Journal of Postgraduate Medicine Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India ISSN: 0022-3859 EISSN: 0972-2823 Vol. 57, Num. 3, 2011, pp. 257-258

Journal of Postgraduate Medicine, Vol. 57, No. 3, July-September, 2011, pp. 257-258

Letter

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, rinaldo_pellican@hotmail.com

Code Number: jp11072

PMID: 21941075
DOI: 10.4103/0022-3859.85227

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.

References

1.	Martha S, Ramreddy S, Pantam N. Study of impaired glucose tolerance, dyslipidemia, metabolic syndrome, and cardiovascular risk in a south Indian population. J Postgrad Med 2011;57:4-8.  Back to cited text no. 1  [PUBMED]
2.	Williams CD, Stengel J, Asike MI, Torres DM, Shaw J, Contreras M, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: A prospective study. Gastroenterology 2011;140:124-31.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.	Ratziu V, Bellentani S, Cortez-Pinto H, Day C, Marchesini G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol 2010;53:372-84.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.	Kadayifci A. Metabolic syndrome and liver transplantation. Panminerva Med 2009;51:205-13.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.	Ryder SD, Beckingham IJ. ABC of diseases of liver, pancreas and biliary system: Chronic viral hepatitis. BMJ 2001;322:219-21.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]

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