Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California.
Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California; Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
Clin Gastroenterol Hepatol. 2022 Dec;20(12):2809-2817.e28. doi: 10.1016/j.cgh.2021.12.002. Epub 2021 Dec 7.
BACKGROUND & AIMS: The increasing rates of obesity and type 2 diabetes mellitus may lead to increased prevalence of nonalcoholic fatty liver disease (NAFLD). We aimed to determine the current and recent trends on the global and regional prevalence of NAFLD.
Systematic search from inception to March 26, 2020 was performed without language restrictions. Two authors independently performed screening and data extraction. We performed meta-regression to determine trends in NAFLD prevalence.
We identified 17,244 articles from literature search and included 245 eligible studies involving 5,399,254 individuals. The pooled global prevalence of NAFLD was 29.8% (95% confidence interval [CI], 28.6%-31.1%); of these, 82.5% of included articles used ultrasound to diagnose NAFLD, with prevalence of 30.6% (95% CI, 29.2%-32.0%). South America (3 studies, 5716 individuals) and North America (4 studies, 18,236 individuals) had the highest NAFLD prevalence at 35.7% (95% CI, 34.0%-37.5%) and 35.3% (95% CI, 25.4%-45.9%), respectively. From 1991 to 2019, trend analysis showed NAFLD increased from 21.9% to 37.3% (yearly increase of 0.7%, P < .0001), with South America showing the most rapid change of 2.7% per year, followed by Europe at 1.1%.
Despite regional variation, the global prevalence of NAFLD is increasing overall. Policy makers must work toward reversing the current trends by increasing awareness of NAFLD and promoting healthy lifestyle environments.
肥胖症和 2 型糖尿病发病率的上升可能导致非酒精性脂肪性肝病（NAFLD）的发病率上升。本研究旨在确定全球和各区域 NAFLD 的当前和近期流行趋势。
从创建至 2020 年 3 月 26 日，我们对文献进行了系统检索，检索时未设语言限制。两位作者独立进行筛选和数据提取。我们进行了荟萃回归分析，以确定 NAFLD 流行率的趋势。
我们从文献检索中确定了 17244 篇文章，并纳入了 245 项符合条件的研究，共涉及 5399254 人。全球 NAFLD 的总体流行率为 29.8%（95%置信区间 [CI]，28.6%-31.1%）；其中，82.5%的纳入研究使用超声诊断 NAFLD，其流行率为 30.6%（95% CI，29.2%-32.0%）。南美洲（3 项研究，5716 人）和北美洲（4 项研究，18236 人）的 NAFLD 流行率最高，分别为 35.7%（95% CI，34.0%-37.5%）和 35.3%（95% CI，25.4%-45.9%）。1991 年至 2019 年，趋势分析显示，NAFLD 的流行率从 21.9%增加到 37.3%（每年增加 0.7%，P<0.0001），其中南美洲的变化速度最快，每年增加 2.7%，其次是欧洲，每年增加 1.1%。
尽管存在地域差异，但全球范围内 NAFLD 的流行率总体呈上升趋势。政策制定者必须努力扭转当前的趋势，提高对 NAFLD 的认识，并促进健康的生活环境。
