Relationship between drinking frequency and fatty liver prevalence or incidence in Japanese undergoing health checkup in 2008‐2019

Abstract

Background & Aims:The relationship between the frequency of drinking and fatty liver in the general population is still poorly understood. This study analysed data from a large cohort who underwent health checkups in Japan between 2008 and 2019 to investigate the prevalence and incidence of fatty liver by alcohol consumption and risk factors for fatty liver. Methods:The prevalence of fatty liver diagnosed with ultrasonography was calculated in 75,670 residents. The incidence of fatty liver in 31,062 residents who underwent ultrasonography at least twice during the period without fatty liver at the first time was calculated using the person-year method. Multivariate logistic analysis was performed to investigate risk factors associated with the prevalence and incidence of fatty liver.

Prevalence of fatty liver and advanced fibrosis by ultrasonography and FibroScan in a general population random sample

“…Until now, the prevalence of fatty liver has been estimated only based on existing data from individuals undergoing medical checkups. 7,8 This study is the first report of an epidemiological survey undertaken on the Japanese general population. As ultrasonography has some weaknesses, such as inability to perform quantitative evaluation, dependence on the operator for diagnosis, and low sensitivity for mild hepatic steatosis, [29][30][31][32][33] FibroScan (CAP) was also used for fatty liver evaluation.…”

“…When limited to the fatty liver of nondrinkers, prevalence of NAFLD was 50.6%, which is almost twice the previously estimated prevalence based on the results of ultrasonography during health checkups. 1,7 It has been pointed out that there are some regional differences in the prevalence of NAFLD in Japan as well, 34 but the prevalence of NAFLD in the Chugoku area, which includes Hiroshima, was reported as 26.84%. It is unlikely that the high prevalence of NAFLD shown by this study was caused by a specific characteristic of the region.…”

“…Regarding the volume of patients with NAFLD, the prevalence of fatty liver in Japan was estimated to be 27.7% based on a large-scale analysis of 75 670 residents who received medical health checkups with abdominal ultrasonography. 7 Another study based on health checkups indicated that the number of patients with NAFLD in Japan was over 10 million, with an estimated prevalence of 40% in men and 20% in women. 8 As mentioned above, the prevalence of fatty liver in the general population has been usually estimated based on the results of ultrasonography at health checkups.…”

“…However, less than 10% of all residents who receive health checkups undergo ultrasonography in Japan. 7 As those previously diagnosed with fatty liver tend to undergo ultrasonography, selection bias might have affected previous estimates, overestimating the actual prevalence. Therefore, adequate estimation of the prevalence of fatty liver in the general population requires studies of randomly selected residents.…”

Prevalence and incidence of fatty liver for people who took part in a health checkup in 2008–2019 in Japan

“…We read the article by Sugiyama et al 1 with great interest. The authors reported on the relationship between alcohol consumption and the occurrence of fatty liver in Japan by evaluating alcoholic fatty liver diseases (AFLD) and non-alcoholic fatty liver diseases (NAFLD) for patients who took part in health examinations.…”