Prevalence of hepatic steatosis as diagnosed on unenhanced abdominal computed tomography

Abstract

Background/Objectives: The prevalence of non-alcoholic fatty liver disease (NAFLD) has been found to be lower in the African American population when compared to European American or Hispanics, even after controlling for obesity and insulin resistance. The prevalence of hepatic steatosis in the local population is unknown. No studies looking at the association between metabolic syndrome and non-alcoholic fatty liver disease have been done in the local population. The aim of this study is to determine the prevalence of hepatic steatosis in patients undergoing unenhanced abdominal Computed Tomography (CT) at Aga Khan University Hospital, Nairobi

Subjects/Methods: A cross-sectional analytical study of resident indigenous African patients undergoing an unenhanced CT abdomen at Aga Khan University Hospital, Nairobi’s (AKUHN) Radiology department. Data from 246 patients who meet the inclusion and exclusion criteria was collected. Metabolic syndrome was diagnosed using the WHO definition.

Results: Of the 246 patients, 39.3% were female and 60.7% were male. Only 77 patients consented to undergo testing for fasting lipid profile. This limited the number of patients who could be diagnosed with metabolic syndrome. Out of the 246 patients, 33 had hepatic steatosis giving a prevalence of 13.4%, at a P value of 0.05 and a confidence interval of 9.0 to 17.8.Although a large number of people reported occasional/social alcohol intake, only 10 patients had alcohol uptake threshold meeting the criteria used. The causes of hepatic steatosis were mainly attributable to non-alcoholic fatty liver disease; only 2.5% had hepatic steatosis due to alcohol consumption. Obesity was found to be a strong risk factor for hepatic steatosis and patients with elevated BMI were up to 4 times more likely to have hepatic steatosis. Diabetes was also found to be a strong risk factor for hepatic steatosis, diabetics were 3 times more likely to have steatosis when compared to non-diabetics.

Conclusions: The prevalence of hepatic steatosis was 13.4%. There was a strong association of hepatic steatosis and diabetes, with diabetics 3 times more likely to have hepatic steatosis. An association was found between the components of metabolic syndrome and hepatic steatosis.