Nonalcoholic fatty liver disease in South India

R Pellicano¹, S Fagoonee²,  
¹ Department of Gastroenterology and Hepatology, Molinette Hospital, University of Turin, Turin, Italy
² Department of Biology, Biochemistry and Genetics, Molecular Biotechnology Center, University of Turin, Turin, Italy

Correspondence Address:
R Pellicano
Department of Gastroenterology and Hepatology, Molinette Hospital, University of Turin, Turin
Italy

Full Text

Sir,

Martha et al., in an interesting observational study, investigated the prevalence of impaired glucose tolerance, dyslipidemia, metabolic syndrome (MS) and cardiovascular risk factors in a south Indian population. Among the exclusion criteria, the authors considered the presence of liver failure, cirrhosis, a previous history of viral hepatitis and liver enzyme values twice the upper limits. [1]

Nonalcoholic fatty liver disease (NAFLD), frequently associated to diabetes, impaired glucose tolerance, dyslipidemia, and MS, [2] includes a spectrum of disorders ranging from steatosis that generally follows a benign and nonprogressive clinical course to nonalcoholic steatohepatitis [3] which sometimes progresses to cirrhosis and hepatocellular carcinoma. [4] NAFLD, a leading cause of abnormal liver enzymes, is now considered the hepatic manifestation of MS. [2] This condoition is either discovered incidentally during laboratory examination or workup of hypertension, diabetes or morbid obesity, by abdominal ultrasound and/or liver enzyme dosage in serum. [3] In order to evaluate a more extensive data set, it would be of great interest to have more details about the liver enzyme dosage results among the population included by Martha et al. Furthermore, since the level of liver enzymes is not associated to prognosis, [5] nor to the cause of liver disease, it would be useful to know the reason for exclusion of subjects with liver enzyme values twice the upper limits.

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