Division of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, CJ250K, Palo Alto, CA, 94304, USA.
Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Hepatol Int. 2020 Mar;14(2):259-269. doi: 10.1007/s12072-020-10023-3. Epub 2020 Mar 4.
Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide. This study aimed to estimate the prevalence, incidence, and outcome of NAFLD in the large and diverse population of Mainland China.
PubMed, Embase, and the Cochrane Library databases were searched to identify published studies with NAFLD epidemiology data in adult participants (≥ 18 years old) from Mainland China. Random effects models were used to determine pooled estimates.
We screened 1,328 studies and included 167 eligible studies (participant n = 1,486,635): 149 studies (n = 1,350,819) for prevalence, 18 studies (n = 147,316) for incidence, 7 studies (n = 5446) for evolution of hepatic steatosis, and 2 studies (n = 647) for mortality analysis. The NAFLD prevalence of the overall populations was 29.88%, with higher rates in males, increasing age and increasing gross regional domestic product (GRDP) per capita (all p ≤ 0.010). The prevalence was the highest in North China (36.41%; higher in Uyghur and Hui Chinese 40.86% and 34.36% vs 28.11% in Han Chinese), higher in diabetics (51.83% vs. 30.76% in non-diabetics) and in obese participants (66.21% vs. 11.72% in lean). The NAFLD incidence was 56.7 (95% CI 47.4-66.8) per 1000 person-years, higher in males and with higher GRDP per capita. The overall mortality was 7.3 (3.3-12.7) per 1000 person-years.
The overall prevalence of NAFLD in Mainland China is about 30%. The highest prevalences were found among regions with higher income, North China, the non-Han ethnic minorities, diabetics, and the obese. China's NAFLD prevalence is on par with Western countries.
非酒精性脂肪性肝病（NAFLD）是全球慢性肝病的主要病因。本研究旨在评估中国大陆庞大且多样化人群中 NAFLD 的流行率、发病率和结局。
检索 PubMed、Embase 和 Cochrane 图书馆数据库，以确定来自中国大陆的成人（≥18 岁）参与者的 NAFLD 流行病学数据的已发表研究。使用随机效应模型确定汇总估计值。
我们筛选了 1328 项研究，纳入了 167 项符合条件的研究（参与者 n=1486635）：149 项研究（n=1350819）用于评估患病率，18 项研究（n=147316）用于评估发病率，7 项研究（n=5446）用于评估肝脂肪变性的演变，2 项研究（n=647）用于评估死亡率分析。总体人群的 NAFLD 患病率为 29.88%，男性、年龄增加和人均国内生产总值（GRDP）增加（均 P≤0.010）的患病率较高。华北地区的患病率最高（36.41%；维吾尔族和回族人群的患病率较高，分别为 40.86%和 34.36%，汉族人群的患病率为 28.11%），糖尿病患者（51.83% vs. 非糖尿病患者的 30.76%）和肥胖患者（66.21% vs. 消瘦患者的 11.72%）的患病率较高。NAFLD 的发病率为 56.7（95%CI 47.4-66.8）/1000 人年，男性和人均 GRDP 较高的人群发病率较高。总体死亡率为 7.3（3.3-12.7）/1000 人年。
中国大陆的 NAFLD 总患病率约为 30%。收入较高的地区、华北地区、非汉族少数民族、糖尿病患者和肥胖患者的患病率最高。中国的 NAFLD 患病率与西方国家相当。
