The Changing Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) in Turkey in the Last Decade

Abstract

Background: The true prevalence of non-alcoholic fatty liver disease (NAFLD) is unknown in Turkey due to a lack of population-based studies. The aim of this study was (i) to determine the overall and region-specific prevalence of NAFLD in Turkey

(ii) to analyze the factors associated with the prevalence

and (iii) to determine the nationwide change in the prevalence of NAFLD in the last decade. Methods: The 10-year data (2007-2016) of 113 239 apparently healthy subjects visiting the check-up clinics of Acibadem Hospitals Group were retrospectively analyzed. A subgroup of patients (n=8120) statistically representing the bigger cohort was selected. The prevalence was analyzed according to ultrasound findings, age, sex, body mass index (BMI), geographical region, and time periods trisected as 2007-2010, 2011-2013, and 2014-2016. Results: The overall prevalence of NAFLD in Turkey was found to be 48.3\%. It was highest among people >50 years of age (65.6\%), male sex (64.0\%), with a BMI>25 kg/m(2) (63.5\%), and in Central and Eastern Anatolia regions (57.1\% and 55.7\%, respectively). The prevalence of NAFLD was 43.5\% between 2007 and 2010, 47.6\% between 2011 and 2013, and 53.1\% between 2014 and 2016, and the rate of increase was 22\%. Multivariate analysis showed that male sex serum alanine aminotransferase level, older age, BMI, type-II diabetes mellitus, hypertension, and dyslipidemia were independent factors associated with NAFLD. Conclusion: NAFLD is a highly prevalent disease affecting almost half of the Turkish population (48.3\%). We are faced with a dramatic increase in NAFLD prevalence in the past 10 years.