Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2015; 21(18): 5695-5706
Published online May 14, 2015. doi: 10.3748/wjg.v21.i18.5695
Prevalence of fatty liver disease and the economy in China: A systematic review
Jin-Zhou Zhu, Qin-Yi Zhou, Yu-Ming Wang, Yi-Ning Dai, Jiang Zhu, Chao-Hui Yu, You-Ming Li
Jin-Zhou Zhu, Yu-Ming Wang, Yi-Ning Dai, Chao-Hui Yu, You-Ming Li, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Qin-Yi Zhou, Department of Statistics, Columbian College of Arts and Science, The George Washington University, Washington, DC 20052, United States
Jiang Zhu, Bureau of Statistics, Municipal Government, Suqian 223800, Jiangsu Province, China
Author contributions: Zhou QY performed the statistical analysis; Wang YM and Dai YN collected the data; Zhu JZ wrote the paper; Zhu J collected and estimated the economic data; Yu CH revised the manuscript; Li YM and Zhu JZ contributed to the conception and design of the study.
Conflict-of-interest: All authors have no conflict of interest related to the manuscript.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: You-Ming Li, Professor, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310003, Zhejiang Province, China. ymli.zju@live.com
Telephone: +86-571-87236603 Fax: +86-571-87080565
Received: November 17, 2014
Peer-review started: November 18, 2014
First decision: December 26, 2014
Revised: January 13, 2015
Accepted: February 11, 2015
Article in press: February 11, 2015
Published online: May 14, 2015
Processing time: 181 Days and 20.4 Hours
Abstract

AIM: To investigate the relationship between the economy and the adult prevalence of fatty liver disease (FLD) in mainland China.

METHODS: Literature searches on the PubMed and Chinese National Knowledge Infrastructure databases were performed to identify eligible studies published before July 2014. Records were limited to cross-sectional surveys or baseline surveys of longitudinal studies that reported the adult prevalence of FLD and recruited subjects from the general population or community. The gross domestic product (GDP) per capita was chosen to assess the economic status. Multiple linear regression and Loess regression were chosen to fit the data and calculate the 95%CIs. Fitting and overfitting of the models were considered in choosing the appropriate models.

RESULTS: There were 27 population-based surveys from 26 articles included in this study. The pooled mean prevalence of FLD in China was 16.73% (95%CI: 13.92%-19.53%). The prevalence of FLD was correlated with the GDP per capita and survey years in the country (adjusted R2 = 0.8736, PGDP per capita = 0.00426, Pyears = 0.0000394), as well as in coastal areas (R2 = 0.9196, PGDP per capita = 0.00241, Pyears = 0.00281). Furthermore, males [19.28% (95%CI: 15.68%-22.88%)] presented a higher prevalence than females [14.1% (95%CI: 11.42%-16.61%), P = 0.0071], especially in coastal areas [21.82 (95%CI: 17.94%-25.71%) vs 17.01% (95%CI: 14.30%-19.89%), P = 0.0157]. Finally, the prevalence was predicted to reach 20.21% in 2020, increasing at a rate of 0.594% per year.

CONCLUSION: This study reveals a correlation between the economy and the prevalence of FLD in mainland China.

Keywords: Fatty liver disease; Epidemiology; Gross domestic product per capita; Prevalence; Economy

Core tip: The influence of the economy on the prevalence of fatty liver disease (FLD) is unclear, especially in China, which was the world’s fastest-growing major economy. In this study, a systematic review of population-based surveys was performed to explore the adult prevalence of FLD in mainland China. The gross domestic product per capita was chosen as an indicator to evaluate local economic status. Our analysis indicated that the mean prevalence of FLD in China was 16.73% and that the prevalence increased as China’s economy developed over the past 20 years. In addition, the prevalence over the next 7 years was estimated based on the current trend.