Clinical Profiles of Asians with NAFLD: A Systematic Review and Meta-Analysis
Year: 2021
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: INTRODUCTION: NAFLD is increasingly prevalent in Asia, where people suffer more metabolic comorbidities at a lower body mass index (BMI), suggesting potential differences in their clinical profile. Therefore, we attempted to characterize the clinical profile of Asians with NAFLD via a meta-analytic approach. METHODS: We searched PubMed, EMBASE, and Cochrane databases from January 1, 2000, to January 17, 2019. Two authors independently reviewed and selected 104 articles (2,247,754 persons) that identified NAFLD in Asians and reported relevant data, especially BMI and ALT, and excluded individuals with other liver disease and excessive alcohol consumption. Individual patient-level data were obtained from seven cohorts in Asia to complement meta-analyzed data. RESULTS: Overall, the mean age was 52.07 (95% CI: 51.28-52.85) years, with those from Southeast Asia (42.66, 95% CI: 32.23-53.11) being significantly younger. The mean BMI was 26.2 kg/m2, higher in moderate-severe versus mild hepatic steatosis (28.3 vs. 25.7) patients and NFS ≥ -1.455 versus <-1.455 (27.09 vs. 26.02), with 34% having nonobese NAFLD. The mean ALT was 31.74 U/L, higher in NFS < -1.455 versus ≥-1.455 (33.74 vs. 27.83), though no differences were found by obesity or steatosis severity. The majority of males (85.7%) and females (60.7%) had normal to minimally elevated ALT (1-1.5 × 95% ULN). Individual patient-level data analysis (N = 7,668) demonstrated similar results. CONCLUSION: About one-third of Asians with NAFLD were nonobese, and the majority did not have markedly elevated ALT. Therefore, abnormal ALT or BMI is not recommended as a criterion for NAFLD screening in this population. Additionally, there were significant differences in the clinical profiles of NAFLD among the different regions of Asia.
Source: Digestive Diseases
DOI: 10.1159/000521662
Authors: Leslie Y. Kam, Daniel Q. Huang, Margaret L.P. Teng, Hirokazu Takahashi, Kenichi Tanaka, Satoshi Yasuda, James Fung, Teng-Yu Lee, Hideyuki Hyogo, Masafumi Ono, Junji Saruwatari, Kentaro Oniki, Yee Hui Yeo, Scott Barnett, Linda Henry, Jie Li, Biyao Zou, Ramsey C. Cheung, Takashi Kumada, Man-Fung Yuen, Yuichiro Eguchi, Hidenori Toyoda, Mindie H. Nguyen
Institutions: Stanford Medicine, National University of Singapore, National University Hospital, Saga University, Ogaki Municipal Hospital, Queen Mary Hospital, University of Hong Kong, Taichung Veterans General Hospital, Chung Shan Medical University, Hiroshima General Hospital, Tokyo Women's Medical University, Kumamoto University, Shandong University, Shandong Provincial Hospital, VA Palo Alto Health Care System, Gifu Kyoritsu University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: Development of innovative drug dosage regimens compatible with diverse treatment responsiveness in depression and schizophrenia, Construction and application of a prediction model for the development of diabetic complications based on the effects of accumulation and variation of blood glucose, blood pressure, and lipids.
OpenAlex ID: W4200367002