Ibinaiye Philip Oluleke, Egbo Benjamin, Olarinoye-Akorede Adebanke, Igashi Bako Joseph, Baduku Tokan Silas, Usman Bello Omuya, Muhammad Manko, Ahmad Abdurrahman El-Fulaty, Tabari Musa Abdulkadir, Shettima Mustapha Kagu, Balogun Muhammed Shakir, Saleh Mohammed Kabir
Department of Radiology, Faculty of Clinical Sciences, Ahmadu Bello University/Ahmadu Bello University Teaching Hospital, Zaria. Nigeria.
Department of Radiology, Jos University Teaching Hospital, Jos, Nigeria.
Niger Med J. 2025 Apr 3;66(1):319-326. doi: 10.71480/nmj-v66i1.723. eCollection 2025 Jan-Feb.
Cryptogenic Steatotic Liver Disease (CSLD) is a novel subject where the liver has significant steatosis but without a known cause or abnormal cardiometabolic risk factors. Its aetiology and associations with sunlight exposure remain underexplored, particularly in Nigeria. CSLD is a growing public health concern in Nigeria, characterized by its potential progression to severe liver complications such as cirrhosis and liver cancer, posing significant health risks. This study aimed to determine the association between CSLD and the level of sun exposure.
This case-control study involved 181 healthy subjects with CSLD and an equal number of normal subjects without CSLD as controls. This made for a total number of 362 subjects. They were recruited into the study consecutively as they emerged after clinical, laboratory, and imaging screenings. A liver ultrasound scan was done using a 3.5MHz frequency transducer to screen for the steatotic liver. The severity of liver steatosis was evaluated by ultrasound bright liver scores (BLS). A daily sun exposure score based on our local pattern was calculated using the information from the administered questionnaire. The data were analyzed with GraphPad Prism software version 6.
the median (IQR) age of CSLD and control groups were 44.0 (28.5 - 54.0) and 44.0 (30.0 - 55.0) years. Wilcoxon matched pairs signed rank comparison test showed no significant difference in the ages of the two study groups ( = 0.5578), indicating age matching of the study participants. There was a significant association (χ = 59.03, df = 18, < 0.0001) between age and development of CSLD. One hundred and eighty-one study subjects with CSLD comprised 83 (45.8%) males and 98 (54.1%) females.The median (IQR) values of the control group's sun exposure score differed significantly from those of the CSLD groups ( = 0.0001) for all categories (mild, moderate, severe steatosis). A multivariate logistic regression analysis model, weighted by years of age and sex, revealed that low sunlight exposure is a significant independent risk factor.
The study shows that limited sun exposure is significantly associated with developing CSLD among Nigerians in Zaria. There is also a significant independent risk factor.
隐源性脂肪性肝病（CSLD）是一个新课题，即肝脏有显著脂肪变性但无已知病因或异常的心脏代谢风险因素。其病因及与阳光照射的关联仍未得到充分研究，尤其是在尼日利亚。CSLD在尼日利亚正成为一个日益严重的公共卫生问题，其特点是有可能进展为肝硬化和肝癌等严重肝脏并发症，带来重大健康风险。本研究旨在确定CSLD与阳光照射水平之间的关联。
本病例对照研究纳入了181名患有CSLD的健康受试者以及同等数量无CSLD的正常受试者作为对照。这样总共有362名受试者。他们在经过临床、实验室和影像学筛查后陆续被纳入研究。使用3.5MHz频率的换能器进行肝脏超声扫描以筛查脂肪性肝病。通过超声肝脏明亮度评分（BLS）评估肝脏脂肪变性的严重程度。根据所管理问卷中的信息，按照当地模式计算每日阳光照射得分。数据使用GraphPad Prism 6软件版本进行分析。
CSLD组和对照组的年龄中位数（四分位间距）分别为44.0（28.5 - 54.0）岁和44.0（30.0 - 55.）岁。Wilcoxon配对符号秩和比较检验显示两个研究组的年龄无显著差异（P = 0.5578），表明研究参与者年龄匹配。年龄与CSLD的发生之间存在显著关联（χ² = 59.03，自由度 = 18，P < 0.0001）。181名患有CSLD的研究受试者中，男性83名（45.8%），女性98名（54.1%）。对照组阳光照射得分的中位数（四分位间距）在所有类别（轻度、中度、重度脂肪变性）中与CSLD组均有显著差异（P = 0.0001）。一个按年龄和性别加权的多因素逻辑回归分析模型显示，低阳光照射是一个显著的独立风险因素。
该研究表明，在扎里亚的尼日利亚人中，阳光照射有限与患CSLD显著相关。这也是一个显著的独立风险因素。
