Original articles
Alcohol use and alcoholic fatty liver disease: a prospective, communitybased study among adults in an urban community in Sri Lanka
Authors:
Madunil Anuk Niriella ,
University of Kelaniya, LK
About Madunil
Faculty of Medicine
Anuradhani Kasturiratne,
University of Kelaniya, LK
About Anuradhani
Faculty of Medicine
Thulani Beddage,
University of Kelaniya, LK
About Thulani
Faculty of Medicine
Shamila Thivanshi De Silva,
University of Kelaniya
About Shamila
Faculty of Medicine
Anuradha Supun Dassanayake,
University of Kelaniya, LK
About Anuradha
Faculty of Medicine
Arunasalam Pathmeswaran,
University of Kelaniya, LK
About Arunasalam
Faculty of Medicine
Ananda Rajitha Wickramasinghe,
University of Kelaniya, LK
About Ananda
Faculty of Medicine
Norihiro Kato,
National Center for Global Health and Medicine, Toyama, JP
Hithanadura Janaka de Silva
University of Kelaniya, LK
About Hithanadura
Faculty of Medicine
Abstract
Background: Data on alcoholic fatty liver (AFL) is limited. Therefore, we investigated alcohol use and AFL in a cohort of adults in an urban community in Sri Lanka.
Methods: 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>14 units, females >7 units per week) and absence of hepatitis B/C markers. Controls were unsafe alcohol consumers who had no fatty liver on ultrasound.
Results: 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]. Male gender [p<0.001], increased waist circumference (WC) [OR 4.9, p<0.01], 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%), meanage- 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 male gender was 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.
Conclusion: In this community-based study among adults from an urban community, unsafe alcohol use was found in 9.1%. Among unsafe alcohol users, the prevalence of AFL was 31.6% and the annual incidence of AFL was 7.7%. New-onset AFL was independently associated with male gender.
How to Cite:
Niriella, M.A., Kasturiratne, A., Beddage, T., De Silva, S.T., Dassanayake, A.S., Pathmeswaran, A., Wickramasinghe, A.R., Kato, N. and de Silva, H.J., 2022. Alcohol use and alcoholic fatty liver disease: a prospective, communitybased study among adults in an urban community in Sri Lanka. Ceylon Medical Journal, 67(2), pp.45–51. DOI: http://doi.org/10.4038/cmj.v67i2.9630
Published on
19 Oct 2022.
Peer Reviewed
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