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( Jie Li ),( Biyao Zou ),( Hideki Fujii ),( Yee Hui Yeo ),( Fanpu Ji ),( Dong Hyun Lee ),( Yuemin Feng ),( Xiaoyu Xie ),( Wanhua Ren ),( Qiang Zhu ),( Mindie H. Nguyen ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: NAFLD is generally correlated with the obesity epidemic. Asia is a heterogeneous region with varying socioeconomic levels and obesity prevalence; therefore, our goal was to estimate the prevalence of NAFLD in Asia through a meta-analytic approach. Methods: PubMed and EMBASE databases were searched from 1989 to 2017 for relevant studies reporting NAFLD prevalence in Asia. All studies were reviewed by three independent investigators. We used random-effects models to provide point estimates with 95% confidence interval (CI) of prevalence. Publication bias was assessed by Egger weighted regression Methods. Results: From the 2700 titles and abstracts reviewed, 195 papers from 13 countries met the inclusion criteria and included 1,753,168 subjects. The overall pooled prevalence for NAFLD in Asia was 31% (95% CI: 29-32). Individual country prevalence was shown in Table 1. In countries with more than 3 studies, the lowest prevalence was seen in Japan (24%, 95% CI: 21-28) and the highest in Iran (36%, 95%CI 31-41). Notably, pooled prevalence from studies with sample <1,000 subjects was much higher (34%, 95% CI: 31-38, 45 studies, n=23,857) than estimate from larger studies (≥1,000 subjects) (30%, 95% CI: 28- 31, 150 studies, n=172,9311). By sub-regions within Asia (Table 2), there was significant regional differences (P<0.01) with the highest NAFLD prevalence seen in West Asia (33%, 95% CI: 28-39, 13 studies, n=32,142) and the lowest in Southeast Asia (24%, 95% CI: 15-33, 5 studies, n=3457). By country income levels, NAFLD prevalence was 30% (95% CI: 29-32, 89 studies, n=1,005,409) for high-income countries and 31% (95% CI: 29-33, 106 studies, n=747,759) for middle-income countries (P<0.63). Conclusions: Overall NAFLD prevalence in Asia is 31% similar to Western countries and by country-income levels within Asia but varies by some sub-regions or Asia with the highest prevalence in West Asia (33%).
Michael H. Le,Yee Hui Yeo,Biyao Zou,Scott Barnet,Linda Henry,Ramsey Cheung,Mindie H. Nguyen 대한간학회 2022 Clinical and Molecular Hepatology(대한간학회지) Vol.28 No.4
Background/Aims: Due to increases in obesity and type 2 diabetes, the prevalence of nonalcoholic fatty liver disease (NAFLD) has also been increasing. Current forecast models may not include non-obese NAFLD. Here, we used the Bayesian approach to forecast the prevalence of NAFLD through the year 2040. Methods: Prevalence data from 245 articles involving 2,699,627 persons were used with a hierarchical Bayesian approach to forecast the prevalence of NAFLD through 2040. Subgroup analyses were performed for age, gender, presence of metabolic syndrome, region, and smoking status. Sensitivity analysis was conducted for clinical setting and study quality. Results: The forecasted 2040 prevalence was 55.7%, a three-fold increase since 1990 and a 43.2% increase from the 2020 prevalence of 38.9%. The estimated average yearly increase since 2020 was 2.16%. For those aged <50 years and ≥50 years, the 2040 prevalence were not significantly different (56.7% vs. 61.5%, P=0.52). There was a significant difference in 2040 prevalence by sex (males: 60% vs. 50%) but the trend was steeper for females (annual percentage change: 2.5% vs. 1.5%, P=0.025). There was no difference in trends overtime by region (P=0.48). The increase rate was significantly higher in those without metabolic syndrome (3.8% vs. 0.84%, P=0.003) and smokers (1.4% vs. 1.1%, P=0.011). There was no difference by clinical/community setting (P=0.491) or study quality (P=0.85). Conclusions: By 2040, over half the adult population is forecasted to have NAFLD. The largest increases are expected to occur in women, smokers, and those without metabolic syndrome. Intensified efforts are needed to raise awareness of NAFLD and to determine long-term solutions addressing the driving factors of the disease.