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

• Published in: The Turkish journal of gastroenterology Vol. 32; no. 3; pp. 302 - 312
• Main Authors: Değertekin, Bülent, Tozun, Nurdan, Demir, Figen, Söylemez, Gizem, Parkan, Şirin, Gürtay, Ezgi, Mutlu, Deniz, Toraman, Meltem, Seymenoğlu, Tolga Hayrettin
• Format: Journal Article
• Language: English
• Published: Turkey AVES 01-03-2021; Turkish Society of Gastroenterology
• Subjects: Aged; Body Mass Index; Demographic aspects; Fatty liver; Female; Humans; LIVER; Male; Middle Aged; Non-alcoholic Fatty Liver Disease - epidemiology; Original; Prevalence; Retrospective Studies; Risk Factors; Statistics; Turkey - epidemiology; Turkey
• ISSN: 2148-5607; 1300-4948; 2148-5607
• DOI: 10.5152/tjg.2021.20062

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.
The 10-year data (2007 to 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 were 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.
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/m2 (63.5%) and in Central and Eastern Anatolia regions (57.1% and 55.7%, respectively). The prevalence of NAFLD was 43.5% between 2007-2010, 47.6% between 2011-2013 and 53.1% between 2014-2016 and the rate of increase was 22%. Multivariate analysis showed that male sex, serum alanine aminotransferase (ALT) level, older age, BMI, type-II diabetes mellitus, hypertension and dyslipidemia were independent factors associated with NAFLD.
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.