The epidemiology of NAFLD in Mainland China with analysis by adjusted gross regional domestic product: a meta-analysis

Wu, Yuankai; Zheng, Qi; Zou, Biyao; Yeo, Yee Hui; Li, Xiaohe; Li, Jie; Xie, Xiaoyu; Feng, Yuemin; Stave, Christopher D; Zhu, Qiang; Cheung, Ramsey; Nguyen, Mindie H.

doi:10.1007/s12072-020-10023-3

Cited by 81 publications

(83 citation statements)

References 20 publications

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“…( 9 ) A recent meta‐analysis of NAFLD in Mainland China reported that the overall prevalence of NAFLD is about 30%. ( 18 ) Thus, the rate of concurrent NAFLD in patients with COVID‐19 in our study is consistent with the prevalence of NALFD in the general population in China, indicating that concurrent NAFLD may not be a risk factor of SARS‐CoV‐2 infection.…”

Section: Discussionsupporting

confidence: 86%

Clinical Features of Patients With COVID‐19 With Nonalcoholic Fatty Liver Disease

et al. 2020

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Background and Aims Previous studies reported that coronavirus disease 2019 (COVID‐19) was likely to result in liver injury. However, few studies investigated liver injury in COVID‐19 patients with chronic liver diseases. We described the clinical features in COVID‐19 patients with non‐alcoholic fatty liver disease (NAFLD). Methods Confirmed COVID‐19 patients from hospitals in 10 cities of Jiangsu province, China were retrospectively included between January 18, 2020, and February 26, 2020. Hepatic Steatosis Index (HSI) was used to defined NAFLD. Results A total of 280 COVID‐19 patients were enrolled. Eighty‐six (30.7%) of 280 COVID‐19 patients were diagnosed as NAFLD by HSI. 100 (35.7%) patients presented abnormal liver function on admission. The median ALT levels (34.5 U/L vs. 23.0 U/L, P<0.001) and the proportion of elevated ALT (>40 U/L) (40.7% vs. 10.8%, P<0.001) were significantly higher in patients with NAFLD than in patients without NAFLD on admission. The proportion of elevated ALT in patients with NAFLD was also significantly higher than patients without NAFLD (65.1% vs. 38.7%, P<0.001) during hospitalization. Multivariate analysis showed that age over 50 years (odds ratio [OR] 2.077, 95% confidence interval [CI] 1.183‐3.648, P=0.011), and concurrent NAFLD (OR 2.956, 95% CI 1.526‐5.726, P=0.001) were independent risk factors of ALT elevation in COVID‐19 patients, while the atomized inhalation of interferon α‐2b (OR 0.402, 95%CI 0.236‐0.683, P=0.001) was associated with the reduced risk of ALT elevation during hospitalization. No patient developed liver failure or death during hospitalization. The complications and clinical outcomes were comparable between COVID‐19 patients with and without NAFLD. Conclusions NAFLD patients are more likely to develop liver injury when infected by COVID‐19. However, no patient developed severe liver‐related complications during hospitalization.

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Section: Discussionsupporting

confidence: 86%

Clinical Features of Patients With COVID‐19 With Nonalcoholic Fatty Liver Disease

et al. 2020

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“…The review also provides direction for future studies on bone health in post-LT patients. However, in the analysis of incidence, we were limited in the interpretation by heterogeneity with a large I 2 value (>90%) [71,72]. Simulation studies have found that large sample sizes result in increased I 2 and can be an inaccurate measure of heterogeneity [73,74].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

A systematic review and meta‐analysis on the incidence of osteoporosis and fractures after liver transplant

Lim

et al. 2021

Transpl Int

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Following liver transplant (LT), osteoporosis is a severe complication that causes morbidity. However, the incidence and risk factors of osteoporosis and fractures have not been well described. Single-arm meta-analysis of studies reporting osteopenia, osteoporosis, and fractures post-LT was performed with meta-regression for study period. Dichotomous variables, continuous variables and time-to-event variables were pooled in odds ratio, weighted mean difference and hazard ratio, respectively. For risk factors with limited data, a systematic review of literature was conducted. There was a significant increase in both osteoporosis and fractures compared to non-LT patients. Osteopenia, osteoporosis and incident fractures were newly diagnosed in 34.53% (CI: 0.17-0.56, n = 301), 11.68% (CI: 0.05-0.24, n = 1251) and 20.40% (CI: 0.13-0.30, n = 4322) of LT patients, respectively. Female gender (P = 0.017) increased risks of osteoporosis but not older age and BMI. Older age, lower pre-LT bone mineral density (BMD), presence of bone disease pre-LT were significant risk factors for fractures but not female gender, post-menopausal state, BMI, smoking and alcohol. There is a high incidence of skeletal complications post-LT. Older age, lower pre-LT BMD and presence of bone disease pre-LT are significant risk factors that are associated with incident fractures physicians should be cognisant of in liver transplant recipients.

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“…11.72% in lean). [ 11 ] The prevalence of NAFLD is paralleled with the rising trend of obesity in China (the prevalence from approximately 2% in 2000 to 7% in 2014). [ 12 ] Moreover, T2DM and obesity also increase the risk of progression from simple steatosis to NASH, cirrhosis, and HCC.…”

Section: Epidemiologymentioning

confidence: 99%

MAFLD vs. NAFLD: shared features and potential changes in epidemiology, pathophysiology, diagnosis, and pharmacotherapy

Xian

Weng

2020

Chinese Medical Journal

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Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, placing an increasing burden on human health. NAFLD is a complex multifactorial disease involving genetic, metabolic, and environmental factors. It is closely associated with metabolic syndrome, obesity, and type 2 diabetes, of which insulin resistance is the main pathophysiological mechanism. Over the past few decades, investigation of the pathogenesis, diagnosis, and treatments has revealed different aspects of NAFLD, challenging the accuracy of definition and therapeutic strategy for the clinical practice. Recently, experts reach a consensus that NAFLD does not reflect the current knowledge, and metabolic (dysfunction) associated fatty liver disease (MAFLD) is suggested as a more appropriate term. The new definition puts increased emphasis on the important role of metabolic dysfunction in it. Herein, the shared features and potential changes in epidemiology, pathophysiology, diagnosis, and pharmacotherapy of the newly defined MAFLD, as compared with the formerly defined NAFLD, are reviewed for updating our understanding.

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The epidemiology of NAFLD in Mainland China with analysis by adjusted gross regional domestic product: a meta-analysis

Cited by 81 publications

References 20 publications

Clinical Features of Patients With COVID‐19 With Nonalcoholic Fatty Liver Disease

Clinical Features of Patients With COVID‐19 With Nonalcoholic Fatty Liver Disease

A systematic review and meta‐analysis on the incidence of osteoporosis and fractures after liver transplant

MAFLD vs. NAFLD: shared features and potential changes in epidemiology, pathophysiology, diagnosis, and pharmacotherapy

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