Background & Aims
Metabolic Associated Fatty Liver Disease (MAFLD) was proposed as a better definition of Non-Alcoholic Fatty Liver Disease (NAFLD) to encompass the metabolic dysregulation associated with NAFLD. This redefinition challenges our understanding of the disease. Hence, this study sought to conduct an updated analysis of the prevalence, clinical characteristics and associated factors of MAFLD, with a further sensitivity analysis done based on lean and non-obese MAFLD individuals.
Methods
Medline and Embase databases were searched to include articles on MAFLD. Meta-analysis of proportions was conducted using the generalised linear mix model. Associating factors were evaluated in conventional pairwise meta-analysis with sensitivity analysis on lean and non-obese MAFLD.
Results
From pooled analysis involving 3,320,108 individuals, the overall prevalence of MAFLD was 38.77% (95%CI: 32.94% to 44.95%). 5.37% (95%CI: 4.36% to 6.59%) and 29.78% (95%CI: 26.06% to 33.79%) being of lean and non-obese respectively had MAFLD. Metabolic complications such as hypertension (OR: 2.63; 95%CI: 1.85 to 3.74; p<0.0001 and OR: 2.03; 95%CI: 1.74 to 2.38; p<0.0001, respectively) and diabetes (OR: 3.80; 95%CI: 2.65 to 5.43; p<0.0001 and OR: 3.46; 95%CI: 2.81 to 4.27; p<0.0001, respectively) were found as significant associating factors associated with lean and non-obese MAFLD.
Conclusions
This meta-analysis supports previous studies in reporting MAFLD to affect more than a third of the global population. While exploration of the pathogenic basis of fatty liver disease without metabolic dysregulation is required, the emphasis on management of concomitant metabolic disease in MAFLD can improve multidisciplinary efforts in managing the complex disease.
This study aimed to examine the rate of re-operation in women with endometriosis over a 10-year period. This was a retrospective study set in a university hospital in the UK. Notes of all women diagnosed with endometriosis were reviewed and data entered on a standard proforma. A total of 486 out of 988 procedures were for treatment of endometriosis. Some 240 (49%) had pelvic pain and 246 (51%) had subfertility. The mean age of those women who had a re-operation was lower than those who did not have any further operations. Using logistic regression, three factors were found to be the most important factors influencing the likelihood of women having re-operation - in decreasing order of importance, these factors were: (1) age, (2) pregnancy achievement and (3) improvement of symptoms. Re-operation occurred in 51% of our study population, the information may be useful for guidance of our patients.
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