Epidemiology of alcoholic and nonalcoholic fatty liver disease in China

Abstract

The prevalence of patients presenting with fatty liver disease (FLD) in China has approximately doubled over the past two decades. At present, FLD, which is typically diagnosed by imaging, is highly prevalent (~27% urban population) in China and is mainly related to obesity and metabolic syndrome (MetS). However, the percentage of alcoholic liver disease (ALD) among patients with chronic liver diseases in clinic is increasing as well, and a synergetic effect exists between heavy alcohol drinking and obesity in ALD. Prevalence figures reveal regional variations, with a median prevalence of ALD and nonalcoholic FLD (NAFLD) of 4.5% and 15.0%, respectively. The prevalence of NAFLD in children is 2.1%, although the prevalence increases to 68.2% among obese children. With the increasing pandemic of obesity and MetS in the general population, China is likely to harbor an increasing reservoir of patients with FLD. The risk factors for FLD resemble to those of Caucasian counterparts, but the ethnic-specific definitions of obesity and MetS are more useful in assessment of Chinese people. Therefore, FLD/NAFLD has become a most common chronic liver disease in China. Public health interventions are needed to halt the worldwide trend of obesity and alcohol abuse to ameliorate liver injury and to improve metabolic health.

Nonalcoholic Fatty Liver Disease

“…Studies from Japan and China recorded a twofold increase in the prevalence of NAFLD over a decade. 23,24 In contrast, the reported prevalence of NAFLD in the United States was already around 30-40% in 2004 and has not increased substantially thereafter 14 . The incidence of NAFLD is difficult to study because ultrasonography cannot reliably quantify liver fat.…”

“…For example, in China the prevalence of NAFLD is higher in coastal and urban areas (up to 30%) than in inland and rural areas (around 1%). 23 In urban areas, the prevalence of NAFLD is around 15-30% in Asia-Pacific countries and 10-20% in Africa.Compared with Western countries, the increase in NAFLD prevalence over time is more marked in Asia and the Pacific areas, probably reflecting rapid lifestyle changes. Studies from Japan and China recorded a twofold increase in the prevalence of NAFLD over a decade.…”

Non-alcoholic fatty liver disease

“…Studies from Japan and China recorded a twofold increase in the prevalence of NAFLD over a decade. 23,24 In contrast, the reported prevalence of NAFLD in the United States was already around 30-40% in 2004 and has not increased substantially thereafter 14 . The incidence of NAFLD is difficult to study because ultrasonography cannot reliably quantify liver fat.…”

The Herbal Composition Gangjihwan fromEphedra intermedia, Lithospermum erythrorhizonandRheum palmatumAmeliorates Hepatic Inflammation and Fibrosis in Obese C57BL/6J Mice and HepG2 Cells

“…In Western society, the NAFLD prevalence is estimated to be 20~30%, whereas it rises to 57~74% among obese patients, increasing up to 90% in morbidly obese subjects (Angulo, 2002;Machado et al, 2006;Milic and Stimac, 2012). There is evidence showing that NAFLD prevalence in the Asian countries is also rapidly growing due to the surge in obesity (Park et al, 2006;Fan, 2013;Chan et al, 2013;Koh et al, 2016).…”