The Global Epidemiology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Among Patients With Type 2 Diabetes

被引：98

作者：

Younossi, Zobair M. ^{[1
,2
,3
]}

Golabi, Pegah ^{[1
,2
,3
]}

Price, Jillian Kallman ^{[1
,2
]}

Owrangi, Soroor ^{[1
]}

Gundu-Rao, Nagashree ^{[3
]}

Satchi, Romona ^{[3
]}

Paik, James M. ^{[1
,2
,3
]}

机构：

[1] Inova Hlth Syst, Beatty Liver & Obes Res Program, Falls Church, VA USA

[2] Inova Fairfax Med Campus, Ctr Liver Dis, Dept Med, Falls Church, VA USA

[3] Global NASH Council, 2411 I St, Washington, DC 20037 USA

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2024年 / 22卷 / 10期

关键词：

NAFLD; MASLD; NASH; MASH; Steatotic Liver Disease; T2D; BURDEN; METAANALYSIS; FIBROSIS; RISK; PREVALENCE; REGRESSION; NASH; BIAS;

D O I：

10.1016/j.cgh.2024.03.006

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD), now known as metabolic dysfunction associated steatotic liver disease (MASLD), is closely associated with type 2 diabetes (T2D). Our aim was to estimate the most recent global prevalence of NAFLD/MASLD, nonalcoholic steatohepatitis (NASH), now known as metabolic dysfunction associated steatohepatitis (MASH), advanced fibrosis, and mortality among patients with T2D. METHODS: We systematically searched PubMed and Ovid MEDLINE for terms including NAFLD, NASH, and T2D published in 1990-2023 according to PRISMA. The meta-analysis was conducted using a random-effects model. Assessment of bias risk used the Joanna Briggs Institute appraisal tool. RESULTS: From 3134 studies included in the initial search, 123 studies (N = 2,224,144 patients with T2D) were eligible. Another 12 studies (N = 2733 T2D patients with liver biopsy) were eligible for histologic assessments. The global pooled prevalence of NAFLD/MASLD among patients with T2D was 65.33% (95% confidence interval, 62.35%-68.18%). This prevalence increased from 55.86% (42.38%-68.53%) in 1990-2004 to 68.81% (63.41%-73.74%) in 2016-2021 (P = .073). The highest NAFLD/MASLD prevalence among T2D patients was observed in Eastern Europe (80.62%, 75.72%-84.73%), followed by the Middle East (71.24%, 62.22%-78.84%), and was lowest in Africa (53.10%, 26.05%-78.44%). Among patients with liver biopsy data, the global pooled prevalence of NASH/MASH, significant fibrosis, and advanced fibrosis was 66.44% (56.61%-75.02%), 40.78% (24.24%-59.70%), and 15.49% (6.99%-30.99%), respectively. The pooled all-cause mortality was 16.79 per 1000 person-years (PY) (10.64-26.40), 4.19 per 1000 PY (1.34-7.05) for cardiac-specific mortality; 6.10 per 1000 PY (0.78-4.88) for extrahepatic cancer-specific fi c mortality; and 2.15 per 1000 PY (0.00-2.21) for liver-specific mortality. CONCLUSIONS: The prevalence of NAFLD/MASLD among T2D is high and growing. The majority of NAFLD/MASLD patients with T2D have NASH/MASH, and a significant fi cant proportion have advanced fibrosis.

引用

页码：1999 / 2010

页数：12