OJEpi  Vol.9 No.4 , November 2019
Epidemiological Investigation of Fatty Liver Disease and Abnormal Liver Function in the Republic of Kazakhstan
Abstract: Aim: Little is known about the epidemiology of fatty liver disease (FLD) among high-risk primary care subjects in Kazakhstan. We investigated the prevalence of FLD (alcoholic liver disease [ALD] and non-alcoholic fatty liver disease [NAFLD]) and abnormal liver function tests (LFTs) in high risk adults in Kazakhstan during their routine visit to the general practitioner. Methods: This multicenter, cross-sectional epidemiological study was carried out at 75 clinical sites in the Republic of Kazakhstan. The full analysis set population consisted of 5109 subjects. Results: Among type 2 diabetes mellitus (T2DM) subjects, established metabolic syndrome (MetS) and/or obese subjects, the prevalence of FLD was 30.8%. LFT abnormalities were found in 53.2% subjects with FLD and 40.0% without FLD. FLD subjects had significantly higher levels of alanine transaminase (ALT; p < 0.001), aspartate transaminase (AST; p < 0.001), serum total bilirubin (STB; p < 0.001), and gamma-glutamyl transpeptidase (GGT; p = 0.021) compared to those without FLD. LFTs increases were significantly higher in subjects with FLD compared to those without FLD and were also significantly higher in ALD subjects compared to those with NAFLD. Conclusion: This study provides insights into the prevalence of FLD and abnormal LFTs in subjects with T2DM and/or established MetS and/or who are obese in primary care settings in Kazakhstan. These findings can help healthcare providers in Kazakhstan and elsewhere to better recognize and manage patients at risk of liver disease, which will improve clinical outcomes.
Cite this paper: Nersesov, A. , Raissova, A. , Kaibullayeva, J. , Jumabayeva, A. and Novitskaya, M. (2019) Epidemiological Investigation of Fatty Liver Disease and Abnormal Liver Function in the Republic of Kazakhstan. Open Journal of Epidemiology, 9, 309-320. doi: 10.4236/ojepi.2019.94022.

[1]   Armstrong, M.J., Houlihan, D.D., Bentham, L., Shaw, J.C., Cramb, R., Olliff, S., et al. (2012) Presence and Severity of Non-Alcoholic Fatty Liver Disease in a Large Prospective Primary Care Cohort. Journal of Hepatology, 56, 234-240.

[2]   Fan J.G. (2013) Epidemiology of Alcoholic and Nonalcoholic Fatty Liver Disease in China. Journal of Gastroenterology and Hepatology, 28, 11-17.

[3]   Paschos, P. and Paletas, K. (2009) Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome. Hippokratia, 13, 9-19.

[4]   Younossi, Z.M., Stepanova, M., Afendy, M., Fang, Y., Younossi, Y., Mir, H., et al. (2011) Changes in the Prevalence of the Most Common Causes of Chronic Liver Diseases in the United States from 1988 to 2008. Clinical Gastroenterology and Hepatology, 9, 524-530.e1.

[5]   Bayard, M., Holt, J. and Boroughs, E. (2006) Nonalcoholic Fatty Liver Disease. American Family Physician, 73, 1961-1968.

[6]   Jüngst, C., Berg, T., Cheng, J., Green, R.M., Jia, J., Mason, A.L., et al. (2013) Intrahepatic Cholestasis in Common Chronic Liver Diseases. European Journal of Clinical Investigation, 43, 1069-1083.

[7]   Anurag, L., Aniket, S., Shalik, J., Amarja, L., Dhananjay, R. and Sachin, J. (2015) Non-Alcoholic Fatty Liver Disease Prevalence and Associated Risk Factors—A Study from Rural Sector of Maharashtra. Tropical Gastroenterology, 36, 25-30.

[8]   Onyekwere, C.A., Ogbera, A.O., Samaila, A.A., Balogun, B.O. and Abdulkareem, F.B. (2015) Nonalcoholic Fatty Liver Disease: Synopsis of Current Developments. Nigerian Journal of Clinical Practice, 18, 703-712.

[9]   Ishii, H., Horie, Y., Yamagishi, Y. and Ebinuma, H. (2010) Alcoholic Liver Disease and Its Relationship with Metabolic Syndrome. Japanese Medical Association Journal, 53, 236-242.

[10]   Chiang, D.J. and McCullough, A.J. (2014) The Impact of Obesity and Metabolic Syndrome on Alcoholic Liver Disease. Clinical Liver Disease, 18, 157-163.

[11]   Kadyrova, R.Kh. and Salkhanov, B.A. (1990) The Prevalence of Obesity among the Adult Population of Kazakhstan. Voprosy Pitaniia, 1, 30-33.

[12]   Salkhanov, B.A. and Kadyrova, R.Kh. (1989) The Role of Nutritional Factors in the Development of Obesity among the Adult Residents of Kazakhstan. Voprosy Pitaniia, 4, 32-36.

[13]   Sikhayeva, N., Talzhanov, Y., Iskakova, A., Dzharmukhanov, J., Nugmanova, R., Zholdybaeva, E. and Ramanculov, E. (2018) Type 2 Diabetes Mellitus: Distribution of Genetic Markers in Kazakh Population. Clinical Interventions in Aging, 13, 377-388.

[14]   World Health Organization (2016) Kazakhstan Statistics Summary (2002-Present).

[15]   World Health Organization (2002) The World Health Report 2002-Reducing Risks, Promoting Healthy Life.

[16]   Kim, W.R., Brown Jr., R.S., Terrault, N.A. and El-Serag, H. (2002) Burden of Liver Disease in the United States: Summary of a Workshop. Hepatology, 36, 227-242.

[17]   European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO) (2016) EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. Obesity Facts, 9, 65-90.