Introduction and objectives

The global prevalence of non-alcoholic fatty liver disease (NAFLD) is approximately 25%, with Hispanic populations at greatest risk. We describe the prevalence of NAFLD in a cohort of Guatemalan adults and examine whether exposure to a protein-energy supplement from conception to two years is associated with lower prevalence of NAFLD.

Materials and methods

From 1969 to 1977, four villages in Guatemala were cluster-randomized to receive a protein-energy supplement (Atole) or a no-protein, low-energy beverage (Fresco). We conducted a follow-up of participants from 2015 to 2017. We assessed blood samples (n = 1093; 61.1% women; aged 37–53 years) for alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and estimated NAFLD prevalence using the liver fat score. We used generalized linear and logistic models to estimate the difference-in-difference effect of Atole from conception to two years on NAFLD.

Results

Median ALT and AST were 19.7 U/L (interquartile range, IQR: 14.1, 27.4) and 26.0 U/L (IQR: 21.4, 32.8), respectively. The median NAFLD liver fat score was 0.2 (IQR: −1.2, 1.6) in women and −1.2 (IQR: −2.2, 0.5) in men (p < 0.0001). The prevalence of NAFLD was 67.4% among women and 39.5% among men (p < 0.0001). The association between Atole exposure from conception to two years and NAFLD was not significant (OR: 0.90, 95% CI: 0.50–1.63).

Conclusions

NAFLD prevalence among Guatemalan adults exceeds the global average. Protein-energy supplementation in early life was not associated with later NAFLD. There is a need for further studies on the causes and onset of NAFLD throughout the life course.

中文翻译：

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在生命早期暴露于蛋白质能量营养干预之后，危地马拉的NAFLD患病率。

介绍和目标

非酒精性脂肪肝疾病（NAFLD）的全球患病率约为25％，而西班牙裔人群的患病风险最高。我们描述了危地马拉成年人群中NAFLD的患病率，并研究了从受孕到两年暴露于蛋白质能量补充剂的摄入是否与NAFLD患病率较低相关。

材料和方法

从1969年到1977年，危地马拉的四个村庄被随机分组​​，以接受蛋白质能量补充剂（Atole）或无蛋白质低能量饮料（Fresco）。我们从2015年至2017年对参与者进行了随访。我们评估了血液样本（n  = 1093； 61.1％的女性；年龄在37-53岁之间）的丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST），并使用肝脂肪评分。我们使用广义线性和逻辑模型来估计从概念到两年的Atole对NAFLD的差异差异影响。

结果

ALT和AST的中位数分别为19.7 U / L（四分位间距，IQR：14.1、27.4）和26.0 U / L（IQR：21.4、32.8）。女性的NAFLD肝脂肪评分中位数为0.2（IQR：-1.2，1.6），男性为-1.2（IQR：-2.2，0.5）（p  <0.0001）。女性的NAFLD患病率为67.4％，男性的患病率为39.5％（p  <0.0001）。受孕至两年的Atole暴露与NAFLD之间的相关性不显着（OR：0.90，95％CI：0.50-1.63）。

结论

危地马拉成年人的NAFLD患病率超过了全球平均水平。早期补充蛋白质能量与后来的NAFLD不相关。在整个生命过程中，需要进一步研究NAFLD的原因和发作。