively increasing prevalence of metabolic risk factors in Singapore,there are limited data about NAFLD per se in the community.We aim to explore the prevalence and perceptions of NAFLD in Singapore.Methods:Attendees at a gastroenterology public forum were enrolled in a cross-sectional observational study evaluating demographic,anthropometric and clinical information.The diagnosis of NAFLD was based on sonographic criteria.Metabolic syndrome was defined according to International Diabetes Federation guidelines.Perceptions of NAFLD were explored using a self-administered survey questionnaire.Results:A total of 227 subjects were recruited,with NAFLD being diagnosed in 40%of the cohort.Relative to those without NAFLD,subjects with NAFLD had higher male preponderance,older age,higher body mass index,waist circumference and more metabolic syndrome(all P<0.05).Although 71.2%subjects had heard about NAFLD before,only 25.4%of them felt that they were at risk of NAFLD.Comparable responses were observed in subjects with no metabolic risk factors relative to subjects with one or more metabolic risk factors(P>0.05).Of note,75.6%of subjects with one or more metabolic risk factors did not think that they were at risk of NAFLD.Conclusion:Our study suggests a significant local prevalence of NAFLD in the community including non-obese individuals.Considering the tendency to underestimate risk of NAFLD,enhanced public education about NAFLD is warranted to improve understanding.