Fatty Liver (cont.)
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What are the estimated numbers of cases of NAFLD and NASH?
As could be
expected, primary NAFLD is observed principally in developed countries. In these
societies, a sedentary lifestyle and high calorie, sugar, and fat diets lead to
DM2 and obesity.
Thus, in developed countries, the overall prevalence of NAFLD in the
population is estimated to be approximately 20%, and that of NASH 3%. The
prevalence of each is presumably much higher in obese and diabetic persons. The
reason for this presumption is that upwards of 55% of patients with NASH have
DM2 and 95% are obese. Thus, the prevalence of simple fatty liver in obese
persons can be estimated to be approximately 90% and that of NASH in obese
persons to be 20%. NASH is typically a disease of middle-aged overweight women
with predominantly central (abdominal) fat distribution. However, there are also
increasing reports of NASH related to obesity in men and even in pediatric
populations.
The Center for Disease Control
reports that currently, approximately one half of the US adultpopulationisoverweight (BMI>25) and one quarter
of the US adult populationisobese(BMI>30). Projecting the prevalence of NAFLD and
NASH in the obese subpopulation to the entire population would suggest that
upwards of 29 million Americans have NAFLD and 6.4 million of these persons have
NASH.
These estimates, however, are very general. Another way to guesstimate is to
study the relationship between the BMI and elevated liver enzymes (serum
transaminases). You see, elevated transaminases can be caused by NAFLD in obese
individuals. Thus, as compared to a normal BMI of less than or equal to 25, the
risk of having elevated transaminases for men is roughly 2 times greater for a
BMI of 25-30, 4 times greater for a BMI of 30-35, 5 times greater for a BMI of
35-40, and 6 times greater for a BMI greater than 40. For women, the risk is 2
times greater for a BMI of 25-30, 2.5 times greater for a BMI of 30-35, 4 times
greater for a BMI of 35-40, and 5 times greater for a BMI greater than 40.
The bottom line is that currently, NAFLD is the most prevalent liver disease
in the Unites States, representing an estimated 24% of cases of liver disease.
Next: What causes NAFLD and NASH? »
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