Faculty of Medicine, University of Kelaniya, Sri Lanka.
National Center for Global Health and Medicine, Toyama, Japan.
Ceylon Med J. 2022 Jun 30;67(2):45-51. doi: 10.4038/cmj.v67i2.9630.
Data on the alcoholic fatty liver (AFL) is limited. Therefore, we investigated alcohol use and AFL patterns among urban, adult Sri Lankans.
The study population (selected by age-stratified random sampling) was screened in 2007 (35-64 years) and re-evaluated in 2014. They were assessed by structured interviews, anthropometric measurements, liver-ultrasound, and biochemical and serological tests. AFL was diagnosed on ultrasound criteria, 'unsafe' alcohol consumption (Asian standards: males>14units, females>7units per week) and absence of hepatitis B/C markers. Controls were unsafe alcohol consumers who had no fatty liver on ultrasound.
2985/3012 (99%) had complete data for analysis. 272/2985 (9.1%) were unsafe-drinkers in 2007 [males-270; mean-age-51.9, SD-8.0 years]. 86/272 (31.6%) had AFL [males-85; mean-age-50.2, SD-8.6 years]. Males [p<0.001], increased waist circumference (WC) [OR 4.9, p<0.01] and BMI>23kg/m2 [OR 3.5, p<0.01] and raised alanine aminotransferase (ALT) [OR 2.8, p<0.01] were independently associated with AFL. 173/272 (63.6%) unsafe alcohol consumers from 2007 were re-evaluated in 2014. 134/173 had either had AFL or had changed to 'safe' or no alcohol consumption. 21/39 (53.8%) [males-21 (100%), mean-age-57.9, SD-7.9 years] who remained 'unsafe' alcohol users who had no fatty liver in 2007 developed AFL after 7-years (annual incidence 7.7%). On bivariate analysis, only males were associated with new-onset AFL. Of the 42 who had AFL at baseline but changed their drinking status from unsafe to safe or no alcohol, 6 had resolution of fatty liver in 2014.
In conclusion, in this community-based study among urban Sri Lankan adults, the annual incidence of AFL among unsafe alcohol users was 7.7%. Furthermore, new-onset AFL was associated with males.
关于酒精性脂肪肝（AFL）的数据有限。因此，我们调查了城市成年斯里兰卡人的饮酒和 AFL 模式。
研究人群（通过年龄分层随机抽样选择）于 2007 年（35-64 岁）进行筛查，并于 2014 年重新评估。他们通过结构化访谈、人体测量、肝脏超声以及生化和血清学检查进行评估。AFL 根据超声标准、“不安全”饮酒（亚洲标准：男性>14 单位，女性>7 单位/周）和无乙型肝炎/丙型肝炎标志物来诊断。对照组为超声检查无脂肪肝的不安全饮酒者。
2985/3012（99%）人有完整的数据进行分析。2007 年，272/2985（9.1%）人是不安全饮酒者[男性 270 人；平均年龄 51.9 岁，标准差 8.0 岁]。86/272（31.6%）人患有 AFL[男性 85 人；平均年龄 50.2 岁，标准差 8.6 岁]。男性（p<0.001）、腰围增加（WC）（OR 4.9，p<0.01）和 BMI>23kg/m2（OR 3.5，p<0.01）以及丙氨酸氨基转移酶（ALT）升高（OR 2.8，p<0.01）与 AFL 独立相关。2007 年的 272 名不安全饮酒者中有 173 人在 2014 年重新评估。173 人中，134 人要么患有 AFL，要么改变为“安全”或不饮酒。39 人中的 21 人（53.8%）[男性 21 人（100%）；平均年龄 57.9 岁，标准差 7.9 岁]仍为“不安全”饮酒者，2007 年无脂肪肝，7 年后（年发病率 7.7%）发生 AFL。在单变量分析中，只有男性与新发 AFL 相关。在基线时患有 AFL 但将饮酒状态从不安全改为安全或不饮酒的 42 人中，有 6 人在 2014 年脂肪肝缓解。
综上所述，在这项针对城市成年斯里兰卡人的基于社区的研究中，不安全饮酒者的 AFL 年发病率为 7.7%。此外，新发 AFL 与男性有关。
