Prevalence, risk factors and association with gallstone disease of non-alcoholic fatty liver disease among rural indigenous communities : A cross-sectional study in Sarawak, Malaysia

Yew, Ting Ting and Cheah, Whye Lian and Koa, Ai Jiun and Chow, Han Bing (2025) Prevalence, risk factors and association with gallstone disease of non-alcoholic fatty liver disease among rural indigenous communities : A cross-sectional study in Sarawak, Malaysia. Malaysian Family Physician, 20 (8). pp. 1-9. ISSN 1985-2274

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Abstract

Introduction: This study aimed to evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) among Dayak communities in Malaysia, shedding light on an underexplored population. Methods: A cross-sectional study was undertaken among Dayak villagers in Sarawak aged 18 years and above using an interview-based questionnaire, followed by an anthropometric measurement, a blood test and an abdominal ultrasound. Results: A total of 324 participants met the inclusion criteria. Among them, 42.9% were men, and the mean age was 49.85±14.9 years. The prevalence of NAFLD was substantially high at 58%, with 43.1% of the participants having mild fatty liver (grade 1). NAFLD was closely associated with waist circumference and body mass index (BMI) (P<0.001). Central obesity, as indicated by waist circumference and BMI, emerged as a potent risk factor, with higher values correlating with an increased likelihood of NAFLD. A higher prevalence of NAFLD was observed in the participants with an advancing age, an elevated triglyceride level (66.7%) and a lower high-density lipoprotein cholesterol level (81.6%). However, these associations did not remain significant in the multivariate analysis. Gallstones, which share common risk factors with NAFLD, were not significantly associated with NAFLD in this population (P=0.853). Conclusion: This study defines the prevalence and association of NAFLD with sociodemographic characteristics, health profiles and gallstone disease among indigenous villages in Dayak communities. A high BMI and central obesity are found to be independent risk factors of NAFLD.

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