FATTY LIVER IN OVERWEIGHT AND OBESE PATIENTS IN WESTERN PART OF SAUDI ARABIA: A study of sonological prevalence

Objective: The aim of the study was to determine the association between fatty liver and obesity in patients presenting to King Abdulaziz University Hospital. Methods: This is a retrospective study reviewing medical records of all obese patients having a fatty liver over a one-year period between April 2003 and April 2004. The data collected included age, gender, nationality, BMI, serum level of alanine (ALT) and aspartate (AST) transaminases, bilirubin, albumin, HbA1C, cholesterol, triglyceride, LDL, and TSH. The fatty liver was diagnosed by routine ultrasound when patients presented with abdominal pain or hepatomegaly. Results: 235 case files were enrolled in the study. The mean age of the study group was 46±14.4 years with 82 males (35%) and 153 females (65%). The mean aspartate aminotransferase level was 43.9±6.18.1units/L (NR 7-53 IU/L); alanine aminotransferase was 36.2±5.1 units/L (NR 11-47 IU/L). A transaminase value above the normal range was present in 15 (6.4%) patients only, whereas values of cholesterol and triglyceride above normal range were seen in 17 patients (7.2%). Overweight and obesity were the main risk factors in our study group. The mean BMI was 33.6±7.5 Kg/m2. Obesity with diabetes is the most important risk for a fatty liver. 78 (33%) of our patients were diabetic. Another risk factor associated with a fatty liver is the metabolic syndrome, which is reported in 14.9% and hypothyroidism in 3.8% of the subjects. Conclusion and recommendations: Overweight and obesity are the most important risk factors for fatty liver in Saudi Arabia. They are more prevalent in females. Ultrasound appears to be a useful noninvasive tool to determine liver involvement with fatty liver in obese adults even in the absence of hypertransaminasemia. We should encourage obese subjects to gradually reduce their weight in order to improve the liver