In a meta-analysis published online February 22 in the journal Hepatology by Dr. Younossi and colleagues, the pooled worldwide prevalence of nonalcoholic fatty liver disease, diagnosed through imaging, was found to be 25.24%. The Middle East and South America had the highest prevalence, while Africa had the lowest prevalence. The incidence of NAFLD in Asia (China and Japan) was 52.34 per 1,000 person years and 28.01 per 1,000 for Israel.
The pooled overall nonalcoholic steatohepatitis, NASH prevalence among biopsied NAFLD patients came to 59.10%. By region, prevalence came to 64.45% for Asia, 69.25% for Europe, and 60.64% for North America. The most common medical comorbidities identified in the meta-analysis were obesity (51.34% NAFLD and NASH), type 2 diabetes (22.51% NAFLD, 43.63% NASH), hyperlipidemia (69.16% NAFLD, 72.13% NASH), hypertension (39.34% NAFLD, 67.97% NASH), and metabolic syndrome (42.54% NAFLD, 70.65% NASH).
The incidence of hepatocellular carcinoma in the NAFLD group was estimated at 0.44 per 1,000 person-years and for NASH 5.29 per 1,000. Liver-specific mortality rates for NAFLD came to 0.77 per 1,000, and 15.44 per 1,000 person years for NASH.
Obesity is a major public health problem and is associated with an increased risk of NAFLD among other metabolic disorders. Even a 5% weight loss can be enough, but we should aim for at least a 10% decrease in weight to reduce risk for metabolic syndrome. As physicians we must encourage lifestyle changes in our patients and help them make the right choices about food and exercise.(Source: Medscape)