prevalence of nonalcoholic steatohepatitis in iran: a population based study

â  â  background non-alcoholic fatty liver disease/steatohepatitis (nafld/nash) is the most common form of chronic liver disease woldwide and is no longer considered a benign disease. its prevalence has not been deterâ­mined in a large-scale population-based study in iran. me t hod s a total of 6583 individuals aged 18 to 65 were randomly selected from three geographically distinct provinces in iran. blood samples were obtained from each subject and a questionnaire was completed exploring data including self-admitted regular alcohol use. serums were tested for anti-hcv antibody (anti-hcv), hepatitis b surface antigen and anti-hepatitis b core antibody. positive samples for anti-hcv antibody were re-tested and those positive in a repeat elisa were confirmed by a recombinant immunoblot assay (riba) test. serums were also tested for alt levels. subjects with elevated alt defined as serum alt ≥40 iu/l with no history of alcohol consumption and negative hbv and hcv infection were considered as “presumed nash”. re s ul ts in this study 5589 subjects were analyzed. two hundred and forty two individuals (4.3%) were diagnosed with elevated alt levels. among individuals with elevated alt, 15 (6.2%) were diagnosed with either hepatitis b or hepatitis c. the overall weighted prevalence of preâ­sumed nash was 2.9%. according to multivariate analysis, male sex, urban lifestyle, and being overweight or obese were significantly associated with “presumed nash”. con c lu s ion obesity and metabolic syndrome, the most predictive factors of fatty liver disease, are increasing in iran, therefore the prevalence of nafld/nash and related complications are expected to increase in the future. this population based study gives a crude estimate of the prevalence of nash around the country. studies with more accurate surrogates of nash need to be done. the disparity among different provinces merits special consideration.