Determination of Risk Factors and their Association with Certain Laboratory Tests of Nonalcoholic Fatty Liver Individuals in Sulaimani City/Kurdistan Region of Iraq

Authors

  • Bakhtyar Kamal Talabani Community Health Department, College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaimani, KGR, Iraq
  • Hardy Hassan Rasul Community Health Department, College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaimani, KGR, Iraq

Keywords:

NAFLD, dietary pattern, Biochemical test, liver disease, Iraq

Abstract

Background and Objectives: Nonalcoholic fatty liver disease is caused by the accumulated high amount of fat in the liver independently of alcohol consumption.The aim of this study was to identify risk factors and their association with certain laboratory tests in nonalcoholic fatty liver patients. Methods: This case-control study was conducted from February 2022 to July 2022 in both Shar Hospital (public sector) and Baxshin Hospital (private sector). 148 Kurdish adult, their age 18 to 70, participated in the study. 148 participants were interviewed in a questionnaire; 74 peoples were of NAFLD (cases), and 74 were without liver disease (controls). SPSS was used to analysis the data. Results: A total of 148Kurdish adults were included in the study. Participants in control group had a higher intake of tea and vegetables compared to case group, was statistically significant. But smoking and physical activity had no statistically significant relationship with NAFLD between bot group (P>0.05). Patients with NAFLD had dyslipidemia, higher mean (s.triglyceride, LDL, and s.cholesterol levels, and lower mean HDL values) than those without NAFLD, and statistically significant differences (P<0.05). Conclusions: It was concluded that drinking tea and eating vegetables strongly correlate with NAFLD because they help the liver be protected from fatty liver changes.

References

Alsuhaibani K, Althunayyan F, Alsudays A, Alharbi A, Aljarallah B. Nonalcoholic fatty liver disease in lean and obese patients in Saudi patients from a single center. J Family Med Prim Care 2021;10:3381. https://doi.org/10.4103/jfmpc.jfmpc_185_21.

Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology 2018;67:328–57.

Rinella ME, Sanyal AJ. Management of NAFLD: a stage-based approach. Nat Rev Gastroenterol Hepatol 2016;13:196–205.

Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non‐alcoholic fatty liver disease and non‐alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011;34:274–85.

Kojima S, Watanabe N, Numata M, Ogawa T, Matsuzaki S. Increase in the prevalence of fatty liver in Japan over the past 12 years: analysis of clinical background. J Gastroenterol 2003;38:954–61.

Zhou Y-J, Li Y-Y, Nie Y-Q, Ma J-X, Lu L-G, Shi S-L, et al. Prevalence of fatty liver disease and its risk factors in the population of South China. World Journal of Gastroenterology: WJG 2007;13:6419.

Lankarani KB, Ghaffarpasand F, Mahmoodi M, Lotfi M, Zamiri N, Heydari ST, et al. Non alcoholic fatty liver disease in southern Iran: a population based study. Hepat Mon 2013;13.

Amirkalali B, Poustchi H, Keyvani H, Khansari MR, Ajdarkosh H, Maadi M, et al. Prevalence of non-alcoholic fatty liver disease and its predictors in north of Iran. Iran J Public Health 2014;43:1275.

Crabb DW, Galli A, Fischer M, You M. Molecular mechanisms of alcoholic fatty liver: role of peroxisome proliferator-activated receptor alpha. Alcohol 2004;34:35–8.

Machado M, Cortez-Pinto H. Non-alcoholic steatohepatitis and metabolic syndrome. Curr Opin Clin Nutr Metab Care 2006;9:637–42.

Angelico F, del Ben M, Conti R, Francioso S, Feole K, Maccioni D, et al. Non‐alcoholic fatty liver syndrome: a hepatic consequence of common metabolic diseases. J Gastroenterol Hepatol 2003;18:588–94.

Juanola O, Martínez-López S, Francés R, Gómez-Hurtado I. Non-alcoholic fatty liver disease: Metabolic, genetic, epigenetic and environmental risk factors. Int J Environ Res Public Health 2021;18. https://doi.org/10.3390/ijerph18105227.

Loria P, Lonardo A, Carulli L, Verrone AM, Ricchi M, Lombardini S, et al. the metabolic syndrome and non‐alcoholic fatty liver disease. Aliment Pharmacol Ther 2005;22:31–6.

Targher G, Arcaro G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease. Atherosclerosis 2007;191:235–40.

Santos AC, Ebrahim S, Barros H. Gender, socio-economic status and metabolic syndrome in middle-aged and old adults. BMC Public Health 2008;8:1–8.

Manuck SB, Phillips J, Gianaros PJ, Flory JD, Muldoon MF. Subjective socioeconomic status and presence of the metabolic syndrome in midlife community volunteers. Psychosom Med 2010;72:35.

Haufe S, Engeli S, Kast P, Böhnke J, Utz W, Haas V, et al. Randomized comparison of reduced fat and reduced carbohydrate hypocaloric diets on intrahepatic fat in overweight and obese human subjects. Hepatology 2011;53:1504–14. https://doi.org/10.1002/HEP.24242.

Kirk E, Reeds DN, Finck BN, Mayurranjan MS, Patterson BW, Klein S. Dietary fat and carbohydrates differentially alter insulin sensitivity during caloric restriction. Gastroenterology 2009;136:1552–60.

Musso G, Cassader M, Rosina F, Gambino R. Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis of randomised trials. Diabetologia 2012;55:885–904. https://doi.org/10.1007/S00125-011-2446-4.

Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, Torres-Gonzalez A, Gra-Oramas B, Gonzalez-Fabian L, et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology 2015;149:367–78.

Trovato FM, Martines GF, Catalano D. Addressing Western dietary pattern in obesity and NAFLD. Nutrire 2018;43. https://doi.org/10.1186/s41110-018-0067-0.

Mehdi Al Khalidi N, Ghanim Kadhim Z, Yahya Almousawi H. Dietary patterns in adult patients with Non-Alcoholic Fatty Liver Disease in Iraq 2021.

P. Kalafati I, Borsa D, Dimitriou M, Revenas K, Kokkinos A, v. Dedoussis G. Dietary patterns and non-alcoholic fatty liver disease in a Greek case–control study. Nutrition 2019;61:105–10. https://doi.org/10.1016/j.nut.2018.10.032.

H. MOHAMMED M, SH. ALDUHOKY L, A. SARHAN S, H. AHMED I. ASSOCIATION OF NON ALCOHOLIC FATTY LIVER WITH TYPE 2 DIABETES MELLITUS. Duhok Medical Journal 2021;15:11–22. https://doi.org/10.31386/dmj.2021.15.1.2.

Instrument WHOWHOS. The WHO STEPwise approach to noncommunicable disease risk factor surveillance (STEPS). Geneva: World Health Organization 2016.

Majid M, Mutar MT, Ibrahim MJ, Saad A, Goyani MS, Abdulmortafea A, et al. DEVELOPING A RELATIVELY VALIDATED AND REPRODUCIBLE FOOD FREQUENCY QUESTIONNAIRE IN BAGHDAD, IRAQ. Global Journal of Public Health Medicine 2022;4:51022.

Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB. Fatty liver: imaging patterns and pitfalls. Radiographics 2006;26:1637–53.

Quinn SF, Gosink BB. Characteristic sonographic signs of hepatic fatty infiltration. American Journal of Roentgenology 1985;145:753–5.

Mathiesen UL, Franzen LE, Åselius H, Resjö M, Jacobsson L, Foberg U, et al. Increased liver echogenicity at ultrasound examination reflects degree of steatosis but not of fibrosis in asymptomatic patients with mild/moderate abnormalities of liver transaminases. Digestive and Liver Disease 2002;34:516–22.

Trovato FM, Catalano D, Musumeci G, Trovato GM. 4Ps medicine of the fatty liver: the research model of predictive, preventive, personalized and participatory medicine—recommendations for facing obesity, fatty liver and fibrosis epidemics. EPMA Journal 2014;5:124.

Masterjohn C, Bruno RS. Therapeutic potential of green tea in nonalcoholic fatty liver disease. Nutr Rev 2012;70:41–56.

Rodriguez-Ramiro I, Vauzour D, Minihane AM. Polyphenols and non-alcoholic fatty liver disease: impact and mechanisms. Proceedings of the Nutrition Society 2016;75:47–60.

van de Wier B, Koek GH, Bast A, Haenen GRMM. The potential of flavonoids in the treatment of non-alcoholic fatty liver disease. Crit Rev Food Sci Nutr 2017;57:834–55.

Salomone F, Godos J, Zelber‐Sagi S. Natural antioxidants for non‐alcoholic fatty liver disease: molecular targets and clinical perspectives. Liver International 2016;36:5–20.

Hakim IA, Harris RB, Brown S, Chow HHS, Wiseman S, Agarwal S, et al. Effect of increased tea consumption on oxidative DNA damage among smokers: a randomized controlled study. J Nutr 2003;133:3303S-3309S.

Hodges JK, Sasaki GY, Bruno RS. Anti-inflammatory activities of green tea catechins along the gut–liver axis in nonalcoholic fatty liver disease: Lessons learned from preclinical and human studies. J Nutr Biochem 2020;85:108478.

Wolfram S. Effects of green tea and EGCG on cardiovascular and metabolic health. J Am Coll Nutr 2007;26:373S-388S.

Ueda M, Nishiumi S, Nagayasu H, Fukuda I, Yoshida K, Ashida H. Epigallocatechin gallate promotes GLUT4 translocation in skeletal muscle. Biochem Biophys Res Commun 2008;377:28690.

Maeda-Yamamoto M, Inagaki N, Kitaura J, Chikumoto T, Kawahara H, Kawakami Y, et al. O-methylated catechins from tea leaves inhibit multiple protein kinases in mast cells. The Journal of Immunology 2004;172:4486–92.

Khan N, Mukhtar H. Multitargeted therapy of cancer by green tea polyphenols. Cancer Lett 2008;269:269–80.

Stangl V, Lorenz M, Stangl K. The role of tea and tea flavonoids in cardiovascular health. Mol Nutr Food Res 2006;50:218–28.

Kim J, Formoso G, Li Y, Potenza MA, Marasciulo FL, Montagnani M, et al. Epigallocatechin gallate, a green tea polyphenol, mediates NO-dependent vasodilation using signaling pathways in vascular endothelium requiring reactive oxygen species and Fyn. Journal of Biological Chemistry 2007;282:13736–45.

Hamza A, Zhan C-G. How can (−)-epigallocatechin gallate from green tea prevent HIV-1 infection? Mechanistic insights from computational modeling and the implication for rational design of anti-HIV-1 entry inhibitors. J Phys Chem B 2006;110:2910–7.

Xu J, Wang J, Deng F, Hu Z, Wang H. Green tea extract and its major component epigallocatechin gallate inhibits hepatitis B virus in vitro. Antiviral Res 2008;78:242–9.

al Khalidi NM, Kadhim ZG, Almousawi HY. Dietary patterns in adult patients with Non-Alcoholic Fatty Liver Disease in Iraq 2021.

Fakhoury-Sayegh N, Younes H, Heraoui GNHA, Sayegh R. Nutritional profile and dietary patterns of lebanese non-alcoholic fatty liver disease patients: a case-control study. Nutrients 2017;9:1245.

al Khalidi NM, Kadhim ZG, Almousawi HY. Dietary patterns in adult patients with Non-Alcoholic Fatty Liver Disease in Iraq 2021.

Vancells Lujan P, Viñas Esmel E, Sacanella Meseguer E. Overview of non-alcoholic fatty liver disease (NAFLD) and the role of sugary food consumption and other dietary components in its development. Nutrients 2021;13:1442.

Shen X, Jin C, Wu Y, Zhang Y, Wang X, Huang W, et al. Prospective study of perceived dietary salt intake and the risk of non‐alcoholic fatty liver disease. Journal of Human Nutrition and Dietetics 2019;32:802–9.

Zhang S, Gu Y, Bian S, Górska MJ, Zhang Q, Liu L, et al. Dietary patterns and risk of non-alcoholic fatty liver disease in adults: a prospective cohort study. Clinical Nutrition 2021;40:537382.

Sahebkar A. Potential efficacy of ginger as a natural supplement for nonalcoholic fatty liver disease. World Journal of Gastroenterology: WJG 2011;17:271.

Mansour-Ghanaei F, Pourmasoumi M, Hadi A, Joukar F. Efficacy of curcumin/turmeric on liver enzymes in patients with non-alcoholic fatty liver disease: a systematic review of randomized controlled trials. Integr Med Res 2019;8:57–61.

Hajimonfarednejad M, Ostovar M, Raee MJ, Hashempur MH, Mayer JG, Heydari M. Cinnamon: A systematic review of adverse events. Clinical Nutrition 2019;38:594–602.

Fakhoury-Sayegh N, Younes H, Heraoui GNHA, Sayegh R. Nutritional profile and dietary patterns of lebanese non-alcoholic fatty liver disease patients: a case-control study. Nutrients 2017;9:1245.

Salehi-Sahlabadi A, Sadat S, Beigrezaei S, Pourmasomi M, Feizi A, Ghiasvand R, et al. Dietary patterns and risk of non-alcoholic fatty liver disease. BMC Gastroenterol 2021;21:1–12.

Lankarani KB, Ghaffarpasand F, Mahmoodi M, Lotfi M, Zamiri N, Heydari ST, et al. Non alcoholic fatty liver disease in southern Iran: a population based study. Hepat Mon 2013;13.

Tajima R, Kimura T, Enomoto A, Saito A, Kobayashi S, Masuda K, et al. No association between fruits or vegetables and non-alcoholic fatty liver disease in middle-aged men and women. Nutrition 2019;61:119–24.

Liu C. Prevalence and risk factors for non‐alcoholic fatty liver disease in Asian people who are not obese. J Gastroenterol Hepatol 2012;27:1555–60.

Salehi-Sahlabadi A, Sadat S, Beigrezaei S, Pourmasomi M, Feizi A, Ghiasvand R, et al. Dietary patterns and risk of non-alcoholic fatty liver disease. BMC Gastroenterol 2021;21:1–12.

Fakhoury-Sayegh N, Younes H, Heraoui GNHA, Sayegh R. Nutritional profile and dietary patterns of lebanese non-alcoholic fatty liver disease patients: a case-control study. Nutrients 2017;9:1245.

Chavez-Tapia NC, Lizardi-Cervera J, Perez-Bautista O, Ramos-Ostos MH, Uribe M. Smoking is not associated with nonalcoholic fatty liver disease. World Journal of Gastroenterology: WJG 2006;12:5196.

Han AL. Association between non-alcoholic fatty liver disease and dietary habits, stress, and health-related quality of life in Korean adults. Nutrients 2020;12:1555.

Santhoshakumari TMJ, Radhika G, Kanagavalli P. A study of anthropometric and lipid profile parameters in non-alcoholic fatty liver disease patients attending a tertiary care hospital at puducherry. IOSR J Dent Med Sci (IOSR-JDMS) 2017;16:33–7

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Published

2023-01-04

Issue

Vol. 24 No. 2 (2022)

Section

ARTICLE