Prevalence of NAFLD in Asia: A Systematic Review and Meta-Analysis of 195 Studies and 1,753,168 Subjects from 13 Countries = Prevalence of NAFLD in Asia: A Systematic Review and Meta-Analysis of 195 Studies and 1,753,168 Subjects from 13 Countries

다국어 초록 (Multilingual Abstract)

Aims: NAFLD is generally correlated with the obesity epidemic. Asia is a heterogeneous region with varying socioeconomic levels and obesity prevalence; therefore, our goal was to estimate the prevalence of NAFLD in Asia through a meta-analytic approach.
Methods: PubMed and EMBASE databases were searched from 1989 to 2017 for relevant studies reporting NAFLD prevalence in Asia. All studies were reviewed by three independent investigators. We used random-effects models to provide point estimates with 95% confidence interval (CI) of prevalence. Publication bias was assessed by Egger weighted regression Methods.
Results: From the 2700 titles and abstracts reviewed, 195 papers from 13 countries met the inclusion criteria and included 1,753,168 subjects. The overall pooled prevalence for NAFLD in Asia was 31% (95% CI: 29-32). Individual country prevalence was shown in Table 1. In countries with more than 3 studies, the lowest prevalence was seen in Japan (24%, 95% CI: 21-28) and the highest in Iran (36%, 95%CI 31-41). Notably, pooled prevalence from studies with sample <1,000 subjects was much higher (34%, 95% CI: 31-38, 45 studies, n=23,857) than estimate from larger studies (≥1,000 subjects) (30%, 95% CI: 28- 31, 150 studies, n=172,9311). By sub-regions within Asia (Table 2), there was significant regional differences (P<0.01) with the highest NAFLD prevalence seen in West Asia (33%, 95% CI: 28-39, 13 studies, n=32,142) and the lowest in Southeast Asia (24%, 95% CI: 15-33, 5 studies, n=3457). By country income levels, NAFLD prevalence was 30% (95% CI: 29-32, 89 studies, n=1,005,409) for high-income countries and 31% (95% CI: 29-33, 106 studies, n=747,759) for middle-income countries (P<0.63).
Conclusions: Overall NAFLD prevalence in Asia is 31% similar to Western countries and by country-income levels within Asia but varies by some sub-regions or Asia with the highest prevalence in West Asia (33%).