Introduction: The term fatty liver covers a range of pathological changes. The basic entity comprising fatty liver is fat deposition within hepatocytes, also known as steatosis. Hepatic steatosis can be seen in many settings related to alcohol, chronic hepatitis C, and Wilson’s disease. Many drugs can also produce hepatic steatosis; steroids, tamoxifen, and amiodarone are among the most frequent offenders. The commonest cause of steatosis is non-alcoholic fatty liver disease (NAFLD) not associated with any of the above situations, and the rest of this article will concentrate on this condition. NAFLD describes a spectrum of pathological changes in the liver ranging from fat alone (steatosis), through non-alcoholic steatohepatitis (NASH), to what has in the past been labeled as cryptogenic cirrhosis. NAFLD is recognized as being increasingly common in the Western world, concomitant with the risk factors for this condition – obesity, hyperlipidemia, and type II diabetes mellitus in particular. In the UK 4% of the population has abnormal liver function tests, of which around half are thought to relate to NAFLD. Data from autopsies in the USA suggest a prevalence of 6.3%, with the condition found in 7–11% of liver biopsies in North America, as compared to a much lower incidence in Japan (Reid, 2001). Incidence increases with age, and with the emerging epidemic of obesity, it is felt that the prevalence of NAFLD will significantly rise. Most commonly, NAFLD is asymptomatic. If symptoms are present, those most frequently described include lethargy and mild right upper quadrant discomfort. There are usually no specific abnormal signs on examination in NAFLD. The most frequently observed abnormal finding is hepatomegaly. Spider naevi has been described, and splenomegaly in up to 25% of cases. The presence of splenomegaly is unexplained, as it is not a sign of portal hypertension in the majority of these patients.
Methods: Three hundred and eight (mean age 21.72 ± 3.71 years) NAFLD patients were included in the study. After baseline anthropometric measurement i.e., body mass index (BMI), and waist circumference (WC); we assessed markers of NAFLD including an ultrasound scan (USS) determined fatty liver. Healthy and Western dietary patterns were identified using factor analysis and all participants received a z-score for these patterns. Prospective associations between the dietary pattern scores and risk of NAFLD were analyzed using multiple logistic regression.
Results: NAFLD was present in 21.7 % of adolescents. A higher BMI, a higher Waist, a lower daily hours of sleep, a lower No. of meals/day, a lower AMDA, a higher grams of alcohol, a higher No. of cigarettes, smoking/per day, and a lower Cup of coffee/per day were associated with a greater risk of NAFLD in adolescents. However, healthy daily habits in adolescents appeared protective against NAFLD, whereas unhealthy daily habits were associated with an increased risk of NAFLD.
Conclusion: Daily habits of adolescents in a general population sample were associated with an increased risk of NAFLD, particularly in obese adolescents. In this study, we assessed liver health using USS to determine the presence of fat in the liver. There were no known cases of liver disease in this cross-sectional study and we didn’t remove the number of participants who had reported consistent harmful drinking. Therefore, it is reasonable to assume that in our cross-sectional, USS-determined fatty liver is likely to represent NAFLD. The aim of our study was firstly to examine the associations of NAFLD with daily habits and secondly to consider whether these associations are confounded by daily habits. The results demonstrate that for USS determined NAFLD there were positive associations with daily habits.