Hepatic steatosis is associated with anthropometry, cardio-metabolic disease risk, sex, age and urbanization, but not with ethnicity in adult Kenyans.
Tropical medicine & international health : TM & IH 2021
Kastberg SE, Lund HS, de Lucia-Rolfe E, Kaduka LU, Boit MK, Corpeleijn E, Friis H, Bernard S, Paquette M, Baas A, Rasmussen JJ, and Christensen DL
DOI : 10.1111/tmi.13696
PubMed ID : 34704339
We aimed to determine the associations of non-alcoholic fatty liver disease (NAFLD) with cardio-metabolic risk factors for diabetes in adult Kenyans.
A cross-sectional study was undertaken among rural and urban Kenyans of different ethnic origin. Ultrasonography scanning (USS) methods were used for the assessment of hepatic fat accumulation for NAFLD assessment and abdominal fat distribution, and simple anthropometry measurements were performed. All participants underwent a 2-h oral glucose tolerance test, and biochemical, haemodynamic and lifestyle data were obtained. Multivariate logistic regression analyses were used to assess sex, age, residency and ethnic differences in the association between NAFLD and various metabolic parameters.
In total, 743 individuals (59.1% women) with a mean age of 38.0 (range 18-68) years participated in the study. Overall, 118 individuals (15.9%) had NAFLD, of whom 94.1% had mild steatosis. Age >40 years was significantly associated with having NAFLD compared to <30 years of no difference found in NAFLD between ethnic groups (Luo, Kamba, Maasai). All body composition and clinical measurements were associated with NAFLD (p<0.045 for OR).
Finding lower odds for NAFLD in men was unexpected, as was the lack of differences in NAFLD among the ethnic groups, while higher odds for NAFLD with increasing age and in urban vs. rural populations was expected. Especially the sex-specific results warrant further studies in black African populations on biology of body composition for having NAFLD, and whether this translates into insulin resistance and higher risk of diabetes and consequently cardiovascular disease in black African women.
Liver fat accumulation (non-alcoholic fatty liver disease) is associated with obesity, especially abdominal obesity. It is also associated with risk factors for cardiovascular disease such as diabetes, hypertension and high cholesterol levels in the blood.
In sub-Saharan Africa, little is known about liver fat accumulation, and the association with obesity levels and risk factors for cardiovascular disease.
Thus, we studied ~750 adults from different ethnic groups in rural and urban Kenya using ultrasound scanning in order to determine liver fat accumulation and its association with cardiovascular disease risk factors. Apart from the proportion (prevalence) of individuals with liver fat accumulation, we wanted to assess differences by sex (women vs. men), age, residency (rural vs. urban), and ethnic groups (Luo, Kamba, Maasai).
We found a prevalence of liver fat accumulation of ~16% in the largest study so far on this topic in sub-Saharan African populations. The most important result was our finding of higher odds of having liver fat accumulation in women vs. men, which is in contrast to the vast majority of studies on sex-differences for accumulating liver fat published in the scientific literature.
Future studies in sub-Saharan African populations should focus on sex-differences in liver fat accumulation, and whether women may be at higher risk of diabetes, hypertension, high cholesterol levels and cardiovascular disease as the proportion of these metabolic disorders keep increasing with economic development in sub-Saharan African countries.