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Cohort profile: the Trivandrum non-alcoholic fatty liver disease (NAFLD) cohort
  1. Jane Chalmers1,2,
  2. Lu Ban1,2,
  3. Kondarapassery B Leena3,4,
  4. Kimberley L Edwards5,
  5. Jane L Grove1,2,
  6. Guruprasad P Aithal1,2,
  7. Kotacherry T Shenoy3,6
  1. 1 NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
  2. 2 Nottingham Digestive Diseases Centre, The University of Nottingham, Nottingham, UK
  3. 3 Population Health and Research Institute (PHRI), Trivandrum, India
  4. 4 Holistic Health and Research Institute, Trivandrum, India
  5. 5 Orthopaedics, Trauma and Sports Medicine, Faculty of Medicine and Health Sciences, School of Medicine, University of Nottingham, Nottingham, UK
  6. 6 Department of Gastroenterology, Sree Gokulam Medical College and Research Foundation, Trivandrum, India
  1. Correspondence to Guruprasad P Aithal; guru.aithal{at}


Purpose The Trivandrum non-alcoholic fatty liver disease (NAFLD) cohort is a population-based study designed to examine the interaction between genetic and lifestyle factors and their association with increased risk of NAFLD within the Indian population.

Participants Between 2013 and 2016, a total of 2222 participants were recruited to this cohort through multistage cluster sampling across the whole population of Trivandrum—a district within the state of Kerala, South India. Data were collected from all inhabitants of randomly selected households over the age of 25.

Findings to date Full baseline clinical and pathological data were collected from 2158 participants. This included detailed demographic profiles, anthropometric measures and lifestyle data (food frequency, physical activity and anxiety and depression questionnaires). Biochemical profile and ultrasound assessment of the liver were performed and whole blood aliquots were collected for DNA analysis.

The NAFLD prevalence within this population was 49.8% which is significantly higher than the global pooled prevalence of 25%. This highlights the importance of robust, prospective studies like this to enable collection of longitudinal data on risk factors, disease progression and to facilitate future interventional studies.

Future plans The complete analysis of data collected from this cohort will give valuable insights into the interaction of the phenotypic and genotypic profiles that result in such a dramatic increased risk of NAFLD within the Indian population. The cohort will also form the basis of future lifestyle interventional studies, aimed at improving liver and metabolic health.

  • hepatology
  • epidemiology
  • hepatobiliary disease

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  • Contributors KTS and GPA contributed the original concept and design of the study. KTS, KBL and JLG were involved in data collection and sample management. JC and LB did the data analysis and interpretation while JC, LB and KLE drafted the work. All the authors have critically revised this article and approved the final version to be published.

  • Funding The Nottingham Biomedical Research Centre (Digestive Diseases theme) supports PHRI and is funded by the National Institute for Health Research (NIHR).

  • Disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Ethics approval Ethical approval for the study was granted by the Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Trivandrum, India.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Researchers may request access to data and biomaterial by contacting the corresponding author.

  • Collaborators Both the NIHR Nottingham Biomedical Research Centre (Gastrointestinal and Liver Disorder theme) and Population Health and Research Institute (PHRI) welcome interest and collaboration with national and international colleagues. For further information please contact the corresponding author.

  • Patient consent for publication Not required.

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