Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular risk factors (data from Russian epidemiological studies)
O. M. Drapkina,
S. E. Evstifeeva,
S. A. Shalnova,
V. A. Kutsenko,
Yu. A. Balanova,
A. E. Imaeva,
A. V. Kapustina,
M. B. Kotova,
S. A. Maksimov,
G. A. Muromtseva,
O. A. Litinskaya,
M. S. Pokrovskaya,
E. M. Filichkina,
A. G. Soplenkova,
L. I. Gomanova,
Yu. V. Doludin,
I. A. Efimova,
A. L. Borisova,
N. S. Karamnova,
O. B. Shvabskaya,
I. A. Viktorova,
N. N. Prishchepa,
A. N. Redko,
S. S. Yakushin,
T. V. Repkina,
T. O. Gonoshilova,
A. V. Kudryavtsev,
N. I. Belova,
L. L. Shagrov,
M. A. Samotrueva,
A. L. Yasenyavskaya,
E. N. Chernysheva,
S. V. Glukhovskaya,
I. A. Levina,
E. A. Shirshova,
E. B. Dorzhieva,
E. Z. Urbanova,
N. Yu. Borovkova,
V. K. Kurashin,
A. S. Tokareva,
Yu. I. Ragino,
G. I. Simonova,
A. D. Khudyakova,
V. N. Nikulin,
O. R. Aslyamov,
G. V Khokhlova,
A. V. Solovyova,
A. A. Rodionov,
O. V. Kryachkova,
Yu. Yu. Shamurova,
I. V. Tantsyreva,
I. N. Baryshnikova,
M. G. Ataev,
M. O. Radzhabov,
M. M. Isakhanova,
M. A. Umetov,
L. V. Elgarova,
I. A. Khakuasheva,
E. I. Yamashkina,
M. V. Esina,
T. A. Kunyaeva,
A. M. Nikitina,
Yu. E. Spiridonova,
N. V. Savvina,
E. A. Naumova,
V. S. Yudin,
A. A. Keskinov,
D. A. Kashtanova,
S. M. Yudin,
A. B. Kontsevaya https://doi.org/10.15829/1728-8800-2025-4316
EDN: CVQNXA
Abstract
Aim. To study the prevalence of non-alcoholic fatty liver disease (NAFLD) and its association with cardiovascular risk factors (RFs).
Material and methods. The database from the ESSE-RF2 and ESSE-RF3 epidemiological studies was used, including data from surveys of population aged 35-64 years in 18 Russian regions (n=21204). To assess the prevalence of NAFLD, the fatty liver index (FLI) was used. Statistical analysis was performed using the statistical programming language and the R environment (version 3.6.1) with open-source code. The significance level for all tested hypotheses was p≤0,05.
Results. Standardized prevalence rates of FLI ≥60 in the ESSE-RF3 study are slightly higher than in the ESSE-RF2 study (39,2% vs 42,3%, respectively). Multivariate analysis adjusted for sex, age, region, settlement type, and education showed significant associations of FLI ≥60 with hypertension, type 2 diabetes, hyperuricemia, lipid metabolism disorders, elevated high-sensitivity C-reactive protein levels, and cerebrovascular accident in men and women.
Conclusion. Multivariate analysis confirmed the closest association of NAFLD with hypertension, type 2 diabetes mellitus, metabolic disorders, nonspecific inflammation, dyslipidemia, and cerebrovascular accident in men and women.
About the Authors
O. M. Drapkina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
S. E. Evstifeeva
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
S. A. Shalnova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
V. A. Kutsenko
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
Yu. A. Balanova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
A. E. Imaeva
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
A. V. Kapustina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
M. B. Kotova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
S. A. Maksimov
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
G. A. Muromtseva
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
O. A. Litinskaya
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
M. S. Pokrovskaya
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
E. M. Filichkina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
A. G. Soplenkova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
L. I. Gomanova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
Yu. V. Doludin
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
I. A. Efimova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
A. L. Borisova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
N. S. Karamnova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
O. B. Shvabskaya
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation
Russian Federation
Moscow
I. A. Viktorova
Omsk State Medical University
Russian Federation
Russian Federation
Omsk
N. N. Prishchepa
City Polyclinic № 1
Russian Federation
Russian Federation
Petrozavodsk
A. N. Redko
4Kuban State Medical University
Russian Federation
Russian Federation
Krasnodar
S. S. Yakushin
5Pavlov Ryazan State Medical University
Russian Federation
Russian Federation
Ryazan
T. V. Repkina
Regional Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Barnaul
T. O. Gonoshilova
Regional Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Barnaul
A. V. Kudryavtsev
Northern State Medical University
Russian Federation
Russian Federation
Arkhangelsk
N. I. Belova
Northern State Medical University
Russian Federation
Russian Federation
Arkhangelsk
L. L. Shagrov
Northern State Medical University
Russian Federation
Russian Federation
Arkhangelsk
M. A. Samotrueva
Astrakhan State Medical University
Russian Federation
Russian Federation
Astrakhan
A. L. Yasenyavskaya
Astrakhan State Medical University
Russian Federation
Russian Federation
Astrakhan
E. N. Chernysheva
Astrakhan State Medical University
Russian Federation
Russian Federation
Astrakhan
S. V. Glukhovskaya
Sverdlovsk Regional Medical College
Russian Federation
Russian Federation
Yekaterinburg
I. A. Levina
Sverdlovsk Regional Medical College
Russian Federation
Russian Federation
Yekaterinburg
E. A. Shirshova
Sverdlovsk Regional Medical College
Russian Federation
Russian Federation
Yekaterinburg
E. B. Dorzhieva
Boyanova Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Ulan-Ude
E. Z. Urbanova
Boyanova Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Ulan-Ude
N. Yu. Borovkova
Volga Region Research Medical University
Russian Federation
Russian Federation
Nizhny Novgorod
V. K. Kurashin
Volga Region Research Medical University
Russian Federation
Russian Federation
Nizhny Novgorod
A. S. Tokareva
Volga Region Research Medical University
Russian Federation
Russian Federation
Nizhny Novgorod
Yu. I. Ragino
Research Institute for Therapy and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
Russian Federation
Russian Federation
Novosibirs
G. I. Simonova
Research Institute for Therapy and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
Russian Federation
Russian Federation
Novosibirs
A. D. Khudyakova
Research Institute for Therapy and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
Russian Federation
Russian Federation
Novosibirs
V. N. Nikulin
Orenburg Regional Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Orenburg
O. R. Aslyamov
Orenburg Regional Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Orenburg
G. V Khokhlova
Orenburg Regional Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Orenburg
A. V. Solovyova
Tver State Medical University
Russian Federation
Russian Federation
Tver
A. A. Rodionov
Tver State Medical University
Russian Federation
Russian Federation
Tver
O. V. Kryachkova
Tver State Medical University
Russian Federation
Russian Federation
Tver
Yu. Yu. Shamurova
South Ural State Medical University
Russian Federation
Russian Federation
Chelyabinsk
I. V. Tantsyreva
South Ural State Medical University
Russian Federation
Russian Federation
Chelyabinsk
I. N. Baryshnikova
South Ural State Medical University
Russian Federation
Russian Federation
Chelyabinsk
M. G. Ataev
S. A. Abusuev Research Institute of Environmental Medicine, Dagestan State Medical University
Russian Federation
Russian Federation
Makhachkala
M. O. Radzhabov
S. A. Abusuev Research Institute of Environmental Medicine, Dagestan State Medical University
Russian Federation
Russian Federation
Makhachkala
M. M. Isakhanova
S. A. Abusuev Research Institute of Environmental Medicine, Dagestan State Medical University
Makhachkala
M. A. Umetov
Berbekov Kabardino-Balkarian State University
Russian Federation
Russian Federation
Nalchik
L. V. Elgarova
Berbekov Kabardino-Balkarian State University
Russian Federation
Russian Federation
Nalchik
I. A. Khakuasheva
Berbekov Kabardino-Balkarian State University
Russian Federation
Russian Federation
Nalchik
E. I. Yamashkina
Ogarev Mordovian State University
Russian Federation
Russian Federation
Saransk
M. V. Esina
Ogarev Mordovian State University
Russian Federation
Russian Federation
Saransk
T. A. Kunyaeva
Ogarev Mordovian State University;
Mordovian Republican Central Clinical Hospital
Russian Federation
Russian Federation
Saransk
A. M. Nikitina
Republican Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Yakutsk
Yu. E. Spiridonova
Republican Center for Public Health and Medical Prevention
Russian Federation
Russian Federation
Yakutsk
N. V. Savvina
Ammosov North-Eastern Federal University
Russian Federation
Russian Federation
Yakutsk
E. A. Naumova
Republican Center for Public Health and Medical Prevention, Exercise Therapy and Sports Medicine
Russian Federation
Russian Federation
Cheboksary
V. S. Yudin
Center for Strategic Planning and Management of Biomedical Health Risks
Russian Federation
Russian Federation
Moscow
A. A. Keskinov
Center for Strategic Planning and Management of Biomedical Health Risks
Russian Federation
Russian Federation
Moscow
D. A. Kashtanova
Center for Strategic Planning and Management of Biomedical Health Risks
Russian Federation
Russian Federation
Moscow
S. M. Yudin
Center for Strategic Planning and Management of Biomedical Health Risks
Russian Federation
Russian Federation
Moscow
A. B. Kontsevaya
National Medical Research Center for Therapy and Preventive Medicine
Moscow
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Supplementary files
What is already known about the subject?
- Non-alcoholic fatty liver disease (NAFLD) can be classified as a non-communicable disease.
- According to a 2023 meta-analysis, the global prevalence of NAFLD has increased by 50,4% over a 20-year period. In the Russian clinical and epidemiological study DIREG, researchers also point to a rapid increase in the prevalence of NAFLD among Russians (+38,1% over 7 years). NAFLD is a multidisciplinary problem and, according to research, is associated with cardiovascular diseases, type 2 diabetes, metabolic syndrome, and excess mortality not associated with liver disease.
What might this study add?
- For the first time in Russia, the prevalence of NAFLD was obtained on a representative sample of the epidemiological study of the adult population, which amounted to 39,2% according to the fatty liver index.
- The analysis performed on a representative Russian sample of the epidemiological study confirmed the association of NAFLD with hypertension, type 2 diabetes, dyslipidemia and hyperuricemia, as well as with cerebrovascular accident in men and women, indicating its multifactorial metabolic nature of the disease.
Review
For citations:
Drapkina O.M., Evstifeeva S.E., Shalnova S.A., Kutsenko V.A., Balanova Yu.A., Imaeva A.E., Kapustina A.V., Kotova M.B., Maksimov S.A., Muromtseva G.A., Litinskaya O.A., Pokrovskaya M.S., Filichkina E.M., Soplenkova A.G., Gomanova L.I., Doludin Yu.V., Efimova I.A., Borisova A.L., Karamnova N.S., Shvabskaya O.B., Viktorova I.A., Prishchepa N.N., Redko A.N., Yakushin S.S., Repkina T.V., Gonoshilova T.O., Kudryavtsev A.V., Belova N.I., Shagrov L.L., Samotrueva M.A., Yasenyavskaya A.L., Chernysheva E.N., Glukhovskaya S.V., Levina I.A., Shirshova E.A., Dorzhieva E.B., Urbanova E.Z., Borovkova N.Yu., Kurashin V.K., Tokareva A.S., Ragino Yu.I., Simonova G.I., Khudyakova A.D., Nikulin V.N., Aslyamov O.R., Khokhlova G.V., Solovyova A.V., Rodionov A.A., Kryachkova O.V., Shamurova Yu.Yu., Tantsyreva I.V., Baryshnikova I.N., Ataev M.G., Radzhabov M.O., Isakhanova M.M., Umetov M.A., Elgarova L.V., Khakuasheva I.A., Yamashkina E.I., Esina M.V., Kunyaeva T.A., Nikitina A.M., Spiridonova Yu.E., Savvina N.V., Naumova E.A., Yudin V.S., Keskinov A.A., Kashtanova D.A., Yudin S.M., Kontsevaya A.B. Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular risk factors (data from Russian epidemiological studies). Cardiovascular Therapy and Prevention. 2025;24(2):4316. (In Russ.) https://doi.org/10.15829/1728-8800-2025-4316. EDN: CVQNXA
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