Age and Gender Patterns of Ultrasound-Detected Fatty Liver and Its Association with Gallstones in a Tertiary Care Hospital
DOI:
https://doi.org/10.52206/jsmc.2025.15.4.1269Abstract
Background: Fatty liver disease shows variable prevalence across age and gender and often coexists with gallstones due to shared metabolic factors.
Objective: To analyze the age- and gender-related patterns of ultrasound-detected fatty liver and its association with gallstones in a tertiary care hospital.
Methodology: A retrospective cross-sectional study was conducted in the Radiology Department, Lady Reading Hospital, Peshawar. Records of all patients diagnosed with fatty liver on ultrasound between January and December 2023 were reviewed. Demographic data and gallstone status were analyzed using chi-square tests, odds ratios (OR), and logistic regression in SPSS version 26.
Results: Among 1,165 patients (705 females, 460 males; mean age 44.25 ± 13.98 years), fatty liver was most frequent in the 41–60 years age group (46.2%). Gallstones were detected in 16.1%, more common in females (18.9%) than males (11.7%) [p = 0.002, OR = 1.68]. The frequency of gallstones increased with age (p = 0.001), with older adults showing higher odds (OR = 4.36 for 61–80 years vs. <20 years).
Conclusion: Fatty liver predominated in middle-aged females, while gallstones were more frequent and age-dependent. These findings highlight overlapping metabolic and hormonal risk factors and the need for preventive research.
Keywords: Age; Fatty Liver; Gallstones; Gender, Ultrasonography.
References
Pouwels S, Sakran N, Graham Y, Leal A, Pintar T, Yang W, et al. Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss. BMC Endocr Disord. 2022 Mar 14;22(1):63. https://doi.org/10.1186/s12902-022-00980-1.
Han SK, Baik SK, Kim MY. Non-alcoholic fatty liver disease: Definition and subtypes. Clin Mol Hepatol. 2023 Feb;29(suppl):S5-S16. https://doi.org/10.3350/cmh.2022.0424.
Seitz HK, Bataller R, Cortez-Pinto H, Gao B, Gual A, Lackner C, et al. Alcoholic liver disease. Nat Rev Dis Primers. 2018 Aug 16;4(1):16. https://doi.org/10.1038/s41572-018-0014-7.
Devarbhavi H, Asrani SK, Arab JP, Nartey YA, Pose E, Kamath PS. Global burden of liver disease: 2023 update. J Hepatol. 2023 Aug;79(2):516-537. https://doi.org/10.1016/j.jhep.2023.03.017.
Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018 Jan;15(1):11-20. https://doi.org/10.1038/nrgastro.2017.109.
Teng ML, Ng CH, Huang DQ, Chan KE, Tan DJ, Lim WH, et al. Global incidence and prevalence of nonalcoholic fatty liver disease. Clin Mol Hepatol. 2023 Feb;29(Suppl):S32-S42. https://doi.org/10.3350/cmh.2022.0365.
Lonardo A, Nascimbeni F, Ballestri S, Fairweather D, Win S, Than TA, et al. Sex Differences in Nonalcoholic Fatty Liver Disease: State of the Art and Identification of Research Gaps. Hepatology. 2019 Oct;70(4):1457-1469. https://doi.org/10.1002/hep.30626.
Muzurovi? E, Polyzos SA, Mikhailidis DP, Borozan S, Novosel D, Cmiljani? O, et al. Non-alcoholic Fatty Liver Disease in Children. Curr Vasc Pharmacol. 2023;21(1):4-25. https://doi.org/10.2174/1570161121666221118155136.
Shapiro WL, Noon SL, Schwimmer JB. Recent advances in the epidemiology of nonalcoholic fatty liver disease in children. Pediatr Obes. 2021 Nov;16(11):e12849. https://doi.org/10.1111/ijpo.12849
Anderson EL, Howe LD, Jones HE, Higgins JP, Lawlor DA, Fraser A. The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis. PLoS One. 2015 Oct 29;10(10):e0140908. https://doi.org/10.1371/journal.pone.0140908.
Brecelj J, Orel R. Non-Alcoholic Fatty Liver Disease in Children. Medicina (Kaunas). 2021 Jul 16;57(7):719. https://doi.org/10.3390/medicina57070719
Cotter TG, Rinella M. Nonalcoholic Fatty Liver Disease 2020: The State of the Disease. Gastroenterology. 2020 May;158(7):1851-1864. https://doi.org/10.1053/j.gastro.2020.01.052.
Cataldo I, Sarcognato S, Sacchi D, Cacciatore M, Baciorri F, Mangia A, et al. Pathology of non-alcoholic fatty liver disease. Pathologica. 2021 Jun;113(3):194-202. https://doi.org/10.32074/1591-951X-242.
Kwak MS, Kim D, Chung GE, Kim W, Kim YJ, Yoon JH. Cholecystectomy is independently associated with nonalcoholic fatty liver disease in an Asian population. World J Gastroenterol. 2015 May 28;21(20):6287-95. https://doi.org/10.3748/wjg.v21.i20.6287
Li X, Guo X, Ji H, Yu G, Gao P. Gallstones in Patients with Chronic Liver Diseases. Biomed Res Int. 2017;2017:9749802. https://doi.org/10.1155/2017/9749802.
Chen LY, Qiao QH, Zhang SC, Chen YH, Chao GQ, Fang LZ. Metabolic syndrome and gallstone disease. World J Gastroenterol. 2012 Aug 21;18(31):4215-20. https://doi.org/10.3748/wjg.v18.i31.4215
Foster KJ, Dewbury KC, Griffith AH, Wright RM. The accuracy of ultrasound in the detection of fatty infiltration of the liver. British Journal of Radiology. 1980;53(629):440–2. https://doi.org/10.1259/0007-1285-53-629-440
Roldan-Valadez E, Favila R, Martínez-López M, Uribe M, Méndez-Sánchez N. Imaging techniques for assessing hepatic fat content in nonalcoholic fatty liver disease. Annals of Hepatology. 2008 Jul–Sep;7(3):212–20. https://doi.org/10.1016/S1665-2681(19)31988-0
Jiang GH, Li S, Li HY, Xie LJ, Li SY, Yan ZT, et al. Bidirectional associations among gallstone disease, non-alcoholic fatty liver disease, kidney stone disease. World J Gastroenterol. 2024 Dec 14;30(46):4914-4928. https://doi.org/10.3748/wjg.v30.i46.4914.
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