High prevalence of non-alcoholic fatty liver disease in the Chinese - results from the Hong Kong liver health census

Background & AimsThe prevalence of non-alcoholic fatty liver disease (NAFLD) in the general Chinese population is not clear, as there have been few large population studies focussing on healthy individuals. We aim to determine the prevalence and risk factors of NAFLD in a healthy Westernized Chinese population. MethodsThis is a prospective cross-sectional study of 2493 volunteers recruited from the general population and the Red Cross Transfusion Center in Hong Kong. All underwent comprehensive questionnaire survey, blood test, abdominal ultrasound and transient elastography. ResultsThe prevalence of NAFLD was 42%. Gender, age, waist circumference, systolic blood pressure, fasting cholesterol and glucose levels were significant factors. The relative risk of NAFLD in those with high waist circumference, diabetes, hypertension, and hypercholesterolaemia was 2.99, 2.01, 1.79 and 1.54 respectively. The degree of steatosis increased with levels of fasting glucose, cholesterol, systolic blood pressure and waist circumference (all P<0.001). The optimal waist circumference was found to be 84 and 74cm for male and females respectively, with a relative risk of 5.16 for those above this limit. In total, 1.2% and 0.002% with NAFLD had advanced liver fibrosis and cirrhosis respectively. ConclusionNon-alcoholic fatty liver disease was found to be highly prevalent in the Chinese population. Increasing levels of risk factors were associated with increasing severity of NAFLD. Lower cut-off levels of waist circumference to predict NAFLD should be adopted for Chinese population.