Dassanayake Anuradha S
Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
Euroasian J Hepatogastroenterol. 2018 Jan-Jun;8(1):69-72. doi: 10.5005/jp-journals-10018-1263. Epub 2018 May 1.
Nonalcoholic fatty liver disease (NAFLD) is becoming one of the most important causes for chronic liver disease and also hepatocellular carcinoma (HCC) in Sri Lanka. This tendency is also recognized worldwide. More than half of the middle-aged and elderly adults in urban Sri Lanka have ultrasonic evidence of NAFLD. The NAFLD is also identified in population from rural areas of Sri Lanka and also in children. Nonalcoholic steatohepatitis (NASH) cirrhosis is the most common cause of referral for liver transplantation in Sri Lankans. The NASH is also the most common cause for rejecting potential donors for liver transplantation in Sri Lanka. Patients who underwent liver transplantation for cryptogenic cirrhosis developed evidence of NASH following liver transplantation. Recent evidence suggests that there is a genetic component to NAFLD. PNPLA3, a single gene polymorphism linked to the short arm of chromosome 22, is associated with the severity of NAFLD. The presence of this genetic polymorphism appears to carry higher risk of patients with NAFLD developing NASH with fibrosis cirrhosis and hepatocellular carcinoma. In a large population-based study from Sri Lanka, there was a tendency to develop NAFLD associated with this genetic polymorphism. In a population-based study, NAFLD was identified as an independent risk factor for development of diabetes. This association is recognized worldwide now. Most patients with HHC in Sri Lanka developed it on a back ground of cryptogenic cirrhosis. At the same time, the prevalence of the markers for hepatitis B and C was rare in Sri Lankan patients with HCC. Dassanayake AS. Nonalcoholic Fatty Liver Disease: Identifying the Disease Burden in Sri Lanka. Euroasian J Hepato-Gastroenterol 2018;8(1):69-72.
非酒精性脂肪性肝病（NAFLD）正成为斯里兰卡慢性肝病以及肝细胞癌（HCC）的最重要病因之一。这种趋势在全球范围内也得到认可。斯里兰卡城市地区超过一半的中老年人有NAFLD的超声证据。NAFLD在斯里兰卡农村地区的人群以及儿童中也有发现。非酒精性脂肪性肝炎（NASH）肝硬化是斯里兰卡人肝移植转诊的最常见原因。NASH也是斯里兰卡肝移植潜在供体被拒绝的最常见原因。因隐源性肝硬化接受肝移植的患者在肝移植后出现了NASH的证据。最近的证据表明，NAFLD存在遗传因素。PNPLA3是一种与22号染色体短臂相关的单基因多态性，与NAFLD的严重程度有关。这种基因多态性的存在似乎使NAFLD患者发生NASH伴纤维化肝硬化和肝细胞癌的风险更高。在斯里兰卡一项基于大规模人群的研究中，存在与这种基因多态性相关的发生NAFLD的倾向。在一项基于人群的研究中，NAFLD被确定为糖尿病发生的独立危险因素。这种关联现在在全球范围内都得到了认可。斯里兰卡大多数HHC患者是在隐源性肝硬化的背景下发病的。与此同时，在斯里兰卡HCC患者中，乙肝和丙肝标志物的患病率很低。Dassanayake AS。非酒精性脂肪性肝病：确定斯里兰卡的疾病负担。《欧亚肝脏胃肠病学杂志》2018年；8(1):69 - 72。
