TY - JOUR
T1 - Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019
T2 - a systematic review and meta-analysis
AU - Li, Jie
AU - Zou, Biyao
AU - Yeo, Yee Hui
AU - Feng, Yuemin
AU - Xie, Xiaoyu
AU - Lee, Dong Hyun
AU - Fujii, Hideki
AU - Wu, Yuankai
AU - Kam, Leslie Y.
AU - Ji, Fanpu
AU - Li, Xiaohe
AU - Chien, Nicholas
AU - Wei, Mike
AU - Ogawa, Eiichi
AU - Zhao, Changqing
AU - Wu, Xia
AU - Stave, Christopher D.
AU - Henry, Linda
AU - Barnett, Scott
AU - Takahashi, Hirokazu
AU - Furusyo, Norihiro
AU - Eguchi, Yuichiro
AU - Hsu, Yao Chun
AU - Lee, Teng Yu
AU - Ren, Wanhua
AU - Qin, Chengyong
AU - Jun, Dae Won
AU - Toyoda, Hidenori
AU - Wong, Vincent Wai Sun
AU - Cheung, Ramsey
AU - Zhu, Qiang
AU - Nguyen, Mindie H.
N1 - Funding Information:
HF is employed by the Endowed Department of Liver Cirrhosis Therapeutics, which receives funding from Gilead Sciences. FJ has received speaker fees from Gilead Sciences, Merck Sharp & Dohme, Abbvie, and Ascletis. NF reports grants from Janssen Pharmaceutical, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme, and Abbvie; and has received speaker fees from Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme, Torii Pharmaceutical, and Roche Diagnostics. YE reports grants from Bristol-Myers Squibb. HTo has received speaker fees from Merck Sharp & Dohme, AbbVie, and Bayer. VW-SW reports personal fees from AbbVie, Allergan, Bristol-Myers Squibb, Echosens, Gilead Sciences, Janssen, Merck, Perspectum Diagnostics, Pfizer, and Terns. RC reports grants from Gilead Sciences. MHN reports grants from Gilead Sciences, Pfizer, Janssen Pharmaceutical, and the US National Cancer Institute; and personal fees from Bayer, Dynavax, Exact Science, Janssen Pharmaceutical, Gilead Sciences, Laboratory of Advanced Medicine, Intercept Pharmaceutical, Novartis, Spring Bank, and Eisai. All other authors declare no competing interests.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/5
Y1 - 2019/5
N2 - Background: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. Asia is a large, heterogeneous area with substantial variation in socioeconomic status and prevalence of obesity. We estimated the prevalence, incidence, and outcomes of NAFLD in the Asian population to assist stakeholders in understanding NAFLD disease burden. Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception to Jan 17, 2019, for studies reporting NAFLD prevalence, incidence, or outcome in Asia. We included only cross-sectional and longitudinal observational studies of patients with NAFLD diagnosed by imaging, serum-based indices, or liver biopsy. Studies that included patients with overlapping liver disease or that did not screen for excess alcohol consumption were excluded. Two investigators independently screened and extracted data. The main outcomes were pooled NAFLD prevalence, incidence, and hepatocellular carcinoma incidence and overall mortality in patients with NAFLD. Summary estimates were calculated using a random-effects model. This study is registered with PROSPERO, number CRD42018088468. Findings: Of 4995 records identified, 237 studies (13 044 518 participants) were included for analysis. The overall prevalence of NAFLD regardless of diagnostic method was 29·62% (95% CI 28·13–31·15). NAFLD prevalence increased significantly over time (25·28% [22·42–28·37] between 1999 and 2005, 28·46% [26·70–30·29] between 2006 and 2011, and 33·90% [31·74–36·12] between 2012 and 2017; p<0·0001). The pooled annual NAFLD incidence rate was 50·9 cases per 1000 person-years (95% CI 44·8–57·4). In patients with NAFLD, the annual incidence of hepatocellular carcinoma was 1·8 cases per 1000 person-years (0·8–3·1) and overall mortality rate was 5·3 deaths per 1000 person-years (1·5–11·4). Interpretation: NAFLD prevalence in Asia is increasing and is associated with poor outcomes including hepatocellular carcinoma and death. Targeted public health strategies must be developed in Asia to target the drivers of this rising epidemic and its associated complications, especially in high-risk groups, such as older obese men. Funding: None.
AB - Background: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. Asia is a large, heterogeneous area with substantial variation in socioeconomic status and prevalence of obesity. We estimated the prevalence, incidence, and outcomes of NAFLD in the Asian population to assist stakeholders in understanding NAFLD disease burden. Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception to Jan 17, 2019, for studies reporting NAFLD prevalence, incidence, or outcome in Asia. We included only cross-sectional and longitudinal observational studies of patients with NAFLD diagnosed by imaging, serum-based indices, or liver biopsy. Studies that included patients with overlapping liver disease or that did not screen for excess alcohol consumption were excluded. Two investigators independently screened and extracted data. The main outcomes were pooled NAFLD prevalence, incidence, and hepatocellular carcinoma incidence and overall mortality in patients with NAFLD. Summary estimates were calculated using a random-effects model. This study is registered with PROSPERO, number CRD42018088468. Findings: Of 4995 records identified, 237 studies (13 044 518 participants) were included for analysis. The overall prevalence of NAFLD regardless of diagnostic method was 29·62% (95% CI 28·13–31·15). NAFLD prevalence increased significantly over time (25·28% [22·42–28·37] between 1999 and 2005, 28·46% [26·70–30·29] between 2006 and 2011, and 33·90% [31·74–36·12] between 2012 and 2017; p<0·0001). The pooled annual NAFLD incidence rate was 50·9 cases per 1000 person-years (95% CI 44·8–57·4). In patients with NAFLD, the annual incidence of hepatocellular carcinoma was 1·8 cases per 1000 person-years (0·8–3·1) and overall mortality rate was 5·3 deaths per 1000 person-years (1·5–11·4). Interpretation: NAFLD prevalence in Asia is increasing and is associated with poor outcomes including hepatocellular carcinoma and death. Targeted public health strategies must be developed in Asia to target the drivers of this rising epidemic and its associated complications, especially in high-risk groups, such as older obese men. Funding: None.
UR - http://www.scopus.com/inward/record.url?scp=85063662628&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063662628&partnerID=8YFLogxK
U2 - 10.1016/S2468-1253(19)30039-1
DO - 10.1016/S2468-1253(19)30039-1
M3 - Article
C2 - 30902670
AN - SCOPUS:85063662628
SN - 2468-1253
VL - 4
SP - 389
EP - 398
JO - The Lancet Gastroenterology and Hepatology
JF - The Lancet Gastroenterology and Hepatology
IS - 5
ER -
