Unexpected Rapid Increase in the Burden of NAFLD in China From 2008 to 2018: A Systematic Review and Meta‐Analysis

Zhou, Feng; Zhou, Jianghua; Wang, Wenxin; Zhang, Xiaojing; Ji, Yan‐Xiao; Zhang, Peng; She, Zhi‐Gang; Zhu, Lihua; Cai, Jingjing; Li, Hongliang

doi:10.1002/hep.30702

Cited by 416 publications

(393 citation statements)

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“…Wei Zhang, 1,2,5 Rui Huang, 1,5 Yi Wang, 3,5 Huiying Rao, 1,5 Lai Wei, 1,5 Grace L. Su, 2,4 and Anna S. Lok 2 Several drugs in development for nonalcoholic fatty liver disease (NAFLD) aim to decrease the amount of fat in the liver. We compared quantity and quality of fat in subcutaneous, visceral and muscle compartments, liver fibrosis, and prevalence of metabolic abnormalities between Chinese patients with moderate/severe hepatic steatosis versus those with mild hepatic steatosis.…”

Section: Fat Accumulation Liver Fibrosis and Metabolic Abnormalitiementioning

confidence: 99%

“…N onalcoholic fatty liver disease (NAFLD) comprises a spectrum from minimal to severe steatosis, and from steatosis alone to steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma (HCC). With the improvement of China's economy, there has been a marked increase in the Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; CAP, controlled attenuation parameter; CI, confidence interval; CT, computed tomography; DMGA, dorsal muscle group area; DMGLDA, dorsal muscle group low density area; FIB-4, Fibrosis-4 markers; HbA1c, glycosylated hemoglobin; HOMA-IR, homeostasis model assessment of insulin resistance; HU, Hounsfield unit; IQR, interquartile range; LFS, liver fat score; LSM, liver stiffness measurement; MS, metabolic syndrome; NAFLD, nonalcoholic fatty liver disease; NAFLD-FS, NAFLD (1) with a rapid increase from 25.4% in 2008-2010 (1) and 18.2%-20% in 2000-2007. (2) The prevalence of NAFLD was 51.6% (95% CI, 47.1-56.2) in persons with high body mass index (BMI) and 10.8% (95% CI, 9.0-12.6) in those with normal BMI.…”

Section: Fat Accumulation Liver Fibrosis and Metabolic Abnormalitiementioning

confidence: 99%

“…(2) The prevalence of NAFLD was 51.6% (95% CI, 47.1-56.2) in persons with high body mass index (BMI) and 10.8% (95% CI, 9.0-12.6) in those with normal BMI. (1) NAFLD is associated with excess fat deposition not only in the liver, but also in the subcutaneous and visceral compartments. Fat can also be deposited in ectopic areas.…”

Section: Fat Accumulation Liver Fibrosis and Metabolic Abnormalitiementioning

confidence: 99%

“…With the improvement of China's economy, there has been a marked increase in the prevalence of NAFLD in China in the last decade. Recent systematic review and meta‐analysis found the prevalence of NAFLD in China was 32.3% (95% confidence interval [CI], 30.2‐34.4) in 2015‐2018, with a rapid increase from 25.4% in 2008‐2010 and 18.2%‐20% in 2000–2007 . The prevalence of NAFLD was 51.6% (95% CI, 47.1‐56.2) in persons with high body mass index (BMI) and 10.8% (95% CI, 9.0‐12.6) in those with normal BMI …”

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confidence: 99%

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Fat Accumulation, Liver Fibrosis, and Metabolic Abnormalities in Chinese Patients With Moderate/Severe Versus Mild Hepatic Steatosis

et al. 2019

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Several drugs in development for nonalcoholic fatty liver disease (NAFLD) aim to decrease the amount of fat in the liver. We compared quantity and quality of fat in subcutaneous, visceral and muscle compartments, liver fibrosis, and prevalence of metabolic abnormalities between Chinese patients with moderate/severe hepatic steatosis versus those with mild hepatic steatosis. NAFLD patients were prospectively recruited from Peking University People's Hospital in Beijing, China. All patients had baseline body composition measurements using computed tomography and analytic morphomics, clinical evaluation, labs and Fibroscan® controlled attenuation parameter and liver stiffness measurement. Moderate/severe hepatic steatosis was defined as computed tomography liver attenuation of 40 Hounsfield units or less. Calorie intake and physical activity were based on self‐report. A total of 160 NAFLD patients were included (46% men, median age 47 years): 50% had normal body mass index (BMI), 24% were diabetic, and 56% had metabolic syndrome (MS). Fifty‐three (33%) had moderate/severe steatosis, of whom 19 (35.8%) had normal BMI, and the rest had mild steatosis. Patients who had moderate/severe steatosis had significantly higher BMI, waist circumference, aminotransferases, controlled attenuation parameter, liver stiffness measurement, and prevalence of MS compared to those with mild steatosis. They also had larger visceral fat area, subcutaneous fat area, and low density dorsal muscle area. In addition, their calorie intake was higher and time spent on recreation activities was shorter. Conclusion: NAFLD patients with moderate/severe steatosis, including those with normal BMI, had higher prevalence of MS and more fat in visceral, subcutaneous, and muscle compartments than those with mild steatosis. They also had more advanced liver disease. Strategies to decrease hepatic fat may benefit both liver and metabolic diseases.

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Section: Fat Accumulation Liver Fibrosis and Metabolic Abnormalitiementioning

confidence: 99%

Section: Fat Accumulation Liver Fibrosis and Metabolic Abnormalitiementioning

confidence: 99%

Section: Fat Accumulation Liver Fibrosis and Metabolic Abnormalitiementioning

confidence: 99%

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confidence: 99%

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Fat Accumulation, Liver Fibrosis, and Metabolic Abnormalities in Chinese Patients With Moderate/Severe Versus Mild Hepatic Steatosis

et al. 2019

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“…It ranges from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and eventually hepatic carcinoma [2]. NAFLD is the most frequent chronic liver disease worldwide, the prevalence of NAFLD in Asia is increasing, and its prevalence in China has rapidly climbed to 29.2% in 2019 [3,4]. NAFLD is strongly associated with obesity, type 2 diabetes mellitus and cardiovascular diseases, all of which leads to serious public health issues worldwide [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Uric acid induced hepatocytes lipid accumulation through regulation of miR-149-5p/FGF21 axis

Chen¹,

Chen²,

Yang³

et al. 2020

BMC Gastroenterol

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Background: Hyperuricemia is a major risk for non-alcoholic fatty liver disease. However, the mechanisms for this phenomenon are not fully understood. This study aimed to investigate whether microRNAs mediated the pathogenic effects of uric acid on non-alcoholic fatty liver disease. Methods: Microarray was used to determine the hepatic miRNA expression profiles of male C57BL/6 mice fed on standard chow diet, high fat diet (HFD), and HFD combined with uric acid-lowering therapy by allopurinol. We validated the expression of the most significant differentially expressed microRNAs and explored its role and downstream target in uric acid-induced hepatocytes lipid accumulation.Results: Microarray analysis and subsequent validation showed that miR-149-5p was significantly up-regulated in the livers of HFD-fed mice, while the expression was down-regulated by allopurinol therapy. MiR-149-5p expression was also significantly up-regulated in uric acid-stimulated hepatocytes. Over-expression of miR-149-5p significantly aggregated uric acid-induced triglyceride accumulation in hepatocytes, while inhibiting miR-149-5p ameliorated the triglyceride accumulation. Luciferase report assay confirmed that FGF21 is a target gene of miR-149-5p. Silencing FGF21 abolished the ameliorative effects of miR-149-5p inhibitor on uric acid-induced hepatocytes lipid accumulation, while overexpression of FGF21 prevented the lipid accumulation induced by miR-149-5p mimics. Conclusions: Uric acid significantly up-regulated the expression of miR-149-5p in hepatocytes and induced hepatocytes lipid accumulation via regulation of miR-149-5p/FGF21 axis.

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Effects of Time-Restricted Eating on Nonalcoholic Fatty Liver Disease

et al. 2023

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ImportanceThe efficacy and safety of time-restricted eating (TRE) on nonalcoholic fatty liver disease (NAFLD) remain uncertain.ObjectiveTo compare the effects of TRE vs daily calorie restriction (DCR) on intrahepatic triglyceride (IHTG) content and metabolic risk factors among patients with obesity and NAFLD.Design, Setting, and ParticipantsThis 12-month randomized clinical trial including participants with obesity and NAFLD was conducted at the Nanfang Hospital in Guangzhou, China, between April 9, 2019, and August 28, 2021.InterventionsParticipants with obesity and NAFLD were randomly assigned to TRE (eating only between 8:00 am and 4:00 pm) or DCR (habitual meal timing). All participants were instructed to maintain a diet of 1500 to 1800 kcal/d for men and 1200 to 1500 kcal/d for women for 12 months.Main Outcomes and MeasuresThe primary outcome was change in IHTG content measured by magnetic resonance imaging; secondary outcomes were changes in body weight, waist circumference, body fat, and metabolic risk factors. Intention-to-treat analysis was used.ResultsA total of 88 eligible patients with obesity and NAFLD (mean [SD] age, 32.0 [9.5] years; 49 men [56%]; and mean [SD] body mass index, 32.2 [3.3]) were randomly assigned to the TRE (n = 45) or DCR (n = 43) group. The IHTG content was reduced by 8.3% (95% CI, −10.0% to −6.6%) in the TRE group and 8.1% (95% CI, −9.8% to −6.4%) in the DCR group at the 6-month assessment. The IHTG content was reduced by 6.9% (95% CI, −8.8% to −5.1%) in the TRE group and 7.9% (95% CI, −9.7% to −6.2%) in the DCR group at the 12-month assessment. Changes in IHTG content were comparable between the 2 groups at 6 months (percentage point difference: −0.2; 95% CI, −2.7 to 2.2; P = .86) and 12 months (percentage point difference: 1.0; 95% CI, −1.6 to 3.5; P = .45). In addition, liver stiffness, body weight, and metabolic risk factors were significantly and comparably reduced in both groups.Conclusions and RelevanceAmong adults with obesity and NAFLD, TRE did not produce additional benefits for reducing IHTG content, body fat, and metabolic risk factors compared with DCR. These findings support the importance of caloric intake restriction when adhering to a regimen of TRE for the management of NAFLD.Trial RegistrationClinicalTrials.gov Identifiers: NCT03786523 and NCT04988230

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Unexpected Rapid Increase in the Burden of NAFLD in China From 2008 to 2018: A Systematic Review and Meta‐Analysis

Cited by 416 publications

References 30 publications

Fat Accumulation, Liver Fibrosis, and Metabolic Abnormalities in Chinese Patients With Moderate/Severe Versus Mild Hepatic Steatosis

Fat Accumulation, Liver Fibrosis, and Metabolic Abnormalities in Chinese Patients With Moderate/Severe Versus Mild Hepatic Steatosis

Uric acid induced hepatocytes lipid accumulation through regulation of miR-149-5p/FGF21 axis

Effects of Time-Restricted Eating on Nonalcoholic Fatty Liver Disease

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