ABSTRACT
Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is a multifactorial disorder with combination of environmental, genetic and metabolic factors that play role in the progression of disease. This study is aimed to explore the familial clustering of NAFLD among the family members of NASH cirrhotic patients and the association of insulin resistance, metabolic syndrome and genetic polymorphism with the familial clustering. Methods: This cross-sectional observational study included 50 NASH cirrhosis patient and 81 1st degree relatives. Family members were screened for fatty liver by ultrasonogram. Insulin resistance, metabolic syndrome, PNPLA3 and staging of liver stiffness by fibroscan were done. Results: Among 81 family members 47 (58.02%) were found having fatty liver. Of these 14(17.28%) had significant fibrosis. PNPLA3 polymorphism was higher (80.85%) in fatty liver group than (55.9%) without fatty liver groups. Sons (57.89%) and daughters (51.6%) were affected by fatty liver equally. Multivariate logistic regression analysis revealed that a subject with TG>150 mg/dl had 6.159 times increase in odds having NAFLD. A subject with PNPLA3 polymorphism had 3.33 times increase in odds having NAFLD. A subject with HOMA-IR >1.6 had 4.375 times increase in odds having NAFLD. Conclusion: This study indicates that there is a strong familial clustering of NAFLD along with significant fibrosis among the family members of NASH cirrhosis patients. This findings warrants screening for NAFLD among the family members of NASH cirrhosis patients especially with PNPLA3 polymorphism.