PMID- 37491159
OWN - NLM
STAT- MEDLINE
DCOM- 20231009
LR  - 20231012
IS  - 1468-3288 (Electronic)
IS  - 0017-5749 (Linking)
VI  - 72
IP  - 11
DP  - 2023 Nov
TI  - Global prevalence of non-alcoholic fatty liver disease in type 2 diabetes 
      mellitus: an updated systematic review and meta-analysis.
PG  - 2138-2148
LID - 10.1136/gutjnl-2023-330110 [doi]
AB  - INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of 
      chronic liver disease, with type 2 diabetes mellitus (T2DM) as a major predictor. 
      Insulin resistance and chronic inflammation are key pathways in the pathogenesis 
      of T2DM leading to NAFLD and vice versa, with the synergistic effect of NAFLD and 
      T2DM increasing morbidity and mortality risks. This meta-analysis aims to 
      quantify the prevalence of NAFLD and the prevalence of clinically significant and 
      advanced fibrosis in people with T2DM. METHODS: MEDLINE and Embase databases were 
      searched from inception until 13 February 2023. The primary outcomes were the 
      prevalence of NAFLD, non-alcoholic steatohepatitis (NASH) and fibrosis in people 
      with T2DM. A generalised linear mixed model with Clopper-Pearson intervals was 
      used for the analysis of proportions with sensitivity analysis conducted to 
      explore heterogeneity between studies. RESULTS: 156 studies met the inclusion 
      criteria, and a pooled analysis of 1 832 125 patients determined that the 
      prevalence rates of NAFLD and NASH in T2DM were 65.04% (95% CI 61.79% to 68.15%, 
      I(2)=99.90%) and 31.55% (95% CI 17.12% to 50.70%, I(2)=97.70%), respectively. 
      35.54% (95% CI 19.56% to 55.56%, I(2)=100.00%) of individuals with T2DM with 
      NAFLD had clinically significant fibrosis (F2-F4), while 14.95% (95% CI 11.03% to 
      19.95%, I(2)=99.00%) had advanced fibrosis (F3-F4). CONCLUSION: This study 
      determined a high prevalence of NAFLD, NASH and fibrosis in people with T2DM. 
      Increased efforts are required to prevent T2DM to combat the rising burden of 
      NAFLD. PROSPERO REGISTRATION NUMBER: CRD42022360251.
CI  - (c) Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - En Li Cho, Elina
AU  - En Li Cho E
AUID- ORCID: 0000-0001-6866-0425
AD  - Department of Medicine, National University Hospital, Singapore.
FAU - Ang, Chong Zhe
AU  - Ang CZ
AD  - Department of Medicine, National University Hospital, Singapore.
FAU - Quek, Jingxuan
AU  - Quek J
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Fu, Clarissa Elysia
AU  - Fu CE
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Lim, Lincoln Kai En
AU  - Lim LKE
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Heng, Zane En Qi
AU  - Heng ZEQ
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Tan, Darren Jun Hao
AU  - Tan DJH
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Lim, Wen Hui
AU  - Lim WH
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Yong, Jie Ning
AU  - Yong JN
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Zeng, Rebecca
AU  - Zeng R
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Chee, Douglas
AU  - Chee D
AD  - Department of Medicine, National University Hospital, Singapore.
FAU - Nah, Benjamin
AU  - Nah B
AD  - Department of Medicine, National University Hospital, Singapore.
FAU - Lesmana, Cosmas Rinaldi Adithya
AU  - Lesmana CRA
AD  - Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, 
      Jakarta, Indonesia.
FAU - Bwa, Aung Hlaing
AU  - Bwa AH
AD  - Department of Medical Research, Union of Myanmar, Naypyidaw, Myanmar.
FAU - Win, Khin Maung
AU  - Win KM
AUID- ORCID: 0000-0003-4126-307X
AD  - Department of Medical Research, Union of Myanmar, Naypyidaw, Myanmar.
FAU - Faulkner, Claire
AU  - Faulkner C
AD  - Department of Medicine, University of Arizona College of Medicine, Phoenix, 
      Arizona, USA.
FAU - Aboona, Majd B
AU  - Aboona MB
AUID- ORCID: 0000-0002-5533-8987
AD  - Department of Medicine, University of Arizona College of Medicine, Phoenix, 
      Arizona, USA.
FAU - Lim, Mei Chin
AU  - Lim MC
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Department of Diagnostic Imaging, National University Health System, Singapore.
FAU - Syn, Nicholas
AU  - Syn N
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Kulkarni, Anand V
AU  - Kulkarni AV
AUID- ORCID: 0000-0002-1240-1675
AD  - Hepatology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India.
FAU - Suzuki, Hiroyuki
AU  - Suzuki H
AUID- ORCID: 0000-0003-2383-5038
AD  - Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
FAU - Takahashi, Hirokazu
AU  - Takahashi H
AD  - Liver Center, Saga University Hospital, Saga, Japan.
FAU - Tamaki, Nobuharu
AU  - Tamaki N
AUID- ORCID: 0000-0003-4634-6616
AD  - Department of Medicine, University of California San Diego, La Jolla, California, 
      USA.
AD  - Department of Medicine, Musashino Red Cross Hospital, Musashino, Japan.
FAU - Wijarnpreecha, Karn
AU  - Wijarnpreecha K
AUID- ORCID: 0000-0002-6232-6343
AD  - Division of Gastroenterology and Hepatology, University of Michigan, Michigan, 
      Michigan, USA.
FAU - Huang, Daniel Q
AU  - Huang DQ
AD  - Department of Medicine, National University Hospital, Singapore.
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Division of Gastroenterology and Hepatology, National University Health System, 
      Singapore.
FAU - Muthiah, Mark
AU  - Muthiah M
AUID- ORCID: 0000-0002-9724-4743
AD  - Department of Medicine, National University Hospital, Singapore.
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Division of Gastroenterology and Hepatology, National University Health System, 
      Singapore.
FAU - Ng, Cheng Han
AU  - Ng CH
AUID- ORCID: 0000-0002-8297-1569
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore 
      chenhanng@gmail.com.
FAU - Loomba, Rohit
AU  - Loomba R
AUID- ORCID: 0000-0002-4845-9991
AD  - Department of Medicine, University of California San Diego, La Jolla, California, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20230725
PL  - England
TA  - Gut
JT  - Gut
JID - 2985108R
SB  - IM
MH  - Humans
MH  - *Non-alcoholic Fatty Liver Disease/complications/epidemiology/pathology
MH  - *Diabetes Mellitus, Type 2/complications/epidemiology
MH  - Prevalence
MH  - *Insulin Resistance
MH  - Fibrosis
OTO - NOTNLM
OT  - DIABETES MELLITUS
OT  - FATTY LIVER
OT  - META-ANALYSIS
OT  - NONALCOHOLIC STEATOHEPATITIS
COIS- Competing interests: DQH served as an advisory board member for Gilead and 
      received funding support from the Singapore Ministry of Health's National Medical 
      Research Council under its NMRC Research Training Fellowship (MOH-000595-01). CHN 
      and MM served as a consultants for Boxer Capital. RL served as a consultant to 
      Aardvark Therapeutics, Altimmune, Anylam/Regeneron, Amgen, Arrowhead 
      Pharmaceuticals, AstraZeneca, Bristol-Myer Squibb, CohBar, Eli Lilly, Galmed, 
      Gilead, Glympse Bio, Hightide, Inipharma, Intercept, Inventiva, Ionis, Janssen 
      Inc., Madrigal, Metacrine, Inc., NGM Biopharmaceuticals, Novartis, Novo Nordisk, 
      Merck, Pfizer, Sagimet, Theratechnologies, 89 Bio, Terns Pharmaceuticals and 
      Viking Therapeutics; in addition, his institutions received research grants from 
      Arrowhead Pharmaceuticals, Astrazeneca, Boehringer-Ingelheim, Bristol-Myers 
      Squibb, Eli Lilly, Galectin Therapeutics, Galmed Pharmaceuticals, Gilead, 
      Intercept, Hanmi, Intercept, Inventiva, Ionis, Janssen, Madrigal Pharmaceuticals, 
      Merck, NGM Biopharmaceuticals, Novo Nordisk, Merck, Pfizer, Sonic Incytes and 
      Terns Pharmaceuticals; cofounder of LipoNexus Inc.
EDAT- 2023/07/26 01:06
MHDA- 2023/10/09 06:42
CRDT- 2023/07/25 21:23
PHST- 2023/04/18 00:00 [received]
PHST- 2023/06/20 00:00 [accepted]
PHST- 2023/10/09 06:42 [medline]
PHST- 2023/07/26 01:06 [pubmed]
PHST- 2023/07/25 21:23 [entrez]
AID - gutjnl-2023-330110 [pii]
AID - 10.1136/gutjnl-2023-330110 [doi]
PST - ppublish
SO  - Gut. 2023 Nov;72(11):2138-2148. doi: 10.1136/gutjnl-2023-330110. Epub 2023 Jul 
      25.