Takanori Ito1, Masatoshi Ishigami1, Biyao Zou2, Taku Tanaka1, Hirokazu Takahashi3,4, Masayuki Kurosaki5, Mayumi Maeda2, Khin Naing Thin2,6, Kenichi Tanaka4, Yuka Takahashi5, Yoshito Itoh7, Kentaro Oniki8, Yuya Seko7, Junji Saruwatari8, Miwa Kawanaka9, Masanori Atsukawa10, Hideyuki Hyogo11, Masafumi Ono12, Eiichi Ogawa13, Scott D Barnett2, Christopher D Stave14, Ramsey C Cheung2,15, Mitsuhiro Fujishiro1, Yuichiro Eguchi3,4, Hidenori Toyoda16, Mindie H Nguyen17. 1. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 2. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, 780 Welch Road, CJ250K, Palo Alto, CA, 94304, USA. 3. Liver Center, Saga University Hospital, Saga, Japan. 4. Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan. 5. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan. 6. Yangon Specialty Hospital, Yangon, Myanmar. 7. Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan. 8. Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan. 9. Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan. 10. Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo, Japan. 11. Department of Gastroenterology and Hepatology, JA Hiroshima General Hospital, Hiroshima, Japan. 12. Department of Internal Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan. 13. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. 14. Lane Medical Library, Stanford University School of Medicine, Palo Alto, CA, USA. 15. Palo Alto Veterans Affairs Healthcare System, Palo Alto, CA, USA. 16. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan. 17. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, 780 Welch Road, CJ250K, Palo Alto, CA, 94304, USA. mindiehn@stanford.edu.
Abstract
BACKGROUND: NAFLD is increasing in Asia including Japan, despite its lower obesity rate than the West. However, NAFLD can occur in lean people, but data are limited. We aimed to investigate the epidemiology of NAFLD in Japan with a focus on lean NAFLD. METHODS: We searched PubMed, Cochrane Library, EMBASE, Web of Science, and the Japan Medical Abstracts Society (inception to 5/15/2019) and included 73 eligible full-text original research studies (n = 258,531). We used random-effects model for pooled estimates, Bayesian modeling for trend and forecasting, contacted authors for individual patient data and analyzed 14,887 (7752 NAFLD; 7135 non-NAFLD-8 studies) patients. RESULTS: The overall NAFLD prevalence was 25.5%, higher in males (p < 0.001), varied by regions (p < 0.001), and increased over time (p = 0.015), but not by per-person income or gross prefectural productivity, which increased by 0.64% per year (1983-2012) and is forecasted to reach 39.3% in 2030 and 44.8% in 2040. The incidence of NAFLD, HCC, and overall mortality were 23.5, 7.6 and 5.9 per 1000 person-years, respectively. Individual patient-level data showed a lean NAFLD prevalence of 20.7% among the NAFLD population, with lean NAFLD persons being older and with a higher all-cause mortality rate (8.3 vs. 5.6 per 1000 person-years for non-lean NAFLD, p = 0.02). Older age, male sex, diabetes, and FIB-4 were independent predictors of mortality, but not lean NAFLD. CONCLUSION: NAFLD prevalence has increased in Japan and may affect half of the population by 2040. Lean NAFLD individuals makeup 20% of the NAFLD population, were older, and had higher mortality.
BACKGROUND: NAFLD is increasing in Asia including Japan, despite its lower obesity rate than the West. However, NAFLD can occur in lean people, but data are limited. We aimed to investigate the epidemiology of NAFLD in Japan with a focus on lean NAFLD. METHODS: We searched PubMed, Cochrane Library, EMBASE, Web of Science, and the Japan Medical Abstracts Society (inception to 5/15/2019) and included 73 eligible full-text original research studies (n = 258,531). We used random-effects model for pooled estimates, Bayesian modeling for trend and forecasting, contacted authors for individual patient data and analyzed 14,887 (7752 NAFLD; 7135 non-NAFLD-8 studies) patients. RESULTS: The overall NAFLD prevalence was 25.5%, higher in males (p < 0.001), varied by regions (p < 0.001), and increased over time (p = 0.015), but not by per-person income or gross prefectural productivity, which increased by 0.64% per year (1983-2012) and is forecasted to reach 39.3% in 2030 and 44.8% in 2040. The incidence of NAFLD, HCC, and overall mortality were 23.5, 7.6 and 5.9 per 1000 person-years, respectively. Individual patient-level data showed a lean NAFLD prevalence of 20.7% among the NAFLD population, with lean NAFLD persons being older and with a higher all-cause mortality rate (8.3 vs. 5.6 per 1000 person-years for non-lean NAFLD, p = 0.02). Older age, male sex, diabetes, and FIB-4 were independent predictors of mortality, but not lean NAFLD. CONCLUSION: NAFLD prevalence has increased in Japan and may affect half of the population by 2040. Lean NAFLD individuals makeup 20% of the NAFLD population, were older, and had higher mortality.
Entities:
Keywords:
Body Mass Index; FIB-4 Index; Fatty liver; Fibrosis; Hepatocellular carcinoma; Japanese; Metabolic syndrome; Nonalcoholic steatohepatitis; Prognosis; Systematic review
Authors: Mohammed Eslam; Hashem B El-Serag; Sven Francque; Shiv K Sarin; Lai Wei; Elisabetta Bugianesi; Jacob George Journal: Nat Rev Gastroenterol Hepatol Date: 2022-06-16 Impact factor: 73.082
Authors: Rosyli F Reveron-Thornton; Margaret L P Teng; Eunice Yewon Lee; Andrew Tran; Sean Vajanaphanich; Eunice X Tan; Sanjna N Nerurkar; Rui Xin Ng; Readon Teh; Debi Prasad Tripathy; Takanori Ito; Taku Tanaka; Nozomi Miyake; Biyao Zou; Connie Wong; Hidenori Toyoda; Carlos O Esquivel; C Andrew Bonham; Mindie H Nguyen; Daniel Q Huang Journal: Hepatol Commun Date: 2022-03-02