Obesity and the extent of liver damage among adult New Zealanders: findings from a national survey

Summary Objective Non‐alcoholic fatty liver disease (NAFLD), defined as excessive fat accumulation in hepatocytes when no other pathologic causes are present, is an increasingly common obesity‐related disorder. We sought to describe the prevalence of elevated liver enzymes, a marker of liver damage,...

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Published in:	Obesity science & practice 2015-12, Vol.1 (2), p.67-77
Main Authors:	Coppell, K. J., Miller, J. C., Gray, A. R., Schultz, M., Mann, J. I., Parnell, W. R.
Format:	Article
Language:	eng
Subjects:	Adults Age Alanine Alanine transaminase Alcohol Body mass index Cardiovascular disease Diabetes Diabetes mellitus Enzymes Ethnic minorities Ethnicity Family medical history Fatty liver g-Glutamyltransferase Hepatitis Hepatocytes Laboratories Liver cancer Liver diseases liver enzymes Mortality non‐alcoholic fatty liver disease (NAFLD) Nutrition Obesity Original Studies Transaminase Womens health
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Summary:	Summary Objective Non‐alcoholic fatty liver disease (NAFLD), defined as excessive fat accumulation in hepatocytes when no other pathologic causes are present, is an increasingly common obesity‐related disorder. We sought to describe the prevalence of elevated liver enzymes, a marker of liver damage, among New Zealand adults, and high‐risk subgroups including those with an elevated body mass index and those with pre‐diabetes or diabetes, to gain a better understanding of the burden of liver disease. Methods A total of 4,721 New Zealanders aged 15+ years participated in a nationally representative nutrition survey. Liver enzymes, alanine transaminase (ALT) and gamma glutamyl transpeptidase (GGT) were measured in serum. Results were available for 3,035 participants, of whom 10.8% were Māori and 4.5% Pacific. Results Overall, the prevalence of elevated ALT and elevated GGT was 13.1% (95% confidence interval [CI]: 11.2 – 15.0) and 13.7% (95% CI: 12.0 – 15.4), respectively. Odds ratios for an elevated ALT or GGT markedly increased with increasing body mass index. Men with obesity had the highest elevated ALT prevalence (28.5%; 95% CI: 21.7–35.4), and women with diabetes had the highest elevated GGT prevalence (36.5%; 95% CI: 26.0–47.0). Adding alcohol consumption categories to each of the adjusted models did not meaningfully change any results, although for women, heavy alcohol consumption was associated with an elevated GGT (overall p = 0.03). Conclusions Obesity‐related liver disease is likely to increasingly burden the New Zealand health sector and contribute to health disparities unless effective obesity treatment and prevention measures are given high priority. © 2015 The Authors. Obesity Science & Practice published by John Wiley & Sons Ltd, World Obesity and The Obesity Society.
ISSN:	2055-2238 2055-2238