Risk assessment of metabolic associated fatty liver disease – A comprehensive screening among community health workers of a rural field practice area in Belagavi

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Abstract

Introduction Non-alcoholic fatty liver disease (NAFLD) is now the largest cause of chronic liver disease globally, with an estimated global prevalence of 25%, putting a significant strain on the healthcare system. Metabolic (dysfunction)-associated fatty liver disease (MAFLD), often known as NAFLD, is defined as hepatic steatosis combined with overweight or obesity, diabetes mellitus, or indications of metabolic dysfunction. This study/systematic screening programme was done among healthcare workers to determine the prevalence and risk factors for MAFLD. Understanding the incidence and risk factors unique to this demographic allows healthcare providers to devise personalised interventions, promote healthy lifestyles, and eventually minimise the burden of MAFLD in the community. Objective: The current study was carried out to determine the risk factors linked to MAFLD in healthcare workers, as well as to gauge their awareness and knowledge of the disease. It also evaluated the prevalence of MAFLD among healthcare workers at Kinaye Primary Health Centre using comprehensive screening methods. Methodology: Between October 2023 and March 2024, a comprehensive cross-sectional survey was carried out among ASHA and Anganwadi staff who were registered with PHC Kinaye. Using the universal sampling technique, a sample size of 130 workers—56 ASHA employees and 74 Anganwadi employees—was obtained. A predesigned and pretested questionnaire was used to gather sociodemographic data, and estimations of random blood sugar, HbA1c, lipid profile (total cholesterol, triglyceride, LDL, HDL, and VLDL), and fibroscan were performed. Statistical analysis: was done in Microsoft Excel and analysed using SPSS version 20. Categorical data were represented as frequency and percentages. Results The participants' average age was 38.10 ± 8.42 years. Sixty-two percent of research participants did not have any comorbidities. Among the 130 patients, 2.4% had hypertension, 5.6% had thyroid disorders, and 9.5% had diabetes. 86.5% of participants engaged in physical activity for fewer than 150 minutes per week, which is the amount advised by the WHO. 50.8% of people were fat. 10.3% had blood sugar readings over 200 mg/dl at random. Out of the 130 individuals, 94.5% had ideal LDL and 93.7% had desirable total cholesterol. 73.5 percent had HDL values below 40. According to the fibro scan data, 73.8% of the subjects showed no liver fibrosis and 45.2% had Grade 0 fatty liver. Waist-Hip ratio and liver fibrosis were found to be significantly correlated using Pearson P-value is 0.007 and the correlation value is 0.217. Physical activity was significantly associated with liver fibrosis with Chi-square value: 13.746, p-value: 0.003, and BMI was significantly associated with fatty liver with Chi-square value: 44.838, p-value: <0.001. Conclusion: Health care workers who are physically inactive are more likely to have fatty liver alterations and liver fibrosis, as well as an elevated waist-hip ratio. Future initiatives should concentrate on helping people who are at-risk change their lifestyles by implementing a nutritious diet and regular exercise, as well as informing the public about fatty liver disease and its preventative measures.

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