Guidelines of prevention and treatment of nonalcoholic fatty liver disease (2018, China)

Fan, Jian Gao; Wei, Lai; Zhang, Hui

doi:10.1111/1751-2980.12685

Cited by 158 publications

(162 citation statements)

References 65 publications

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“…Hence, in view of the limitations of the original studies, we cannot provide a stratified analysis by NAFL and NASH. Currently, liver biopsy remains the clinical gold standard for diagnosing NASH . More studies on the association between H. pylori infection and NAFLD diagnosed by liver biopsy are needed in the near future.…”

Section: Discussionmentioning

confidence: 99%

Association between Helicobacter pylori infection and nonalcoholic fatty liver disease: A systematic review and meta‐analysis of observational studies

Zhou

Yang

et al. 2019

Helicobacter

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Background The association between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD) has been shown in many observational studies, but these conclusions remain controversial. Hence, we performed a meta‐analysis to elucidate the association. Methods A comprehensive search was conducted on relevant studies published from inception to December 31, 2018, in PubMed, EMBASE, and Web of Science databases. Odds ratio (OR) with 95% confidence interval (95% CI) were pooled by random‐effect model, generic inverse variance method. Subgroup and sensitivity analyses were also done. Publication bias was estimated by the funnel plot, Begg's test, and Egger's test. Results Fifteen studies (eleven cross‐sectional, two case‐control, and two cohort studies) were included in this meta‐analysis. The pooled OR of NAFLD in patients with H. pylori infection was 1.19 (95% CI: 1.11‐1.29, P < 0.00001) when compared with the patients without H. pylori infection. Similar results were observed when the subgroup analyses were stratified by different geographical locations, study designs, and confounders adjustment. In subgroup analysis stratified by different H. pylori testing methods, the correlation still exists when using UBT, serology, RUT, or SAT, but there was no statistically significant difference when using multiple detection methods (OR = 2.96, 95% CI: 0.37‐23.94, P = 0.31). Sensitivity analyses showed that our results were robust. No evidence of substantial publication bias was detected. Conclusions Current evidence indicated that a positive association between H. pylori infection and the risk of NAFLD. Further prospective studies are warranted to strengthen the association and to clarify whether there is a causative link between them.

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Section: Discussionmentioning

confidence: 99%

Association between Helicobacter pylori infection and nonalcoholic fatty liver disease: A systematic review and meta‐analysis of observational studies

Zhou

Yang

et al. 2019

Helicobacter

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“…Ultrasound, CT and MRI have high sensitivity and specificity in the diagnosis of liver steatosis (26,27). According to the Chinese guidelines for the prevention and treatment of NAFLD (2018 updated edition) (28), the diagnosis of NAFLD should meet the following requirements: (1) liver biopsy indicates significant hepatic steatosis and/or imaging examination, such as ultrasound, CT and MRI results consistent with the manifestations of fatty liver, which liver fat content is more than 5%, (2) no history of alcohol consumption more than 30 g for men and 20 g for women per day, and (3) rule out other factors or diseases that contribute to hepatic steatosis.…”

Section: Imaging Evaluation Of the Liver Metastasis Assessmentmentioning

confidence: 99%

Effect of Non-alcoholic Fatty Liver Disease on the Risk of Synchronous Liver Metastasis: Analysis of 451 Consecutive Patients of Newly Diagnosed Colorectal Cancer

Zhang

2020

Front. Oncol.

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Background: The purpose of this study was to investigate the effect of non-alcoholic fatty liver disease (NAFLD) on the risk of synchronous colorectal liver metastasis (synCRLM).Methods: A retrospective analysis was performed on 451 consecutive patients with newly diagnosed colorectal cancer (CRC) from January 2014 to January 2019. According to the presence of NAFLD, the CRC patients were divided into two groups, NAFLD group (60 cases) and the control group (391 cases). The clinicopathological features and the prevalence of synCRLM between the two groups were compared. Logistic regression analysis was used to analyze the risk factors of synCRLM. Different non-invasive liver fibrosis scoring models were used to evaluate the effect of advanced fibrosis and cirrhosis stage in NAFLD on the prevalence of synCRLM.Results: The prevalence of synCRLM was significantly higher in patients with NAFLD than that in patients without NAFLD (18.33 vs. 7.42%; χ 2 = 7.669, P = 0.006). A logistic regression analysis indicated that NAFLD, CEA, CA19-9, and lymph node status were risk factors for synCRLM, and NAFLD showed the highest hazard ratio (3.930 [95% confidence interval: 1.616 ∼ 9.560]). In NAFLD patients, both fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) were significantly lower in those with synCRLM compared to those without synCRLM [FIB-4: 1.246 (0.833 ∼ 1.276) vs. 1.436 (1.016 ∼ 2.699), Z = −2.130, P = 0.033; NFS: −1.282 (−2.407 ∼ −0.262) vs. −0.255 (−1.582 ∼ 0.755), Z = −2.302, P = 0.021; Mann-Whitney test].Conclusion: NAFLD may be associated with increased liver metastasis, and for NAFLD-related advanced liver fibrosis and cirrhosis may be associated with reduced synchronous liver metastasis in CRC patients. However, the correlation between simple steatosis and steatohepatitis remains to be further determined. Certain factors such as NAFLD, lymph node metastasis, elevated levels of preoperative CEA and CA19-9 are suggesting a high risk of synCRLM.

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“…The ultrasonographers were unaware of the study's purpose and laboratory values. Fatty liver disease was diagnosed according to the standards of the Chinese Liver Disease Association (29).…”

Section: Diagnosis Of Nafldmentioning

confidence: 99%

Serum vitamin D concentrations are associated with obese but not lean NAFLD: a cross-sectional study

Wang

Shi

Wang

et al. 2020

Preprint

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Background: Low serum vitamin D concentrations have been reported to be associated with an increased risk of non-alcoholic fatty liver disease (NAFLD). However, whether slim or obese people show a similar association between vitamin D and NAFLD remains speculative. This study aimed to explore the relationship between serum vitamin D concentrations and NAFLD in lean and obese Chinese adults.Methods: This cross-sectional study included 2538 participants (1360 men and 1178 women) who underwent their health checkups at the First Affiliated Hospital of Zhejiang University School of Medicine in 2019. NAFLD was diagnosed by liver ultrasound excluding other causes. The association of serum vitamin D concentrations with NAFLD was analyzed in lean and obese participants.Results: The overall prevalence of NAFLD was 33.61% (13.10% in lean and 53.32% in obese) in this study population. The serum vitamin D levels of obese NAFLD patients were lower than that of the obese NAFLD-free controls. However, the serum vitamin D levels of lean NAFLD patients were comparable to that of the lean NAFLD-free controls. Serum vitamin D levels were negatively correlated with the prevalence of NAFLD in obese but not lean participants. Serum vitamin D levels were independently associated with the risk of NAFLD in obese participants, with an adjusted odd ratio (95% CI) of 0.986 (0.979–0.992). However, the serum vitamin D levels were not related to the risk of NAFLD in lean participants.Conclusions: Low serum vitamin D levels are associated with NAFLD in obese but not lean participants.

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Guidelines of prevention and treatment of nonalcoholic fatty liver disease (2018, China)

Cited by 158 publications

References 65 publications

Association between Helicobacter pylori infection and nonalcoholic fatty liver disease: A systematic review and meta‐analysis of observational studies

Association between Helicobacter pylori infection and nonalcoholic fatty liver disease: A systematic review and meta‐analysis of observational studies

Effect of Non-alcoholic Fatty Liver Disease on the Risk of Synchronous Liver Metastasis: Analysis of 451 Consecutive Patients of Newly Diagnosed Colorectal Cancer

Serum vitamin D concentrations are associated with obese but not lean NAFLD: a cross-sectional study

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