Prevalence of Non-alcoholic Fatty Liver Disease (NAFLD) in Saudi Arabia: Systematic Review and Meta-analysis

Abstract

Liver disease is fast emerging as a global health priority. Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries, with an increasing prevalence associated with the rising prevalence of diabetes mellitus and obesity. The worldwide prevalence of NAFLD may be in the order of 25%, but in the Middle East, it may be even higher. This study aimed to estimate the prevalence of NAFLD in the Kingdom of Saudi Arabia (KSA). A systematic review and meta-analysis were undertaken. Electronic searches were carried out through Medline, EMBASE, CINAHL, Web of Science, and Google Scholar, for articles from inception to April 2020. Studies conducted on adult populations in any setting reporting NAFLD prevalence were included. Pooled proportions and associated 95% confidence intervals (CIs) were presented in forest plots using a random effect model. Eight studies, including 4045 participants, were included. The pooled prevalence of NAFLD among all adult populations in KSA was 16.8% (11.1%-22.5%). Amongst those with type 2 diabetes, the prevalence was 58.0% (45.0%-70.9%). There were no true general population studies of the prevalence of NAFLD in KSA available. This review suggests that NAFLD is common in the KSA, and that type 2 diabetes is a risk factor in KSA as identified elsewhere in the world.

Keywords: diabetes type 2; kingdom of saudi arabia (ksa); non-alcoholic fatty liver; prevalence; systematic review and meta analysis.

Figure 1. Flow diagram of articles screening and selection process for studies. Arrows represent the step-wise process.

n, numbers; NAFLD, non-alcoholic fatty liver disease.

Figure 2. Forest plot of the prevalence of NAFLD by subgroups. Black square boxes represent the prevalence, and flat diagonally placed shape shows heterogeneity.

NAFLD, non-alcoholic fatty liver disease; 95% CI, confidence interval; T2DM, type 2 diabetes mellitus