Skip to main content
Top
Published in: Digestive Diseases and Sciences 11/2015

01-11-2015 | Review

Prevalence of Nonalcoholic Fatty Liver Disease and Economy

Authors: Jin-Zhou Zhu, Yi-Ning Dai, Yu-Ming Wang, Qin-Yi Zhou, Chao-Hui Yu, You-Ming Li

Published in: Digestive Diseases and Sciences | Issue 11/2015

Login to get access

Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) is a growing health issue around the world.

Aim

This study is to investigate whether adult prevalence of NAFLD correlates with national economic status.

Methods

Literature search on PubMed database was conducted to identify eligible records fully published before September 2014. Gross national income (GNI) per capita was chosen to evaluate national economic status. Pearson coefficient, linear regression, and unpaired t test were performed in the statistical analyses.

Results

Twenty-one population-based surveys (seven in East Asia, five in South Asia, three in Middle East, and six in Europe) were included. The pooled prevalence of NAFLD was 24.24 %, and the global prevalence was positively correlated with GNI per capita (r = 0.4782, P = 0.0283). Europe witnessed a higher prevalence (28.04 %) than Middle East (12.95 %, P = 0.0092) and East Asia (19.24 %, P = 0.0083). Male presented a higher prevalence than female (P = 0.019), especially in Europe (P = 0.0132) and in Caucasians (P = 0.0383). Furthermore, male prevalence and rural prevalence individually were correlated with economic status (r = 0.5725, P = 0.0257 and r = 0.7389, P = 0.0060). Lastly, the urban (23.93 %) witnessed a higher prevalence than the rural or the urban + rural (12.65 %, P = 0.0141) in the countries of GNI per capita <$10,000.

Conclusions

This study suggested that countries with higher economic status tend to present a higher prevalence of NAFLD. It is believed to provide a distinctive epidemiologic perspective to global situation of NAFLD.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bugianesi E, Leone N, Vanni E, et al. Expanding the natural history of nonalcoholic steatohepatitis: from cryptogenic cirrhosis to hepatocellular carcinoma. Gastroenterology. 2002;123:134–140.CrossRefPubMed Bugianesi E, Leone N, Vanni E, et al. Expanding the natural history of nonalcoholic steatohepatitis: from cryptogenic cirrhosis to hepatocellular carcinoma. Gastroenterology. 2002;123:134–140.CrossRefPubMed
2.
go back to reference Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology (Baltimore, MD). 2003;37:1202–1219.CrossRef Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology (Baltimore, MD). 2003;37:1202–1219.CrossRef
3.
go back to reference Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34:274–285.CrossRefPubMed Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34:274–285.CrossRefPubMed
4.
go back to reference Milic S, Stimac D. Nonalcoholic fatty liver disease/steatohepatitis: epidemiology, pathogenesis, clinical presentation and treatment. Dig Dis (Basel, Switzerland). 2012;30:158–162.CrossRef Milic S, Stimac D. Nonalcoholic fatty liver disease/steatohepatitis: epidemiology, pathogenesis, clinical presentation and treatment. Dig Dis (Basel, Switzerland). 2012;30:158–162.CrossRef
5.
6.
go back to reference Younossi ZM, Stepanova M, Afendy M, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol. 2011;9:524–530. (quiz e521–e560).CrossRefPubMed Younossi ZM, Stepanova M, Afendy M, et al. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol. 2011;9:524–530. (quiz e521–e560).CrossRefPubMed
7.
go back to reference Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011;140:124–131.CrossRefPubMed Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011;140:124–131.CrossRefPubMed
8.
go back to reference Wagenknecht LE, Scherzinger AL, Stamm ER, et al. Correlates and heritability of nonalcoholic fatty liver disease in a minority cohort. Obesity (Silver Spring, MD). 2009;17:1240–1246. Wagenknecht LE, Scherzinger AL, Stamm ER, et al. Correlates and heritability of nonalcoholic fatty liver disease in a minority cohort. Obesity (Silver Spring, MD). 2009;17:1240–1246.
9.
go back to reference Fischer GE, Bialek SP, Homan CE, Livingston SE, McMahon BJ. Chronic liver disease among Alaska-Native people, 2003–2004. Am J Gastroenterol. 2009;104:363–370.CrossRefPubMed Fischer GE, Bialek SP, Homan CE, Livingston SE, McMahon BJ. Chronic liver disease among Alaska-Native people, 2003–2004. Am J Gastroenterol. 2009;104:363–370.CrossRefPubMed
10.
go back to reference Bialek SR, Redd JT, Lynch A, et al. Chronic liver disease among two American Indian patient populations in the southwestern United States, 2000–2003. J Clin Gastroenterol. 2008;42:949–954.CrossRefPubMed Bialek SR, Redd JT, Lynch A, et al. Chronic liver disease among two American Indian patient populations in the southwestern United States, 2000–2003. J Clin Gastroenterol. 2008;42:949–954.CrossRefPubMed
11.
go back to reference Mendez-Sanchez N, Arrese M, Zamora-Valdes D, Uribe M. Current concepts in the pathogenesis of nonalcoholic fatty liver disease. Liver Int. 2007;27:423–433.CrossRefPubMed Mendez-Sanchez N, Arrese M, Zamora-Valdes D, Uribe M. Current concepts in the pathogenesis of nonalcoholic fatty liver disease. Liver Int. 2007;27:423–433.CrossRefPubMed
12.
go back to reference Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1–e34.CrossRefPubMed Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1–e34.CrossRefPubMed
13.
go back to reference Mishra P, Younossi ZM. Abdominal ultrasound for diagnosis of nonalcoholic fatty liver disease (NAFLD). Am J Gastroenterol. 2007;102:2716–2717.CrossRefPubMed Mishra P, Younossi ZM. Abdominal ultrasound for diagnosis of nonalcoholic fatty liver disease (NAFLD). Am J Gastroenterol. 2007;102:2716–2717.CrossRefPubMed
14.
go back to reference Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283:2008–2012.CrossRefPubMed Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283:2008–2012.CrossRefPubMed
17.
go back to reference Toshikuni N, Tsutsumi M, Arisawa T. Clinical differences between alcoholic liver disease and nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20:8393–8406.PubMedCentralCrossRefPubMed Toshikuni N, Tsutsumi M, Arisawa T. Clinical differences between alcoholic liver disease and nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20:8393–8406.PubMedCentralCrossRefPubMed
18.
go back to reference Fan JG. Epidemiology of alcoholic and nonalcoholic fatty liver disease in China. J Gastroenterol Hepatol. 2013;28:11–17.CrossRefPubMed Fan JG. Epidemiology of alcoholic and nonalcoholic fatty liver disease in China. J Gastroenterol Hepatol. 2013;28:11–17.CrossRefPubMed
19.
go back to reference Fan JG, Saibara T, Chitturi S, Kim BI, Sung JJ, Chutaputti A. What are the risk factors and settings for non-alcoholic fatty liver disease in Asia-Pacific? J Gastroenterol Hepatol. 2007;22:794–800.CrossRefPubMed Fan JG, Saibara T, Chitturi S, Kim BI, Sung JJ, Chutaputti A. What are the risk factors and settings for non-alcoholic fatty liver disease in Asia-Pacific? J Gastroenterol Hepatol. 2007;22:794–800.CrossRefPubMed
20.
go back to reference Sanyal AJ, American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease. Gastroenterology. 2002;123:1705–1725.CrossRefPubMed Sanyal AJ, American Gastroenterological Association. AGA technical review on nonalcoholic fatty liver disease. Gastroenterology. 2002;123:1705–1725.CrossRefPubMed
21.
go back to reference Angulo P. GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2007;25:883–889.CrossRefPubMed Angulo P. GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2007;25:883–889.CrossRefPubMed
22.
go back to reference Liu CJ. Prevalence and risk factors for non-alcoholic fatty liver disease in Asian people who are not obese. J Gastroenterol Hepatol. 2012;27:1555–1560.CrossRefPubMed Liu CJ. Prevalence and risk factors for non-alcoholic fatty liver disease in Asian people who are not obese. J Gastroenterol Hepatol. 2012;27:1555–1560.CrossRefPubMed
23.
go back to reference Jamali R, Khonsari M, Merat S, et al. Persistent alanine aminotransferase elevation among the general Iranian population: prevalence and causes. World J Gastroenterol. 2008;14:2867–2871.PubMedCentralCrossRefPubMed Jamali R, Khonsari M, Merat S, et al. Persistent alanine aminotransferase elevation among the general Iranian population: prevalence and causes. World J Gastroenterol. 2008;14:2867–2871.PubMedCentralCrossRefPubMed
24.
go back to reference Eshraghian A, Dabbaghmanesh MH, Eshraghian H, Fattahi MR, Omrani GR. Nonalcoholic fatty liver disease in a cluster of Iranian population: thyroid status and metabolic risk factors. Arch Iran Med. 2013;16:584–589.PubMed Eshraghian A, Dabbaghmanesh MH, Eshraghian H, Fattahi MR, Omrani GR. Nonalcoholic fatty liver disease in a cluster of Iranian population: thyroid status and metabolic risk factors. Arch Iran Med. 2013;16:584–589.PubMed
25.
go back to reference Lankarani KB, Ghaffarpasand F, Mahmoodi M, et al. Non alcoholic fatty liver disease in southern Iran: a population based study. Hepat Mon. 2013;13:e9248.PubMedCentralCrossRefPubMed Lankarani KB, Ghaffarpasand F, Mahmoodi M, et al. Non alcoholic fatty liver disease in southern Iran: a population based study. Hepat Mon. 2013;13:e9248.PubMedCentralCrossRefPubMed
29.
go back to reference Fan JG, Zhu J, Li XJ, et al. Prevalence of and risk factors for fatty liver in a general population of Shanghai. China J Hepatol. 2005;43:508–514.CrossRefPubMed Fan JG, Zhu J, Li XJ, et al. Prevalence of and risk factors for fatty liver in a general population of Shanghai. China J Hepatol. 2005;43:508–514.CrossRefPubMed
30.
go back to reference Chen CH, Huang MH, Yang JC, et al. Prevalence and risk factors of nonalcoholic fatty liver disease in an adult population of taiwan: metabolic significance of nonalcoholic fatty liver disease in nonobese adults. J Clin Gastroenterol. 2006;40:745–752.CrossRefPubMed Chen CH, Huang MH, Yang JC, et al. Prevalence and risk factors of nonalcoholic fatty liver disease in an adult population of taiwan: metabolic significance of nonalcoholic fatty liver disease in nonobese adults. J Clin Gastroenterol. 2006;40:745–752.CrossRefPubMed
31.
go back to reference Zelber-Sagi S, Nitzan-Kaluski D, Halpern Z, Oren R. Prevalence of primary non-alcoholic fatty liver disease in a population-based study and its association with biochemical and anthropometric measures. Liver Int. 2006;26:856–863.CrossRefPubMed Zelber-Sagi S, Nitzan-Kaluski D, Halpern Z, Oren R. Prevalence of primary non-alcoholic fatty liver disease in a population-based study and its association with biochemical and anthropometric measures. Liver Int. 2006;26:856–863.CrossRefPubMed
32.
go back to reference Zhou YJ, Li YY, Nie YQ, et al. Prevalence of fatty liver disease and its risk factors in the population of South China. World J Gastroenterol. 2007;13:6419–6424.PubMedCentralCrossRefPubMed Zhou YJ, Li YY, Nie YQ, et al. Prevalence of fatty liver disease and its risk factors in the population of South China. World J Gastroenterol. 2007;13:6419–6424.PubMedCentralCrossRefPubMed
33.
go back to reference Amarapurkar D, Kamani P, Patel N, et al. Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6:161–163.PubMed Amarapurkar D, Kamani P, Patel N, et al. Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6:161–163.PubMed
34.
go back to reference Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology (Baltimore, MD). 2005;42:44–52.CrossRef Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology (Baltimore, MD). 2005;42:44–52.CrossRef
35.
go back to reference Haring R, Wallaschofski H, Nauck M, Dorr M, Baumeister SE, Volzke H. Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum γ-glutamyl transpeptidase levels. Hepatology (Baltimore, MD). 2009;50:1403–1411.CrossRef Haring R, Wallaschofski H, Nauck M, Dorr M, Baumeister SE, Volzke H. Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum γ-glutamyl transpeptidase levels. Hepatology (Baltimore, MD). 2009;50:1403–1411.CrossRef
36.
go back to reference Mohan V, Farooq S, Deepa M, Ravikumar R, Pitchumoni CS. Prevalence of non-alcoholic fatty liver disease in urban south Indians in relation to different grades of glucose intolerance and metabolic syndrome. Diabetes Res Clin Pract. 2009;84:84–91.CrossRefPubMed Mohan V, Farooq S, Deepa M, Ravikumar R, Pitchumoni CS. Prevalence of non-alcoholic fatty liver disease in urban south Indians in relation to different grades of glucose intolerance and metabolic syndrome. Diabetes Res Clin Pract. 2009;84:84–91.CrossRefPubMed
37.
go back to reference Dassanayake AS, Kasturiratne A, Rajindrajith S, et al. Prevalence and risk factors for non-alcoholic fatty liver disease among adults in an urban Sri Lankan population. J Gastroenterol Hepatol. 2009;24:1284–1288.CrossRefPubMed Dassanayake AS, Kasturiratne A, Rajindrajith S, et al. Prevalence and risk factors for non-alcoholic fatty liver disease among adults in an urban Sri Lankan population. J Gastroenterol Hepatol. 2009;24:1284–1288.CrossRefPubMed
38.
go back to reference Das K, Mukherjee PS, et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology (Baltimore, MD). 2010;51:1593–1602.CrossRef Das K, Mukherjee PS, et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology (Baltimore, MD). 2010;51:1593–1602.CrossRef
39.
go back to reference He S, Bao W, Shao M, et al. Risk factors for non-alcoholic fatty liver disease in a Chinese population. Acta Gastro-Enterol Belgica. 2011;74:503–508. He S, Bao W, Shao M, et al. Risk factors for non-alcoholic fatty liver disease in a Chinese population. Acta Gastro-Enterol Belgica. 2011;74:503–508.
40.
go back to reference Pinidiyapathirage MJ, Dassanayake AS, Rajindrajith S, et al. Non-alcoholic fatty liver disease in a rural, physically active, low income population in Sri Lanka. BMC Res Notes. 2011;4:513.PubMedCentralCrossRefPubMed Pinidiyapathirage MJ, Dassanayake AS, Rajindrajith S, et al. Non-alcoholic fatty liver disease in a rural, physically active, low income population in Sri Lanka. BMC Res Notes. 2011;4:513.PubMedCentralCrossRefPubMed
41.
go back to reference Hou XH, Zhu YX, Lu HJ, et al. Non-alcoholic fatty liver disease’s prevalence and impact on alanine aminotransferase associated with metabolic syndrome in the Chinese. J Gastroenterol Hepatol. 2011;26:722–730.CrossRefPubMed Hou XH, Zhu YX, Lu HJ, et al. Non-alcoholic fatty liver disease’s prevalence and impact on alanine aminotransferase associated with metabolic syndrome in the Chinese. J Gastroenterol Hepatol. 2011;26:722–730.CrossRefPubMed
42.
go back to reference Caballeria L, Pera G, Rodriguez L, et al. Metabolic syndrome and nonalcoholic fatty liver disease in a Spanish population: influence of the diagnostic criteria used. Eur J Gastroenterol Hepatol. 2012;24:1007–1011.CrossRefPubMed Caballeria L, Pera G, Rodriguez L, et al. Metabolic syndrome and nonalcoholic fatty liver disease in a Spanish population: influence of the diagnostic criteria used. Eur J Gastroenterol Hepatol. 2012;24:1007–1011.CrossRefPubMed
43.
go back to reference Wong VW, Chu WC, Wong GL, et al. Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese: a population study using proton-magnetic resonance spectroscopy and transient elastography. Gut. 2012;61:409–415.CrossRefPubMed Wong VW, Chu WC, Wong GL, et al. Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese: a population study using proton-magnetic resonance spectroscopy and transient elastography. Gut. 2012;61:409–415.CrossRefPubMed
44.
go back to reference Jeong EH, Jun DW, Cho YK, et al. Regional prevalence of non-alcoholic fatty liver disease in Seoul and Gyeonggi-do. Korea Clin Mol Hepatol. 2013;19:266–272.CrossRefPubMed Jeong EH, Jun DW, Cho YK, et al. Regional prevalence of non-alcoholic fatty liver disease in Seoul and Gyeonggi-do. Korea Clin Mol Hepatol. 2013;19:266–272.CrossRefPubMed
45.
go back to reference Chiloiro M, Caruso MG, Cisternino AM, et al. Ultrasound evaluation and correlates of fatty liver disease: a population study in a Mediterranean area. Metab Syndr Relat Disorders. 2013;11:349–358.CrossRef Chiloiro M, Caruso MG, Cisternino AM, et al. Ultrasound evaluation and correlates of fatty liver disease: a population study in a Mediterranean area. Metab Syndr Relat Disorders. 2013;11:349–358.CrossRef
46.
go back to reference Gruchot M, Graeter T, Oeztuerk S, et al. Fasting time and lipid parameters: association with hepatic steatosis—data from a random population sample. Lipids Health Dis. 2014;13:18.PubMedCentralCrossRefPubMed Gruchot M, Graeter T, Oeztuerk S, et al. Fasting time and lipid parameters: association with hepatic steatosis—data from a random population sample. Lipids Health Dis. 2014;13:18.PubMedCentralCrossRefPubMed
Metadata
Title
Prevalence of Nonalcoholic Fatty Liver Disease and Economy
Authors
Jin-Zhou Zhu
Yi-Ning Dai
Yu-Ming Wang
Qin-Yi Zhou
Chao-Hui Yu
You-Ming Li
Publication date
01-11-2015
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 11/2015
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-015-3728-3

Other articles of this Issue 11/2015

Digestive Diseases and Sciences 11/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.