Epidemiological Investigation of Fatty Liver Disease and Abnormal Liver Function in the Republic of Kazakhstan

Aim: Little is known about the epidemiology of fatty liver disease (FLD) among high-risk primary care subjects in Kazakhstan. We investigated the prevalence of FLD (alcoholic liver disease [ALD] and non-alcoholic fatty liver disease [NAFLD]) and abnormal liver function tests (LFTs) in high risk adults in Kazakhstan during their routine visit to the general practitioner. Methods: This multicenter, cross-sectional epidemiological study was carried out at 75 clinical sites in the Republic of Kazakhstan. The full analysis set population consisted of 5109 subjects. Results: Among type 2 diabetes mellitus (T2DM) subjects, established metabolic syndrome (MetS) and/or obese subjects, the prevalence of FLD was 30.8%. LFT abnormalities were found in 53.2% subjects with FLD and 40.0% without FLD. FLD subjects had significantly higher levels of alanine transaminase (ALT; p < 0.001), aspartate transaminase (AST; p < 0.001), serum total bilirubin (STB; p < 0.001), and gamma-glutamyl transpeptidase (GGT; p = 0.021) compared to those without FLD. LFTs increases were significantly higher in subjects with FLD compared to those without FLD and were also significantly higher in ALD subjects compared to those with NAFLD. Conclusion: This study provides insights into the prevalence of FLD and abnormal LFTs in subjects with T2DM and/or established MetS and/or who are obese in primary care settings in Kazakhstan. These findings can help healthcare providers in Kazakhstan and elsewhere to better recognize and manage patients at risk of liver disease, which will improve clinical outcomes.