Vincent Wai-Sun Wong1, Grace Lai-Hung Wong1, David Ka-Wai Yeung2, Tina Kit-Ting Lau1, Carmen Ka-Man Chan1, Angel Mei-Ling Chim1, Jill M Abrigo3, Ruth Suk-Mei Chan4, Jean Woo4, Yee-Kit Tse1, Winnie Chiu-Wing Chu5, Henry Lik-Yuen Chan6. 1. Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. 2. Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China. 3. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China. 4. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Centre for Nutritional Studies, The Chinese University of Hong Kong, Hong Kong, China. 5. Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China; Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: winnie@med.cuhk.edu.hk. 6. Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: hlychan@cuhk.edu.hk.
Abstract
BACKGROUND & AIMS: Because abdominal ultrasonography cannot reliably quantify hepatic steatosis, accurate data on the incidence of non-alcoholic fatty liver disease (NAFLD) are lacking. We aimed to study the population incidence of NAFLD with state-of-the-art non-invasive tests. METHODS: This was a prospective cohort study. The intrahepatic triglyceride (IHTG) content was measured serially with proton-magnetic resonance spectroscopy in community subjects. Transient elastography was performed to assess liver fibrosis. RESULTS: 565 subjects (mean age 48 years, 62.7% women) without NAFLD at baseline underwent follow-up assessment after a median interval of 47 months (range 34-60 months). 78 (13.8%) subjects developed incident fatty liver with a mean IHTG content of 8.9% (SD 5.3%). 16 (20.5%) subjects had an IHTG content ⩾ 11.0% suggestive of moderate to severe steatosis. After excluding 2 men with significant alcohol consumption, the population incidence of NAFLD at 3-5 years was 13.5% (95% CI 10.6-16.3%; 3.4% per year). Only 1 subject with incident NAFLD had high liver stiffness (11.1 kPa) suggestive of advanced fibrosis. Metabolic syndrome at baseline was the strongest predictor of incident fatty liver. Incident central obesity developed in 31.0% of subjects with incident fatty liver and 5.6% of those without (p<0.001). No subject with incident fatty liver had regression of impaired fasting glucose, which occurred in 51.1% of those without incident fatty liver (p=0.001). CONCLUSIONS: 13.5% of the Hong Kong Chinese adult population develop NAFLD in 3-5 years, but few have severe steatosis or advanced fibrosis. Metabolic syndrome is the most important risk factor of incident NAFLD.
BACKGROUND & AIMS: Because abdominal ultrasonography cannot reliably quantify hepatic steatosis, accurate data on the incidence of non-alcoholic fatty liver disease (NAFLD) are lacking. We aimed to study the population incidence of NAFLD with state-of-the-art non-invasive tests. METHODS: This was a prospective cohort study. The intrahepatic triglyceride (IHTG) content was measured serially with proton-magnetic resonance spectroscopy in community subjects. Transient elastography was performed to assess liver fibrosis. RESULTS: 565 subjects (mean age 48 years, 62.7% women) without NAFLD at baseline underwent follow-up assessment after a median interval of 47 months (range 34-60 months). 78 (13.8%) subjects developed incident fatty liver with a mean IHTG content of 8.9% (SD 5.3%). 16 (20.5%) subjects had an IHTG content ⩾ 11.0% suggestive of moderate to severe steatosis. After excluding 2 men with significant alcohol consumption, the population incidence of NAFLD at 3-5 years was 13.5% (95% CI 10.6-16.3%; 3.4% per year). Only 1 subject with incident NAFLD had high liver stiffness (11.1 kPa) suggestive of advanced fibrosis. Metabolic syndrome at baseline was the strongest predictor of incident fatty liver. Incident central obesity developed in 31.0% of subjects with incident fatty liver and 5.6% of those without (p<0.001). No subject with incident fatty liver had regression of impaired fasting glucose, which occurred in 51.1% of those without incident fatty liver (p=0.001). CONCLUSIONS: 13.5% of the Hong Kong Chinese adult population develop NAFLD in 3-5 years, but few have severe steatosis or advanced fibrosis. Metabolic syndrome is the most important risk factor of incident NAFLD.
Authors: Mohammed Eslam; Shiv K Sarin; Vincent Wai-Sun Wong; Jian-Gao Fan; Takumi Kawaguchi; Sang Hoon Ahn; Ming-Hua Zheng; Gamal Shiha; Yusuf Yilmaz; Rino Gani; Shahinul Alam; Yock Young Dan; Jia-Horng Kao; Saeed Hamid; Ian Homer Cua; Wah-Kheong Chan; Diana Payawal; Soek-Siam Tan; Tawesak Tanwandee; Leon A Adams; Manoj Kumar; Masao Omata; Jacob George Journal: Hepatol Int Date: 2020-10-01 Impact factor: 6.047
Authors: Alina M Allen; Terry M Therneau; Joseph J Larson; Alexandra Coward; Virend K Somers; Patrick S Kamath Journal: Hepatology Date: 2018-03-23 Impact factor: 17.425
Authors: Michelle T Long; Alison Pedley; Joseph M Massaro; Udo Hoffmann; Jiantao Ma; Rohit Loomba; Raymond T Chung; Emelia J Benjamin Journal: Liver Int Date: 2018-03-12 Impact factor: 5.828
Authors: Jeremy Lok Wei; Jonathan Chung-Fai Leung; Thomson Chi-Wang Loong; Grace Lai-Hung Wong; David Ka-Wai Yeung; Ruth Suk-Mei Chan; Henry Lik-Yuen Chan; Angel Mei-Ling Chim; Jean Woo; Winnie Chiu-Wing Chu; Vincent Wai-Sun Wong Journal: Am J Gastroenterol Date: 2015-07-28 Impact factor: 10.864