Skip to main content

Advertisement

Log in

Prevalence and risk factors of non-alcoholic fatty liver disease in a multiracial suburban Asian population in Malaysia

  • Original Article
  • Published:
Hepatology International Aims and scope Submit manuscript

Abstract

Background

The prevalence of non-alcoholic fatty liver disease (NAFLD) in the Malaysian population is not known. Malaysia has a multiracial Asian population with three major Asian races: Malay, Chinese, and Indian living together. The aim of the study is to determine the prevalence and risk factors in a suburban Malaysian population.

Methods

Consecutive subjects who came for a health checkup at a suburban medical facility were recruited for the study. All individuals had clinical assessments, anthropometric measurements, blood tests, and ultrasonography of the liver performed. Those with significant alcohol consumption and history of chronic liver disease were excluded.

Results

Of the 1,621 “health screened” individuals analyzed, 368 (22.7 %) were found to have NAFLD. They comprised Chinese 1,269 (78.3 %), Malay 197 (12.1 %), and Indian 155 (9.6 %). Males and “older” age group ≥45 years had high prevalence rates with the highest in Indian (68.2 %) and Malay (64.7 %) males. Chinese females <45 years had the lowest prevalence of 5.2 %. A significant increase in the prevalence of fatty liver between age <45 years and ≥45 years was seen in female of all three races but in male, this increase was seen only among the Indians. NAFLD was strongly associated with diabetes mellitus, glucose intolerance, body mass index ≥23, low high-density lipoprotein cholesterol, hypertriglyceridemia, and hypertension.

Conclusion

NAFLD is common in suburban Malaysian population. Older Indian and Malay males have an inordinately high prevalence of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ludwig J, Viggiano TR, McGill DB, et al. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc. 1980;55:434–8.

    CAS  PubMed  Google Scholar 

  2. Bellentani S, Saccoccio G, Masutti F, et al. Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med. 2000;132:112–7.

    Article  CAS  Google Scholar 

  3. Browning JD, Szczepaniak LS, Dobbins R, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004;40:1387–95.

    Article  Google Scholar 

  4. Clark JM. The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol. 2006;40:S5–10.

    PubMed  Google Scholar 

  5. Yoshiike N, Seino F, Tajima S, et al. Twenty-year changes in the prevalence of overweight in Japanese adults: the National Nutrition Survey 1976–1995. Obes Rev. 2002;3:183–90.

    Article  CAS  Google Scholar 

  6. Gu D, Reynolds K, Wu X, et al. Prevalence of the metabolic syndrome and overweight among adults in China. Lancet. 2005;365:1398–405.

    Article  Google Scholar 

  7. Huang KC. Obesity and its related diseases in Taiwan. Obes Rev. 2008;9(Suppl 1):32–4.

    Article  Google Scholar 

  8. Ding EL, Malik VS. Convergence of obesity and high glycemic diet on compounding diabetes and cardiovascular risks in modernizing China: an emerging public health dilemma. Global Health. 2008;4:4.

    Article  Google Scholar 

  9. Cheng TO. Rising prevalence of diabetes in China. J Natl Med Assoc. 2003;95:1115–6.

    PubMed  PubMed Central  Google Scholar 

  10. Chan JC, Ng MC, Critchley JA, et al. Diabetes mellitus—a special medical challenge from a Chinese perspective. Diabetes Res Clin Pract. 2001;54(Suppl 1):S19–27.

    Article  Google Scholar 

  11. Farrell GC. Non-alcoholic steatohepatitis: what is it, and why is it important in the Asia-Pacific region? J Gastroenterol Hepatol. 2003;18:124–38.

    Article  Google Scholar 

  12. Chitturi S, Wong VW, Farrell G. Nonalcoholic fatty liver in Asia: firmly entrenched and rapidly gaining ground. J Gastroenterol Hepatol. 2011;26(Suppl 1):163–72.

    Article  Google Scholar 

  13. Omagari K, Kadokawa Y, Masuda J, et al. Fatty liver in non-alcoholic non-overweight Japanese adults. Incidence and clinical characteristics. J Gastroenterol Hepatol. 2002;17:1098–105.

    Article  Google Scholar 

  14. Fan JG, Zhu J, Li XJ, et al. Prevalence of, and risk factors for, fatty liver in a general population of Shanghai, China. J Hepatol. 2005;43:508–14.

    Article  Google Scholar 

  15. Jimba S, Nakagami T, Takahashi M, et al. Prevalence of non-alcoholic fatty liver disease and its association with impaired glucose metabolism in Japanese adults. Diabet Med. 2005;22:1141–5.

    Article  CAS  Google Scholar 

  16. Park SH, Jeon WK, Kim SH, et al. Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol. 2006;21:138–43.

    Article  Google Scholar 

  17. Chen CH, Huang MH, Yang JC, et al. Prevalence and risk factors of non-alcoholic fatty liver disease in an adult population of Taiwan: metabolic significance of non-alcoholic fatty liver disease in non-obese adults. J Clin Gastroenterol. 2006;40:745–52.

    Article  CAS  Google Scholar 

  18. Zhou YJ, Li YY, Nie YQ, et al. Prevalence of fatty liver disease and its risk factors in the population of South China. World J Gastroenterol. 2007;13:6419–24.

    Article  Google Scholar 

  19. Amarapurkar D, Kamani P, Patel N, et al. Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6:161–3.

    PubMed  Google Scholar 

  20. Dassanayake AS, Kasturiratne A, Rajindrajith S, et al. Prevalence and risk factors for non-alcoholic fatty liver disease among adults in an urban Sri Lankan population. J Gastroenterol Hepatol. 2009;24:1284–8.

    Article  Google Scholar 

  21. Farrell GC, Chitturi S, Lau GK, et al. Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region: executive summary. J Gastroenterol Hepatol. 2007;22:775–7.

    Article  Google Scholar 

  22. Khalid BA, Usha R, Ng ML, et al. Prevalence of diabetes, hypertension and renal disease amongst railway workers in Malaysia. Med J Malaysia. 1990;45:8–13.

    CAS  PubMed  Google Scholar 

  23. Khebir BV, Osman A, Khalid BA. Changing prevalence of diabetes mellitus amongst rural Malays in Kuala Selangor over a 10 year period. Med J Malaysia. 1996;51:41–7.

    CAS  PubMed  Google Scholar 

  24. Rampal L, Rampal S, Khor GL, et al. A national study on the prevalence of obesity among 16,127 Malaysians. Asia Pac J Clin Nutr. 2007;16:561–6.

    PubMed  Google Scholar 

  25. Malik A, Cheah PL, Hilmi I, et al. Non-alcoholic fatty liver in Asians: a demographic, anthropometric, biochemical and histological study. J Dig Dis. 2007;8:58–64.

    Article  CAS  Google Scholar 

  26. Department of Statistics, Malaysia (2012) http://www.statistics.gov.my. Cited January 20, 2012.

  27. Health Communications Australia. The Asia-Pacific perspective: redefining obesity and its treatment. Melbourne: Health Communications Australia; 2000.

    Google Scholar 

  28. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC7 report. JAMA. 2003;289:2560–72.

    Article  CAS  Google Scholar 

  29. Fan JG, Saibara T, Chitturi S, et al. What are the risk factors and settings for non-alcoholic fatty liver disease in Asia-Pacific? J Gastroenterol Hepatol. 2007;22:794–800.

    Article  Google Scholar 

  30. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications—part 1: diagnosis and classification of diabetes mellitus. Geneva: World Health Organization; 1999. p. 20–1.

    Google Scholar 

  31. Khoo KL, Tan H, Khoo TH. Cardiovascular mortality in Peninsular Malaysia: 1950–1989. Med J Malaysia. 1991;46:7–20.

    CAS  PubMed  Google Scholar 

  32. Hughes K, Lun KC, Yeo PP. Cardiovascular disease in Chinese Malays and Indian in Singapore: difference in mortality. J Epidemiol Community Health. 1990;44:24–8.

    Article  CAS  Google Scholar 

  33. Danaraj TJ, Acker MS, Danaraj W, et al. Ethnic group differences in coronary heart disease in Singapore: an analysis of necropsy records. Am Heart J. 1959;58:516–26.

    Article  CAS  Google Scholar 

  34. Lee J, Heng D, Chia KS, et al. Risk factors and incident coronary heart disease in Chinese, Malay and Asian Indian males: the Singapore Cardiovascular Cohort Study. Int J Epidemiol. 2001;30(5):983–8.

    Article  CAS  Google Scholar 

  35. Mak KH, Chia KS, Kark JD, et al. Ethnic differences in acute myocardial infarction in Singapore. Eur Heart J. 2003;24:151–60.

    Article  Google Scholar 

  36. Wilkinson P, Sayer J, Laji K, et al. Comparison of case fatality in South Asians and White patients after acute myocardial infarction. BMJ. 1996;312:1330–3.

    Article  CAS  Google Scholar 

  37. Ismail MN, Chee SS, Nawawi H, et al. Obesity in Malaysia. Obes Rev. 2002;3:203–8.

    Article  CAS  Google Scholar 

  38. Rampal S, Rampal L, Rahmat R, et al. Variation in the prevalence, awareness, and control of diabetes in a multiethnic population: a nationwide population study in Malaysia. Asia Pac J Public Health. 2010;22:194–202.

    Article  Google Scholar 

Download references

Conflict of interest

This study did not receive any source of external funding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Khean-Lee Goh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Goh, SC., Ho, E.LM. & Goh, KL. Prevalence and risk factors of non-alcoholic fatty liver disease in a multiracial suburban Asian population in Malaysia. Hepatol Int 7, 548–554 (2013). https://doi.org/10.1007/s12072-012-9359-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12072-012-9359-2

Keywords

Navigation