Non-alcoholic fatty liver disease: Epidemiology and non-invasive assessment / Chan Wah Kheong
This thesis consists ten chapters and presents the findings from four research projects in eight areas of interest concerning the epidemiology and non-invasive assessment of nonalcoholic fatty liver disease (NAFLD). In a cross-sectional study of 399 patients with diabetes mellitus in the Diabetic...
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Format: | Thesis |
Published: |
2014
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Online Access: | http://studentsrepo.um.edu.my/4637/1/Final_PhD_Thesis_for_Submission.pdf http://studentsrepo.um.edu.my/4637/ |
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Summary: | This thesis consists ten chapters and presents the findings from four research projects in
eight areas of interest concerning the epidemiology and non-invasive assessment of nonalcoholic
fatty liver disease (NAFLD). In a cross-sectional study of 399 patients with
diabetes mellitus in the Diabetic Clinic, University of Malaya Medical Centre, the
prevalence of NAFLD was 49.6% and was highest among the Malays and the Indians
compared to the Chinese. Further analysis revealed that low level of physical activity and
high percentage calorie intake from fat, high cholesterol food and high saturated fatty acid
food was associated with NAFLD in centrally obese but not in lean patients with diabetes
mellitus. In addition, NAFLD was not found to be associated with ischemic heart disease
in patients with diabetes mellitus. In a separate study on 35 NAFLD patients with paired
liver biopsy over a mean interval of 6.4 years, it was found that patients can undergo
significant disease progression, and fibrosis is irreversible without specific interventions.
From the studies on non-invasive assessment of NAFLD, controlled attenuation
parameter was found to be excellent for the detection of significant hepatic steatosis but
less useful for distinguishing the different grades of significant hepatic steatosis, while
plasma M30 was found to be less useful for the diagnosis of non-alcoholic steatohepatitis
among NAFLD patients. The use of liver stiffness measurement for patients with
indeterminate and high NAFLD fibrosis scores allowed accurate prediction of advanced
fibrosis and reduced the number of patients requiring a liver biopsy. In the study on 472
students at the Faculty of Medicine, University of Malaya, the prevalence of NAFLD was
8.1% and was again highest among the Indians and the Malays compared to the Chinese.
This study confirmed that differences in the prevalence of NAFLD among the different
ethnic groups in Malaysia can be observed as early as young adulthood. |
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