Zhong Lixian, Wu Chutian, Li Yuting, Zeng Qiuting, Lai Leizhen, Chen Sisi, Tang Shaohui
Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, P.R. China.
Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong 510630, P.R. China.
Ther Adv Chronic Dis. 2022 May 19;13:20406223221083508. doi: 10.1177/20406223221083508. eCollection 2022.
A large number of systemic reviews and meta-analyses have explored the relationship between nonalcoholic fatty liver disease (NAFLD) and multiple health outcomes. The aim of this study is to conduct an umbrella review to assess the strength and evidence for the association between NAFLD and health outcomes.
We systematically identified the present meta-analyses of observational studies reporting an association between NAFLD and health outcomes. For each meta-analysis, we assessed the quality with AMSTAR2 and graded the epidemiologic evidence.
Fifty-four articles comprising 111 unique meta-analyses were included in this study. Eighty-five unique outcomes showed significant associations ( ← 0.05), whereas 26 unique outcomes showed insignificant associations, and we cannot assess the epidemiologic evidence. For 85 significant health outcomes, four outcomes (carotid intima-media thickness (C-IMT), peak A velocity, left ventricle end-diastolic diameter, incident chronic kidney disease (CKD) in adult patients) was graded as high quality of evidence, 23 outcomes were graded as the moderate quality of evidence, and the remaining 58 outcomes were graded as weak quality of evidence. Fourty-seven (87.03%) studies showed critically low methodological quality.
In this umbrella review, only four statistically significant health outcomes showed high epidemiologic evidence. NAFLD seems to relate to an increased risk of C-IMT, peak A velocity, left ventricle end-diastolic diameter, and incident CKD in adult patients.
大量的系统评价和荟萃分析探讨了非酒精性脂肪性肝病（NAFLD）与多种健康结局之间的关系。本研究的目的是进行一项综合性综述，以评估NAFLD与健康结局之间关联的强度和证据。
我们系统地检索了目前关于NAFLD与健康结局之间关联的观察性研究的荟萃分析。对于每项荟萃分析，我们使用AMSTAR2评估其质量，并对流行病学证据进行分级。
本研究纳入了54篇文章，其中包含111项独特的荟萃分析。85项独特的结局显示出显著关联（P＜0.05），而26项独特的结局显示出不显著的关联，并且我们无法评估其流行病学证据。对于85项显著的健康结局，四项结局（颈动脉内膜中层厚度（C-IMT）、A峰流速、左心室舒张末期内径、成年患者新发慢性肾脏病（CKD））被评为高质量证据，23项结局被评为中等质量证据，其余58项结局被评为低质量证据。47项（87.03%）研究显示方法学质量极低。
在本综合性综述中，只有四项具有统计学意义的健康结局显示出高流行病学证据。NAFLD似乎与成年患者C-IMT增加、A峰流速增加、左心室舒张末期内径增加以及新发CKD的风险增加有关。
