Fatty Liver ; diagnosis ; epidemiology ; Humans ; Liver Diseases, Alcoholic ; diagnosis ; epidemiology ; Non-alcoholic Fatty Liver Disease

No abstract available.
Coronary Disease/*diagnosis ; Fatty Liver, Alcoholic/*diagnosis ; Female ; Humans ; Male ; Non-alcoholic Fatty Liver Disease/*diagnosis/*epidemiology

Early Diagnosis ; Humans ; Non-alcoholic Fatty Liver Disease ; diagnosis ; epidemiology ; prevention & control ; Risk Factors

OBJECTIVETo supply evidence for establishing the standard for Chinese medicine (CM) syndrome differentiation by investigating the distribution and characteristics of CM syndromes in patients with nonalcoholic fatty liver disease (NAFLD).

METHODS928 NAFLD patients' symptoms, signs, tongue and pulse parameters were studied by clinical epidemiologic survey. And the results were analyzed by the cluster analysis and factor analysis.

RESULTSThe results of cluster analysis showed that the CM syndrome typings of fatty liver patients were mainly classified as dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency, which were in accordance with clinical practice. The results of factor analysis indicated that overweight/obesity, abdominal distension, hypochondriac pain, discomfort in the hepatic region were common "condition factors" of fatty liver patients. The 5 "syndrome factors" such as dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency showed identification significance in syndrome typing.

CONCLUSIONSThe basic CM syndrome typings of NAFLD were dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency. The four parameters of fatty liver patients could be classified by statistical analysis as condition factors and syndrome factors (which could reflect CM syndrome characteristics), which could provide certain evidence for establishing CM syndrome differentiation standards.

Adult ; Aged ; Cluster Analysis ; Factor Analysis, Statistical ; Fatty Liver ; diagnosis ; epidemiology ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Non-alcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease seen in patients with obesity, diabetes, and metabolic syndrome. Metabolic syndrome is an important predictor of the severe form of NAFLD, nonalcoholic steatohepatitis (NASH), and NASH patients with diabetes have an increased risk of liver cirrhosis and hepatocellular carcinoma. With the prevalence of obesity and diabetes around the world, NAFLD has become a global public health problem. NAFLD is not only one of the most important causes of liver-related disability and mortality, but also associated with the increasing incidence of diabetes and cardiovascular disease. The effective prevention and treatment of NAFLD is expected to reduce the burden of liver disease and cardiovascular disease. Therefore, this article overviews the advances in the diagnosis, prevention, and treatment of NAFLD.
Carcinoma, Hepatocellular ; epidemiology ; Cardiovascular Diseases ; epidemiology ; Diabetes Mellitus ; epidemiology ; Humans ; Liver Cirrhosis ; epidemiology ; Liver Neoplasms ; epidemiology ; Metabolic Syndrome ; epidemiology ; Non-alcoholic Fatty Liver Disease ; diagnosis ; epidemiology ; therapy ; Obesity ; epidemiology ; Prevalence

OBJECTIVETo assess the characteristics and daily treatment compliance of non-alcoholic fatty liver disease (NAFLD) patients in China.

METHODSNAFLD adult patients from 21 clinics of 12 cities in China were enrolled in this registry. Physical examination such as demographic characteristics (height, weight, waist circumference measurement), blood pressure and clinical laboratory and ultrasonographic examination of liver were undertaken. Daily practice including life style and medication were recorded and assessed in accordance with 2006 Chinese NAFLD treatment guidelines.

RESULTSA total of 1656 patients were enrolled (1146 male and 510 female), mean of 45.8 ± 12.6 years old, mean duration of NAFLD history was (47.2 ± 47.7) months. 44.9% of NAFLD were suffering from metabolic syndromes. Patients with central obesity have higher incidence of hypertension and lower level of high-density lipoprotein cholesterol (HDL-C) than those without central obesity, P < 0.05. Body mass index (BMI), waist circumference, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in ALT abnormal group were higher than those in ALT normal group (P < 0.05), HDL-C was lower in ALT abnormal group (P < 0.05). Significant differences existed between the BMI, female waist circumference, TG, fast insulin, HOMA index, ALT, AST and HDL-C among subgroups with mild, moderate and severe steatosis. Majority of the patients did not follow recommendations of NAFLD treatment guidelines. Among targeted population only 15.3% of patients used insulin sensitizers and 23.8% took lipid lowering medicine according to the guideline.

CONCLUSIONData indicated that nearly half of NAFLD patients co-morbid with metabolic disorders. Therapy compliance was unsatisfactory and the gap between current practice and Chinese NAFLD treatment guidelines was not optimal.

Adult ; Asian Continental Ancestry Group ; China ; epidemiology ; Fatty Liver ; diagnosis ; epidemiology ; therapy ; Female ; Humans ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Risk Factors ; Waist Circumference

A new definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has recently been proposed. We aim to examine the associations of MAFLD, particularly its discordance from non-alcoholic fatty liver disease (NAFLD), with the progression of elevated brachial-ankle pulse wave velocity (baPWV) and albuminuria in a community-based study sample in Shanghai, China. After 4.3 years of follow-up, 778 participants developed elevated baPWV and 499 developed albuminuria. In comparison with the non-MAFLD group, the multivariable adjusted odds ratio (OR) of MAFLD group for new-onset elevated baPWV was 1.25 (95% confidence interval (CI) 1.01-1.55) and 1.35 (95% CI 1.07-1.70) for albuminuria. Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria (OR 1.77; 95% CI 1.07-2.94). Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria. In conclusion, MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index, waist circumference, and hip circumference. Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria, supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.
Humans ; Pulse Wave Analysis ; Albuminuria ; Ankle Brachial Index ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Vascular Stiffness ; Prospective Studies ; Risk Factors ; China/epidemiology*

The Korean Genome Epidemiology Study (KoGES) is a principal cohort study providing valuable evidence for the prevention of major chronic diseases such as hypertension, obesity, and diabetes in Korea. Since 2001, the Ansan-Anseong cohort is one of the representative cohorts in the KoGES and recruited about 10,000 participants from Ansan and Anseong city to undergo a comprehensive health examination biennially. About 3,000 participants in the Ansan cohort underwent abdominal computed tomography scan to detect the presence of nonalcoholic fatty liver disease (NAFLD). The prevalence of NAFLD was about 23% in this study, and it was twice as high in subjects with diabetes compared to those without. Subjects with NAFLD had early diastolic dysfunction in tissue Doppler study and showed lower vitamin D concentrations than those without. We also found that the palatin-like phospholipase domain containing 3 single nucleotide polymorphisms were significantly associated with NAFLD. Interim prospective analysis after six years showed that NAFLD was associated with worsening of metabolic risk factors and an about 2.6 higher likelihood of developing diabetes than in those without. These results present the clinical importance of the diagnosis and treatment of NAFLD to reduce the future development of diabetes and cardiovascular diseases.
Cardiovascular Diseases ; Chronic Disease ; Cohort Studies ; Diagnosis ; Epidemiology* ; Fatty Liver ; Genome* ; Gyeonggi-do ; Hypertension ; Korea ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Phospholipases ; Polymorphism, Single Nucleotide ; Prevalence ; Prospective Studies ; Risk Factors ; Vitamin D

BACKGROUND/AIMS: A close relationship has been established between nonalcoholic fatty liver disease (NAFLD) and an elevated risk of coronary heart disease (CHD), but little is known about the association between alcoholic fatty liver disease (AFLD) and CHD risk. The aim of this study was to determine whether AFLD is associated with elevated CHD risk. METHODS: We retrospectively enrolled 10,710 subjects out of 11,469 individuals who visited the Konkuk University Health Care Center for a routine health checkup in 2010. AFLD was diagnosed made when the usual amount of alcohol consumption exceeded 210 g/week in males and 140 g/week in females for the previous 2 years and when hepatic steatosis was detected by liver ultrasonography. The 10-year risk for CHD was estimated using the Framingham Risk Score. RESULTS: Hepatic steatosis was diagnosed in 4,142 of the 10,710 individuals (38.7%); the remainder (i.e., n=6,568) became the control group. The 4,142 individuals with hepatic steatosis were divided into two groups: NAFLD (n=2,953) and AFLD (n=1,189). The risk of CHD was higher in AFLD (6.72+/-0.12) than in the control group (5.50+/-0.04, P<0.001), and comparable to that in NAFLD (7.32+/-0.07, P=0.02). CONCLUSIONS: Individuals with AFLD have an elevated 10-year risk of CHD that is comparable to those with NAFLD. Therefore, AFLD should be considered a significant risk for future CHD, and preventive measures should be considered earlier.
Adult ; Age Factors ; Alcohol Drinking ; Body Mass Index ; Coronary Disease/*diagnosis/etiology ; Cross-Sectional Studies ; Fatty Liver, Alcoholic/complications/*diagnosis/ultrasonography ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/complications/*diagnosis/*epidemiology/ultrasonography ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Sex Factors

BACKGROUND/AIMS: Hypothyroidism is reported to contribute to the development of nonalcoholic fatty liver disease (NAFLD). We compared the risk of the development of NAFLD among three groups with different thyroid hormonal statuses (control, subclinical hypothyroidism, and overt hypothyroidism) in a 4-year retrospective cohort of Korean subjects. METHODS: Apparently healthy Korean subjects without NAFLD and aged 20-65 years were recruited (n=18,544) at health checkups performed in 2008. Annual health checkups were applied to the cohort for 4 consecutive years until December 2012. Based on their initial serum-free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels, they were classified into control, subclinical hypothyroidism (TSH >4.2 mIU/L, normal fT4), and overt hypothyroidism (TSH >4.2 mIU/L, fT4 <0.97 ng/dL) groups. NAFLD was diagnosed on the basis of ultrasonography findings. RESULTS: NAFLD developed in 2,348 of the 18,544 subjects, representing an overall incidence of 12.7%: 12.8%, 11.0%, 12.7% in the control, subclinical hypothyroidism, and overt hypothyroidism groups, respectively. The incidence of NAFLD did not differ significantly with the baseline thyroid hormonal status, even after multivariate adjustment (subclinical hypothyroidism group: hazard ratio [HR]=0.965, 95% confidence interval [CI]=0.814-1.143, P=0.67; overt hypothyroidism group: HR=1.255, 95% CI=0.830-1.899, P=0.28). CONCLUSIONS: Our results suggest that the subclinical and overt types of hypothyroidism are not related to an increased incidence of NAFLD.
Adult ; Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Hypothyroidism/*complications/*diagnosis ; Incidence ; Kaplan-Meier Estimate ; Liver/ultrasonography ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/*complications/*diagnosis/epidemiology ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Thyrotropin/analysis ; Thyroxine/analysis