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[This article belongs to Volume - 71, Issue - 2]
Published on : 2026-02-28 21:30:49
Article Code: AMJ-28-02-2026-12368
Title : Screening for Non-Alcoholic Fatty Liver Disease (NAFLD) Among Adults in Singapore: A Community-Based Cross-Sectional Study in Tampines Regional Centre
Author(s) : Wei Ming Tan, Siti Nurhidayah Binte Rahman, Kok Hian Tan, Rajesh Kumar Sharma & Li Ling Tan
Abstract :
Background & objectives: Non-alcoholic fatty liver disease (NAFLD) is an emerging public health issue affecting 20-30% of the general population globally and up to 40% in Singapore. We aimed to estimate the prevalence of NAFLD and associated risk factors among adults at high risk for NAFLD (≥35 years) in Tampines Regional Centre, Singapore.
Methods: A community-based cross-sectional study was conducted among 392 adults at high risk for NAFLD using simple random sampling in an urban residential area of Singapore. Clinical assessment, blood investigations (liver function tests, lipid profile), and anthropometric measurements were performed. NAFLD was diagnosed using the fatty liver index (FLI >60) and risk stratification for advanced liver fibrosis by using the FIB-4 score. Participants with indeterminate/high-risk FIB-4 scores underwent vibration-controlled transient elastography (VCTE). Prevalence of NAFLD (proportions with 95% confidence interval [CI]) and risk factors associated with NAFLD (multivariable regression) were calculated.
Results: The prevalence of NAFLD among adults at high risk was 33.4% (95% CI: 28.9%-38.2%), and was higher among men (41.2%), those with diabetes mellitus (45.6%), and those with obesity (42.1%). Male sex, Malay ethnicity, diabetes mellitus, elevated alanine aminotransferase, and elevated triglycerides were significantly associated with high risk of NAFLD on multivariable analysis.
Interpretation & conclusions: One in three screened adults had NAFLD, increasing to nearly one in two among those with diabetes. Community-based screening using validated non-invasive tools offers a pragmatic pathway for early NAFLD detection in Singapore's multi-ethnic population.