Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2014 to 2018 in Japan: A large-scale multicenter retrospective study

Hideki Fujii¹, Yuichiro Suzuki², Koji Sawada³, Miwa Tatsuta⁴, Tatsuji Maeshiro⁵, Hiroshi Tobita⁶, Tsubasa Tsutsumi⁷, Takemi Akahane⁸, Chitomi Hasebe⁹, Miwa Kawanaka¹⁰, Takaomi Kessoku^{11

12

13}, Yuichiro Eguchi¹⁴, Hayashi Syokita¹⁵, Atsushi Nakajima¹³, Tomoari Kamada¹⁶, Hitoshi Yoshiji⁸, Takumi Kawaguchi⁷, Hiroshi Sakugawa¹⁷, Asahiro Morishita¹⁸, Tsutomu Masaki¹⁸, Takumi Ohmura¹⁹, Toshio Watanabe²⁰, Norifumi Kawada¹, Yoshioki Yoda²¹, Nobuyuki Enomoto², Masafumi Ono²², Kanako Fuyama²³, Kazufumi Okada²³, Naoki Nishimoto²³, Yoichi M Ito²³, Yoshihiro Kamada²⁴, Hirokazu Takahashi²⁵, Yoshio Sumida²⁶; Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD)²⁷

Affiliations

¹ Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
² First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
³ Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
⁴ Department of Gastroenterology, KKR Takamatsu Hospital, Takamatsu, Kagawa, Japan.
⁵ First Department of Internal Medicine, University of the Ryukyus Hospital, Okinawa, Japan.
⁶ Department of Hepatology, Shimane University Hospital, Izumo, Shimane, Japan.
⁷ Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
⁸ Department of Gastroenterology, Nara Medical University, Kashihara, Nara, Japan.
⁹ Department of Gastroenterology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan.
¹⁰ Department of General Internal Medicine 2, Kawasaki Medical Center, Kawasaki Medical School, Kita, Okayama, Japan.
¹¹ Kanagawa Dental University Yokohama Clinic, Yokohama, Japan.
¹² Department of Palliative Medicine and Gastroenterology, International University Health and Welfare Narita Hospital, Chiba, Japan.
¹³ Division of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
¹⁴ Loco Medical General Institute, Saga, Japan.
¹⁵ Department of Gastroenterology, Northern OKINAWA Medical Center, Nago, Okinawa, Japan.
¹⁶ Department of Health Care Medicine, Kawasaki Medical School, Kita, Okayama, Japan.
¹⁷ Department of Gastroenterology, Heartlife Hospital, Okinawa, Japan.
¹⁸ Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
¹⁹ Department of Health Care, Asahikawa-Kosei General Hospital, Asahikawa, Hokkaido, Japan.
²⁰ Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
²¹ JA Yamanashi Koseiren Health Care Center, Yamanashi, Japan.
²² Division of Innovative Medicine for Hepatobiliary and Pancreatology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
²³ Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan.
²⁴ Department of Advanced Metabolic Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan.
²⁵ Liver Center, Saga University Hospital, Saga, Japan.
²⁶ Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan.
²⁷ The Japan Strategic Medical Administration Research Center (J-SMARC), Aichi, Japan.

PMID: 37537735
DOI: 10.1111/hepr.13947

Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2014 to 2018 in Japan: A large-scale multicenter retrospective study

Hideki Fujii et al. Hepatol Res. 2023 Nov.

. 2023 Nov;53(11):1059-1072.

doi: 10.1111/hepr.13947. Epub 2023 Aug 28.

Authors

Affiliations

¹ Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
² First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
³ Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
⁴ Department of Gastroenterology, KKR Takamatsu Hospital, Takamatsu, Kagawa, Japan.
⁵ First Department of Internal Medicine, University of the Ryukyus Hospital, Okinawa, Japan.
⁶ Department of Hepatology, Shimane University Hospital, Izumo, Shimane, Japan.
⁷ Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
⁸ Department of Gastroenterology, Nara Medical University, Kashihara, Nara, Japan.
⁹ Department of Gastroenterology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan.
¹⁰ Department of General Internal Medicine 2, Kawasaki Medical Center, Kawasaki Medical School, Kita, Okayama, Japan.
¹¹ Kanagawa Dental University Yokohama Clinic, Yokohama, Japan.
¹² Department of Palliative Medicine and Gastroenterology, International University Health and Welfare Narita Hospital, Chiba, Japan.
¹³ Division of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
¹⁴ Loco Medical General Institute, Saga, Japan.
¹⁵ Department of Gastroenterology, Northern OKINAWA Medical Center, Nago, Okinawa, Japan.
¹⁶ Department of Health Care Medicine, Kawasaki Medical School, Kita, Okayama, Japan.
¹⁷ Department of Gastroenterology, Heartlife Hospital, Okinawa, Japan.
¹⁸ Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
¹⁹ Department of Health Care, Asahikawa-Kosei General Hospital, Asahikawa, Hokkaido, Japan.
²⁰ Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
²¹ JA Yamanashi Koseiren Health Care Center, Yamanashi, Japan.
²² Division of Innovative Medicine for Hepatobiliary and Pancreatology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
²³ Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan.
²⁴ Department of Advanced Metabolic Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan.
²⁵ Liver Center, Saga University Hospital, Saga, Japan.
²⁶ Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan.
²⁷ The Japan Strategic Medical Administration Research Center (J-SMARC), Aichi, Japan.

PMID: 37537735
DOI: 10.1111/hepr.13947

Abstract

Aim: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. The aim of this study was to determine the recent prevalence and clinical characteristics of NAFLD in Japan.

Methods: This study initially included 410 061 retrospectively enrolled adults from the medical health checkup registry for metabolic syndrome, chronic kidney disease, and fatty liver in Japan (MIRACLE-J; UMIN-CTR no. UMIN000049419), who were evaluated between 2014 and 2018 at 13 health centers in Japan. Individuals consuming >20 g of alcohol/day or with chronic liver disease were excluded. Fatty liver was diagnosed by ultrasonography. The probability of NAFLD with advanced fibrosis was estimated based on the fibrosis-4 index and NAFLD fibrosis score.

Results: A total of 71 254 participants were included in the final analysis. The overall prevalence of NAFLD was 25.8%. There was a significant, twofold difference in NAFLD prevalence between men (37.4%) and women (18.1%). Nonalcoholic fatty liver disease prevalence increased linearly with body mass index, triglycerides, and low-density lipoprotein cholesterol regardless of threshold values, even in the absence of obesity. Among patients with NAFLD, 14% had diabetes mellitus, 31% had hypertension, and 48% had dyslipidemia. The estimated prevalence of NAFLD with advanced fibrosis was 1.7% and 1.0% according to the fibrosis-4 index and NAFLD fibrosis score, respectively.

Conclusions: The prevalence of NAFLD was approximately one-quarter of the general population in Japan. There was a linear relationship between NAFLD prevalence and various metabolic parameters, even in nonobese participants. The prevalence of NAFLD with advanced fibrosis was estimated to be 1%-2%.

Keywords: abdominal obesity; central obesity; metabolic syndrome.

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References

REFERENCES

1. GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13-27. https://doi.org/10.1056/nejmoa1614362
1. Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15(1):11-20. https://doi.org/10.1038/nrgastro.2017.109
1. Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD development and therapeutic strategies. Nat Med. 2018;24(7):908-922. https://doi.org/10.1038/s41591-018-0104-9
1. Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357. https://doi.org/10.1002/hep.29367
1. Tokushige K, Ikejima K, Ono M, Eguchi Y, Kamada Y, Itoh Y, et al. Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis 2020. J Gastroenterol. 2021;56(10):951-963. https://doi.org/10.1111/hepr.13688

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Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2014 to 2018 in Japan: A large-scale multicenter retrospective study

Affiliations

Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2014 to 2018 in Japan: A large-scale multicenter retrospective study

Authors

Affiliations

Abstract

References

REFERENCES

Grants and funding

LinkOut - more resources

Full Text Sources