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How Common Is NAFLD In Asia Pacific And Is There Local Differences

Worldwide Epidemiology of NASH. NAFLD may be the most common form of chronic liver disease in USA, Australia, Asia and EuropeMcCullough AJ, 2002Mulhall BP 2002Clark JM 2003Farrell GC. 2003Ruhl 2003. . Global challenges in Liver Diseases 2006. Problems In Studying Epidemiology Of NAFLD And NASH.

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How Common Is NAFLD In Asia Pacific And Is There Local Differences

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    1. How Common Is NAFLD In Asia Pacific And Is There Local Differences Deepak Amarapurkar Consultant Gastroenterologist and hepatologist, Bombay hospital & medical research centre, Mumbai

    2. Worldwide Epidemiology of NASH NAFLD may be the most common form of chronic liver disease in USA, Australia, Asia and Europe McCullough AJ, 2002 Mulhall BP 2002 Clark JM 2003 Farrell GC. 2003 Ruhl 2003

    4. Problems In Studying Epidemiology Of NAFLD And NASH Lack of definitive laboratory test Studies dependence on different definitions Published series with biopsy confirmation are selected cases that have presented to medical attention Values of alcohol consumption in published series ranged from < 20 gm/week to <140 gm/week

    5. Prevalence of fatty liver Estimated prevalence is 5 % of population 20 to 30 % adults in western countries have NAFLD of which 2 to 3 % are NASH (Imaging & autopsy study) Steatosis seen in 70 % obese & 35 % lean patients NASH seen in 18.5 % obese & 2.7 % lean patients Hepatology 2003

    6. Problems in Assessing NAFLD In Asian Pacific Region Inaccurate evaluation of alcohol abuse Infrequent use of liver test in general practice Lack of presentation of asymptomatic individual Burden of viral hepatitis Reluctance to do liver biopsy Lack of awareness of the severity Pursued slowly progressive nature Considered as a disease of affluence Chitturi S, Farrell G, George J JGH 2004

    7. Prevalence of NAFLD In General Population In Asian Pacific Region Name of the Percentage NAFLD in Country Adults Japan 9 30% China 5 18% Korea 18 % India 5 28% Indonesia 30% Malaysia 17 % Singapore 5%

    8. Prevalence of NAFLD In General Population In Asian Pacific Region Name of the Percentage NAFLD in Country Adults Australia ) Lack of data, perception Taiwan ) amongst the clinician around Hongkong ) 10- 30% Sri Lanka ) Philippines )

    9. Studies on non alcoholic Fatty Liver Disease And Non-alcoholic steatohepatitis In Asia

    10. Prevalence of Risk Factors For NAFLD in Asian Pacific Region Diabetes Obesity Metabolic Syndrome

    11. Prevalence of NAFLD In High Risk Population In Asian Pacific Region Name of the Diabetes Obesity Dyslipidemia country Japan 40-50% 50-80% 42-58% China 35% 70-80% 57% Korea 35% 10-50% 26-35% India 30-90% 15-20% NA Indonesia 52% 47% 56%

    16. Prevalence Of The Metabolic Syndrome In Asians

    17. Increasing Incidence of NAFLD Has been well documented from studies in Japan and China Almost all countries in Asian Pacific region have reported increased incidence of diabetes, obesity, central obesity and insulin resistance

    18. NonAlcoholic Fatty Liver Disease Histopathologic Spectrum Steatosis Steatohepatitis

    19. NASH In Asia Pacific Future Shock Western Eastern Population Population Age at Presentation 4th 8th decade 4th 8th decade Prevalence 20-30% -10% Obesity 71% (30-100) 44% (12-89) T2DM 28% (2-55) 34% (11-39) Hyperlipidemia 38% (15-81) 41% (28-81) Natural History Worse with Limited data severe firbosis Chitturi Et al JGH 2004

    20. THANK YOU

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