Grant: Project Grant

Non-alcoholic Fatty Liver Disease (NAFLD) is a chronic liver disease resulting from excess amounts of fat in the liver. It is the most common liver disease in Canada, affecting 25% of the population and causing substantial liver-related morbidity and mortality. Despite the importance of this condition there are no community-based studies describing the burden of NAFLD in Canada and in particular the First Nations (FN) populations, who are at a significantly higher risk of developing NAFLD due to the high rates of diabetes and obesity (established risk factors for NAFLD) in this population. To address this knowledge gap, we will conduct surveys of ~2,000 adult residents in FN and non-FN communities using portable ultrasounds. Persons with NAFLD will be assessed for disease severity by clinical, biochemical and radiologic (FibroScans) features and followed for 5 years with biannual clinical visits to monitor the course of the disease. Those without NAFLD at baseline will be reassessed with repeat ultrasounds at the end of the 5-year follow-up period to determine the incidence of new cases. This study is designed to improve the awareness, understanding and ultimately, provide more effective care for Canadians with NAFLD. While documenting the extent and severity of the condition in rural and FN communities, the researchers will work with community leaders and elders to develop educational programs, prevention strategies and identify lifestyle changes that would be of therapeutic benefit. The research findings will also inform and assist in health policy planning aimed at decreasing risk factors, improving early detection, predicting outcomes and identifying resources for NAFLD care in this country. Finally, the results will form the basis for an envisioned national NAFLD study that will address the unmet needs of a large segment of the Canadian population.