中国地区近10年非酒精性脂肪肝病的贝叶斯单臂Meta分析
Bayesian Single-Arm Meta-Analysis of Nonalcoholic Fatty Liver Disease in China in Recent 10 Years
DOI: 10.12677/ACM.2023.13122772, PDF,   
作者: 文永昊：青海大学研究生院，青海 西宁；青海大学附属医院，肝胆胰外科，青海 西宁；樊海宁*：青海大学附属医院，肝胆胰外科，青海 西宁
关键词: 非酒精性脂肪肝；患病率；贝叶斯方法；Nonalcoholic Fatty Liver Disease； Prevalence； Bayesian Method
摘要: 目的：系统评价中国近10年来的NAFLD的流行特征。方法：计算机检索PubMed、Embase、知网、万方等数据库2012年1月1日至2022年10月31日NAFLD的发病率的横断面研究。由2名研究者独立筛选文献后提取数据资料并评价纳入研究的偏倚风险，利用R软件(4.1.2)进行Meta分析。结果：共纳入141项研究，总人数1,218,241人。贝叶斯荟萃分析结果显示我国NAFLD的总体患病率为27.61% (95% CI 25.79~29.48)，其中，男性患病率为31.63% (95% CI 29.71-33.57)，在40~49岁之间达到高峰。女性患病率为19.02% (95% CI 17.01~21.19)，在60~69岁之间达到高峰。在BMI < 18.5、18.5 ≤ BMI < 24、24 ≤ BMI < 28和28 ≤ BMI的人群NAFLD患病率分别为3.54% (95% CI 1.73~6.22)、11.52% (95% CI 8.94~ 14.57)、38.56% (95% CI 34.50~42.74)和60.82% (95% CI 55.65~65.81)。在正常血糖、空腹血糖受损和糖尿病人群的NAFLD患病率分别为23.77% (95% CI 16.02~33.13)、43.18% (95% CI 36.93~ 49.68)和51.64% (95% CI 48.08~55.15)。代谢综合征和高脂血症患者NAFLD患病率分别为43.62% (95% CI 36.69~50.82)和44.13% (95% CI 39.92~48.50)。NAFLD合并糖尿病、超重、肥胖、代谢综合征及高脂血症的患病率分别为22.68% (95% CI 19.14~26.59)、48.35% (95% CI 44.59~52.14)、45.55% (95% CI 36.91~54.53)、43.62% (95% CI 36.69~50.82)和65.61% (95% CI 59.95~71.02)。结论：我国近10年来NAFLD的患病率在各个地区差异大，以沿海发达地区和西北地区较为严重。患病率和年龄、性别等因素相关联，绝经后的老年女性患病率增加，这一荟萃分析为2型糖尿病和肥胖患者中NAFLD的高患病率提供了证据。需要根据疾病的特点对重点人群进行NAFLD的管理，预防其进展，管理共病。
Abstract: Objective: To systematically evaluate the prevalence of NAFLD in China in the past 10 years. Meth-ods: A cross-sectional study of the incidence of NAFLD was conducted in PubMed, Embase, CNJI, Wanfang and other databases from January 1, 2012 to October 31, 2022. After literature screening independently, two researchers extracted data and evaluated the risk of bias in the included stud-ies. A meta-analysis was performed using R software (4.1.2). Results: A total of 141 studies with a total of 1,218,241 participants were included. Bayesian meta-analysis showed that the overall prevalence of NAFLD in China was 27.61% (95% CI 25.79~29.48), among which the prevalence in males was 31.63% (95% CI 29.71~33.57), peaking between the ages of 40 and 49. The prevalence in females was 19.02% (95% CI 17.01~21.19), peaking between 60 and 69 years of age. The preva-lence of NAFLD in BMI < 18.5, 18.5 ≤ BMI < 24, 24 ≤ BMI < 28 and 28 ≤ BMI groups was 3.54% (95% CI 1.73~6.22), 11.52% (95% CI 8.94~14.57) and 38.56% (95% CI 34.50~42.74) and 60.82% (95% CI 55.65~65.81). The prevalence of NAFLD in patients with normal glucose, impaired fasting glucose and diabetes was 23.77% (95% CI 16.02~33.13), 43.18% (95%CI 36.93~ 49.68) and 51.64% (95% CI 48.08-55.15), respectively. The prevalence of NAFLD in patients with metabolic syndrome and hyperlipidemia was 43.62% (95% CI 36.69~ 50.82) and 44.13% (95% CI 39.92~ 48.50), respec-tively. The prevalence rates of NAFLD combined with diabetes, overweight, obesity, metabolic syn-drome and hyperlipidemia were 22.68% (95% CI 19.14~26.59), 48.35% (95% CI 44.59~52.14) and 45.55% (95% CI 36.91~54.53), 43.62% (95% CI 36.69~50.82) and 65.61% (95% CI 59.95~71.02). Conclusion: The prevalence of NAFLD in China in recent 10 years is different in different regions, especially in the developed coastal areas and northwest areas. The prevalence is associated with age, sex and other factors, increasing in older postmenopausal women, and this meta-analysis pro-vides evidence for the high prevalence of NAFLD in patients with type 2 diabetes and obesity. NAFLD needs to be managed in key populations according to the characteristics of the disease, to prevent its progression, and to manage comorbidity.
文章引用：文永昊, 樊海宁. 中国地区近10年非酒精性脂肪肝病的贝叶斯单臂Meta分析[J]. 临床医学进展, 2023, 13(12): 19692-19702. https://doi.org/10.12677/ACM.2023.13122772

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