Non-alcoholic fatty liver disease incidence, remission and risk factors among a general Chinese population with a 6-year follow-up

Wu, Jing; He, Su‐Mei; Xu, Hao; Chi, Xiumei; Sun, Jian; Wang, Xiaomei; Gao, Xiuzhu; Wu, Ruihong; Shao, Mingbai; Zhao, Heng; Jia, Jing; Wang, Chunyan; Niu, Junqi

doi:10.1038/s41598-018-25641-z

Cited by 13 publications

(15 citation statements)

References 25 publications

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“…Our results are different to the few other, smaller, general population studies in the three Western and Chinese population cohorts which reported NAFLD resolution rates of about 25% to 50% [4–6]. Whether lifestyle interventions were made in these populations is unclear.…”

Section: Discussioncontrasting

confidence: 99%

“…The improvements in some metabolic associations and the small reduction in weight (1.6% from baseline) after 7 years were inadequate for NAFLD resolution. In the Chinese study by Wu et al mentioned previously, male gender and lower BMI level at baseline were associated with NAFLD remission [6]. However, there was no significant difference in the change in weight during follow-up between the sustained NAFLD and NAFLD remission groups [6].…”

Section: Discussionmentioning

confidence: 99%

“…Zelber-Sagi et al reported a 36% resolution rate in 66 Israeli patients with NAFLD after 7 years, with a 75% remission rate among NAFLD patients who lost 5% or more of their baseline weight [5]. A more recent general population study from China reported a 24.6% remission rate in 134 individuals with NAFLD after 6 years; those with lower weight at baseline and male subjects were more likely to undergo NAFLD remission [6].…”

Section: Introductionmentioning

confidence: 99%

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Non-resolution of non-alcoholic fatty liver disease (NAFLD) among urban, adult Sri Lankans in the general population: A prospective, cohort follow-up study

et al. 2019

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BackgroundThere are few studies investigating the natural course of non-alcoholic fatty liver disease (NAFLD) in the community. We assessed resolution of NAFLD in a general population cohort of urban Sri Lankans adults.MethodsParticipants were selected by age-stratified random sampling from electoral lists. They were initially screened in 2007 and re-evaluated in 2014. On both occasions structured interview, anthropometric-measurements, liver ultrasonography, and biochemical/serological tests were performed. NAFLD was diagnosed on ultrasound criteria for fatty liver, safe-alcohol consumption (<14-units/week for men, <7-units/week for women) and absence of hepatitis B/C markers. Non-NAFLD was diagnosed on absence of any ultrasound criteria for fatty liver and safe-alcohol consumption. Resolution of NAFLD was defined as absence of ultrasound criteria for fatty liver. Changes in anthropometric indices [Weight, Body-Mass-Index (BMI), waist-circumference (WC), waist-hip ratio (WHR)], clinical [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and biochemical measurements [Triglycerides (TG), High Density Lipoprotein (HDL), Total Cholesterol (TC), HbA1c%] at baseline and follow-up were compared.ResultsOf the 2985 original study participants, 2148 (71.9%) attended follow-up after 7 years. This included 705 who had NAFLD in 2007 and 834 who did not have NAFLD in 2007. Out of 705 who had NAFLD in 2007, 11(1.6%) changed their NAFLD status due to excess alcohol consumption. After controlling for baseline values, NAFLD patients showed significant reduction in BMI, weight, WHR, HDL and TC levels and increase in HbA1c levels compared to non-NAFLD people. Despite this, none of them had complete resolution of NAFLD.ConclusionWe did not find resolution of NAFLD in this general population cohort. The observed improvements in anthropometric, clinical and biochemical measurements were inadequate for resolution of NAFLD.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-resolution of non-alcoholic fatty liver disease (NAFLD) among urban, adult Sri Lankans in the general population: A prospective, cohort follow-up study

et al. 2019

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“…NAFLD is one of the main causes of chronic liver disease, which has become one of the major causes of liver disease-related morbidity and mortality in Western countries [9]. An independent epidemiological survey showed that, from 2007 to 2013, the prevalence of NAFLD in the general population increased from 23.5% to 44.3% among men and from 17.6% to 43.1% among women [10]. The prevalence of NAFLD in the average adult rose from 15% to more than 31% over a 10-year period, according to a survey in Shanghai and Beijing, China [11].…”

Section: Introductionmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease Aggravated the Severity of Acute Pancreatitis in Patients

Zhang

et al. 2019

BioMed Research International

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Background and Aim The incidence of nonalcoholic fatty liver disease (NAFLD) as a metabolic disease is increasing annually. In the present study, we aimed to explore the influence of NAFLD on the severity of acute pancreatitis (AP). Methods The severity of AP was diagnosed and analyzed according to the 2012 revised Atlanta Classification. Outcome variables, including the severity of AP, organ failure (all types of organ failure), and systemic inflammatory response syndrome (SIRS), were compared for patients with and without NAFLD. Results Six hundred and fifty-six patients were enrolled in the study and were divided into two groups according to the presence or absence of NAFLD. The non-NAFLD group contained 278 patients and the main etiology in this group was gallstone. The NAFLD group consisted of 378 patients and the main etiology was hyperlipidemia. The incidence of mild AP, moderately severe AP, and severe AP was 77.30%, 18.3%, and 4.3% in the non-NAFLD group and 58.2%, 33.9%, and 7.9% in the NAFLD group, respectively. There were significant differences between the two groups according to the severity of AP (P ≤ 0.001). In addition, the Ranson and BISAP scores as well as the incidence of SIRS and organ failure in the NAFLD group were higher than those in the non-NAFLD group (all P < 0.05). The patients were further divided into non-NAFLD, mild-NAFLD, and moderate-severe NAFLD (M+S-NAFLD) groups. The results showed that the severity of AP increased gradually from the non-NAFLD group to the M+S-NAFLD group. In addition, the incidence rates of SIRS and organ failure showed an upward trend with the aggravation of fatty liver severity. Multivariate logistic analysis showed that patients with NAFLD, especially those with M+S-NAFLD, had higher risks of SIRS and organ failure. Conclusions Compared with non-NAFLD, NAFLD has a clinically relevant impact on the severity of AP and may be an early prognostic parameter for patients with AP.

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“…224 Moreover, patients with NAFLD commonly have higher BMI in cross-sectional studies compared with patients without NAFLD. 225,226 In the Coronary Artery Risk Development in Young Adults Study, weight gain during young adulthood seem to predict future development of NAFLD. 227 Furthermore, weight loss, either by lifestyle intervention [228][229][230] or bariatric surgery, [231][232][233] seem to resolve both NAFLD and insulin resistance.…”

Section: Obesity Obesity (Body Mass Index [Bmi]mentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease : Aspects on Diagnosis and Long-term Prognosis

Nasr

2019

Linköping University Medical Dissertations

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Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease affecting approximately 25% of the global population. NAFLD is commonly recognized as the hepatic manifestation of the metabolic syndrome, i.e. abdominal adiposity, dyslipidaemia, hypertension, and type 2 diabetes mellitus (T2DM). Most individuals with NAFLD will develop T2DM, and vice versa-making the two conditions highly intertwined. The histological spectrum of NAFLD ranges from simple steatosis to non-alcoholic steatohepatitis (NASH), which is defined by hepatocellular injury and inflammation, with risk of developing fibrosis and subsequent cirrhosis and hepatocellular carcinoma. The gold standard for diagnosing NAFLD is liver biopsy. However, because of its invasive nature, liver biopsy entails some risk of adverse events and even death. Also, there is a high risk of sampling error, as well as intraand interobserver variability, making the results unreliable. Therefore, several non-invasive methods have been developed and validated in evaluating presence of fat and absence of fibrosis in patients with NAFLD. However, evaluation of inflammation and hepatocellular injury (i.e. NASH) or staging of fibrosis, still requires liver biopsy. Liver fat content can be assessed using various methods. The conventional histopathological method consists of a visual semiquantitative approach in which the pathologist uses a four-point scale: grade 0 corresponds to fat deposition in <5% of hepatocytes and corresponds (grade 1=5-33%, 2=34-66%, and 3=67-100%). A diagnosis of NAFLD requires that at least 5% of hepatocytes contain fat vacuoles. An alternate approach is to quantitatively assess steatosis using stereological point counting (SPC). Both the semiquantitative histological method and SPC rely on biopsies, however, in vivo proton magnetic resonance spectroscopy (1 H-MRS) is a reliable non-invasive method that can be used to quantitatively assess total hepatic lipid content, or proton density fat fraction (PDFF). In Paper I we compared the conventional semiquantitative histological method (grade 0-3) with SPC and 1 H-MRS. We found a strong positive correlation between 1 H-MRS and SPC, whereas the correlations between 1 H-MRS or SPC and histopathological grading were substantially weaker. Using the widely used cutoff participants were found to have steatosis (specificity 100%, sensitivity 53%). Reducing the cutoff cumbed to the workload. My boss and fellow skåning, Henrik Hjortswang, for teaching me that best patient care is given by seeking knowledge as a researcher, carrying it forward as a teacher and applying it as a clinician. Also, for giving me all opportunities to research, participate on courses and attend congresses on available time. My clinical tutor and mentor, Rikard Svernlöv, for helping me realize that there is a life outside of work, helping me cope with clinical dilemmas, and for being a role model in all things, big and small, in the role as a physician. I only have 40 years left until retirement, and then I prom...

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Non-alcoholic fatty liver disease incidence, remission and risk factors among a general Chinese population with a 6-year follow-up

Cited by 13 publications

References 25 publications

Non-resolution of non-alcoholic fatty liver disease (NAFLD) among urban, adult Sri Lankans in the general population: A prospective, cohort follow-up study

Non-resolution of non-alcoholic fatty liver disease (NAFLD) among urban, adult Sri Lankans in the general population: A prospective, cohort follow-up study

Nonalcoholic Fatty Liver Disease Aggravated the Severity of Acute Pancreatitis in Patients

Non-Alcoholic Fatty Liver Disease : Aspects on Diagnosis and Long-term Prognosis

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