• Hepatic fibrosis
• Hepatic function
• Metabolic dysfunction-associated steatotic liver disease
• Omega-3-acid ethyl ester
• Pemafibrate

• Humans
• Male
• Female
• Middle Aged
• Benzoxazoles/therapeutic use
• Fatty Acids, Omega-3/therapeutic use
• Hypertriglyceridemia/drug therapy
• Hypertriglyceridemia/complications
• Butyrates/therapeutic use
• Liver/metabolism
• Liver/drug effects
• Fatty Liver/drug therapy
• Biomarkers/blood
• Biomarkers/metabolism
• Alanine Transaminase/blood
• Alanine Transaminase/metabolism
• Treatment Outcome
• Follow-Up Studies
• Adult
• Aged

• diabetes type 2
• dm
• fatty liver disease
• nafld
• non-alcoholic
• prevalence
• systematic review and meta-analysis

• diabetes type 2
• kingdom of saudi arabia (ksa)
• non-alcoholic fatty liver
• prevalence
• systematic review and meta analysis

• MR/P008348/1 Medical Research Council

• carbohydrate
• diet
• non-alcoholic fatty liver disease
• nutrition
• type 2 diabetes

• Animals
• Cornus/chemistry
• Diabetes Mellitus, Experimental/drug therapy
• Diabetes Mellitus, Experimental/metabolism
• Diabetes Mellitus, Experimental/pathology
• Diet, High-Fat
• Disease Models, Animal
• Inflammation/etiology
• Inflammation/pathology
• Inflammation/prevention & control
• Iridoid Glycosides/pharmacology
• Male
• Mice
• Mice, Inbred ICR
• Non-alcoholic Fatty Liver Disease/drug therapy
• Non-alcoholic Fatty Liver Disease/metabolism
• Non-alcoholic Fatty Liver Disease/pathology
• Oxidative Stress/physiology
• Protective Agents/pharmacology
• Signal Transduction

• Animals
• Diet, High-Fat/adverse effects
• Fatty Liver/genetics
• Fatty Liver/metabolism
• Insulin Resistance/physiology
• Insulin-Secreting Cells/metabolism
• Mice
• Mice, Knockout
• Obesity/etiology
• Obesity/metabolism
• Pancreas/metabolism
• Serotonin/metabolism
• Sirtuin 3/genetics
• Sirtuin 3/metabolism

• MR/S025618/1 Medical Research Council
• MR/L020149/1 Medical Research Council
• MR/N00275X/1 Medical Research Council
• MR/R022259/1 Medical Research Council
• MR/J0003042/1 Medical Research Council
• MR/L02036X/1 Medical Research Council
• 212625/Z/18/Z Wellcome Trust

• dyslipidemia
• nomogram
• nonalcoholic fatty liver disease

• Adult
• Asian People
• China/epidemiology
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Nomograms
• Non-alcoholic Fatty Liver Disease/epidemiology
• Non-alcoholic Fatty Liver Disease/ethnology
• Non-alcoholic Fatty Liver Disease/etiology
• Retrospective Studies

Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease (CLD). NAFLD is also related to obesity and metabolic syndromes, which are common in Saudi Arabia. However, it is yet unclear what proportion of CLD cases is because of NAFLD in Saudi Arabia.

To investigate the prevalence and clinical characteristics of NAFLD among patients with CLD in Saudi Arabia.

This retrospective study included all patients with any CLD who had successfully undergone transient elastography (FibroScan) examination at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between April 2015 and April 2018. These CLD patients were then grouped as NAFLD and non-NAFLD patients. Serum hemoglobin, alanine aminotransferase, gamma-glutamyl transferase, albumin and bilirubin levels; platelet count and international normalized ratio within 1 month after the FibroScan examination were assessed. For NAFLD patients, glycated hemoglobin levels and abdominal ultrasound examination results were also assessed. Statistical analysis was carried out using Student’s t-test and linear regression.

The prevalence of NAFLD among CLD patients was 22.5% (111 of 494 CLD patients), and it was the third most common CLD after chronic hepatitis B and C. Compared with non-NAFLD patients, NAFLD patients had significantly higher mean age (53.65 ± 12.7 vs. 48.07 ± 14.6 years; P < 0.001), mean serum alanine aminotransferase level (61.84 vs. 50.23 IU/L; P < 0.001) and mean controlled attenuation parameter (297.83 vs. 238.41; P < 0.001). NAFLD patients also had a higher rate of ultrasound-detected features of cirrhosis (16.2% vs. 3.7%, P < 0.001), but there was no significant difference in fibrosis severity. In addition, their mean glycated hemoglobin level (6.85) was elevated (range: 5–13). Age and platelet count were significantly correlated with presence of cirrhosis.

NAFLD is the third most common CLD in Western Saudi Arabia, and it is associated with older age and metabolic syndromes, with one-third of the patients having advanced fibrosis or cirrhosis.

• Chronic liver disease
• Saudi Arabia
• diabetes
• nonalcoholic fatty liver disease
• obesity

• Diabetes
• NAFLD
• gallstone
• obese
• prevalence

To see the frequency of incidental fatty liver on ultrasound and its association with diabetes mellitus and hypertension.

A cross sectional study was conducted from January 2016 to June 2016 in the department of Surgery and Radiology at Hamdard University Hospital. Patients of both genders and all ages were selected by non purposive convenience sampling. Critically ill, trauma cases and all those patients who had a history of chronic liver disease, alcohol intake and expected pregnancy were excluded. Blood pressure and random blood sugar were recorded.

Six hundred patients were included in the study with mean age of 44.65±18.8 years. 240 patients (40%) had incidental finding of fatty liver on ultrasound. Out of 240 with fatty liver patients 117 were males (48.8%) and 123 were females (51.3%). Total 141 patients were diagnosed with hypertension, out of which 81(57.44%, p< 0.001) had fatty liver on ultrasound. Diabetes mellitus was diagnosed in 84 patients, in which 57 patients (67.8%, p<0.001) had fatty liver.

Fatty liver is a frequently found incidental finding on ultrasound. There is a significant association of fatty liver with diabetes mellitus and hypertension.

• Diabetes mellitus
• Fatty liver
• Hypertension

The effect of cigarette smoking on the onset of nonalcoholic fatty liver disease (NAFLD) is unclear, especially that associated with drinking small amounts of alcohol. We conducted a longitudinal study to investigate the relationship between cigarette smoking and NAFLD onset, which was stratified according to the amount of alcohol consumed.

We enrolled 7,905 Japanese subjects who had received annual health checkups more than twice between April 2003 and August 2013, 4,045 of whom met at least one of the following exclusion criteria and were excluded: (a) fatty liver at baseline; (b) hepatitis B or hepatitis C; (c) alcohol consumption (men: ≥210 g/wk; women: ≥140 g/wk); (d) change in alcohol drinking status between baseline and the study’s endpoint; (e) change in cigarette smoking habits between baseline and the study’s endpoint; or (f) current treatment with antidiabetic agents, antihypertensive agents, and/or lipid-lowering agents. The remaining 3,860 subjects (1,512 men, 2,348 women) were divided into two groups based on average alcohol consumption.

After adjusting for the variables associated with metabolic disease, smoking was associated with fatty liver disease onset compared with nonsmokers in nondrinkers (adjusted hazard ratio = 1.988, 95% confidence interval 1.057–3.595; p = 0.034). No association was found between smoking and fatty liver disease onset in the low alcohol consumption group (men: <210 g alcohol/week; women: <140 g alcohol/week). The fatty liver disease incidence increased significantly among the nondrinkers as the number of cigarettes smoked increased (p = 0.001).

Cigarette smoking may be a significant risk factor associated with NAFLD onset in nondrinkers. These results may help clinicians to identify patients who are at a high risk of developing NAFLD and to prevent the progression of NAFLD by promoting earlier interventions that help people discontinue unhealthy lifestyle habits.

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Alcohol Drinking/epidemiology
• Cigarette Smoking/adverse effects
• Cigarette Smoking/epidemiology
• Female
• Humans
• Japan/epidemiology
• Longitudinal Studies
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease/epidemiology
• Non-alcoholic Fatty Liver Disease/etiology
• Risk Factors
• Young Adult

• Japan Society for the Promotion of Science

• Iranian adults
• Liver markers
• Metabolic syndrome

• Body mass index
• Diabetes mellitus
• Glycaemic control
• Lipids
• Non-alcoholic fatty liver disease
• Obesity

• type 2 diabetes mellitus
• non-alcoholic fatty liver disease (nafld)
• health check for 10-year follow up
• ultrasonography

• Adult
• Diabetes Mellitus, Type 2/epidemiology
• Female
• Humans
• Incidence
• Japan
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease/diagnostic imaging
• Non-alcoholic Fatty Liver Disease/epidemiology
• Regression Analysis
• Risk Factors
• Sex Distribution

• Diabetes
• Liver Fibrosis
• NAFLD
• Saudi Arabia
• Stiffness Measurements

Non‐alcoholic fatty liver disease (NAFLD) is a metabolic disorder of the liver. The relationship between NAFLD and type 2 diabetes remains largely unknown. The aim of the present study was to determine the incidence of complications arising from the interaction between NAFLD and type 2 diabetes.

A total of 212 individuals with type 2 diabetes were included in the study. The presence of NAFLD was determined in individuals using abdominal ultrasonography for the diagnosis of fatty liver disease. Patients were divided into three groups based on the duration of diabetes and NAFLD diagnosis. Type 2 diabetes patients were placed in group A; patients with type 2 diabetes longer than NAFLD were placed in group B; and patients with NAFLD longer than type 2 diabetes were placed in group C. All individuals had undergone electrocardiogram, blood pressure measurements, and thorough medical history and physical examinations (Doppler ultrasound, electrophysiology, fundoscopy, cardiac computed tomography). Laboratory measurements included fasting blood glucose, glycated hemoglobin, oral glucose tolerance test, liver and renal function, lipid profile, and urinary albumin excretion.

Compared with groups A and B, the patients of group C showed a higher prevalence of significant coronary artery disease and hypertension (P < 0.05). Compared with groups A and B, the patients of group C showed a lower prevalence of diabetic retinopathy and diabetic peripheral neuropathy (P < 0.05). There was no significant difference in the prevalence of diabetic nephropathy among the three groups (P > 0.05).

NAFLD combined with type 2 diabetes is associated with the presence of significant coronary artery disease and hypertension.

• Diabetic complication
• Non-alcoholic fatty liver disease
• Type 2 diabetes

• Bayesian Network
• Bi-directional Longitudinal Cohort
• Generalized Estimating Equation
• Metabolic Syndrome
• Nonalcolic Fatty Liver Disease
• Reciprocal Causality

• Adult
• Bayes Theorem
• Blood Glucose/metabolism
• Body Mass Index
• China/epidemiology
• Disease Progression
• Female
• Follow-Up Studies
• Forecasting
• Humans
• Incidence
• Male
• Metabolic Syndrome/complications
• Metabolic Syndrome/diagnosis
• Metabolic Syndrome/epidemiology
• Middle Aged
• Non-alcoholic Fatty Liver Disease/diagnostic imaging
• Non-alcoholic Fatty Liver Disease/epidemiology
• Non-alcoholic Fatty Liver Disease/etiology
• Prevalence
• Prognosis
• Retrospective Studies
• Risk Factors
• Ultrasonography

• Fatty liver
• Metabolic syndrome
• Obesity
• Sudan
• Type 2 diabetes

Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common chronic liver condition in Western World and across the globe. NAFLD prevalence is estimated to be around one-third of the total population. There are no published data that project the future prevalence of NAFLD, but with an increase in epidemic of diabetes and obesity, it is possible to suggest an increase in a number of individuals with NAFLD. NAFLD is associated with insulin resistance and occurs with an increase in cluster of features of metabolic syndrome and type 2 diabetes. Therefore, it is important to exclude the possibility of diabetes in those individuals with evidence of fatty liver. The global diabetes epidemic continues to grow, and it is estimated that the number of people with diabetes will double by year 2030. NAFLD is also a risk factor for an increase in cardiovascular incidence independent of age, sex, low-density lipoprotein-cholesterol, smoking, and cluster of metabolic syndromes. It is expected that NAFLD will be an important challenge for health providers in the near future. Taking all these factors into consideration, we believe that increasing awareness of metabolic and cardiovascular impact of NAFLD among general practitioners and health authorities may decrease the serious consequences of late diagnosis of NAFLD. Importantly, the collaboration between medical specialties is vital in decreasing the impact of the epidemic of NAFLD. The focus of this review is in the role of primary care physician in diagnosis, treatment and prevention of NAFLD and patients education.

• Cardiovascular disease
• insulin resistance
• nonalcoholic fatty liver disease
• primary care physician
• type 2 diabetes mellitus

• Diabetes
• NAFLD
• Obesity
• Prevalence
• Sudanese

Some risk factors for atherosclerosis are followed by non-alcoholic fatty liver disease (NAFLD). We wanted to use Multislice computed tomography (MSCT) as technique for searching relationship between NAFLD and coronary artery disease (CAD).

The relationship between NAFLD and CAD was investigated using MSCT.

A total of 372 individuals with or without cardiac symptoms who had undergone MSCT angiography were included in the study. The patients were divided into two groups according to the presence of NAFLD. Coronary artery segments were visually evaluated via MSCT angiography. Based on the coronary artery stenosis degree, those with no or minimal plaques were considered normal, whereas those who had stenosis of less than 50% and at least one plaque were considered to have non-obstructive coronary artery disease (non-obsCAD). The patients who had at least one plaque and coronary artery stenosis of 50% or more were considered to have obstructive coronary artery disease (obsCAD). NAFLD was determined according to the MSCT protocol, using the liver density.

According to the liver density, the number of patients with non-alcoholic fatty liver disease (group 1) was 204 (149 males, 54.8%) and with normal liver (group 2) was 168 (95 males, 45.2%). There were 50 (24.5%) non-obsCAD and 57 (27.9%) obsCAD cases in Group 1, and 39 (23.2%) non-obsCAD and 23 (13.7%) obsCAD cases in Group 2.

The present study using MSCT demonstrated that the frequency of coronary artery disease in patients with NAFDL was significantly higher than that of patients without NAFDL.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide. Several lines of evidence have indicated a pathogenic role of insulin resistance, and a strong association with type 2 diabetes (T2MD) and metabolic syndrome. Importantly, NAFLD appears to enhance the risk for T2MD, as well as worsen glycemic control and cardiovascular disease in diabetic patients. In turn, T2MD may promote NAFLD progression. The opportunity to take into account NAFLD in T2MD prevention and care has stimulated several clinical studies in which antidiabetic drugs, such as metformin, thiazolidinediones, GLP-1 analogues and DPP-4 inhibitors have been evaluated in NAFLD patients. In this review, we provide an overview of preclinical and clinical evidences on the possible efficacy of antidiabetic drugs in NAFLD treatment. Overall, available data suggest that metformin has beneficial effects on body weight reduction and metabolic parameters, with uncertain effects on liver histology, while pioglitazone may improve liver histology. Few data, mostly preclinical, are available on DPP4 inhibitors and GLP-1 analogues. The heterogeneity of these studies and the small number of patients do not allow for firm conclusions about treatment guidelines, and further randomized, controlled studies are needed.

• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/drug therapy
• Diabetes Mellitus, Type 2/pathology
• Disease Progression
• Fatty Liver/complications
• Fatty Liver/drug therapy
• Fatty Liver/pathology
• Humans
• Hypoglycemic Agents/therapeutic use
• Insulin Resistance/genetics
• Metabolic Syndrome/complications
• Metabolic Syndrome/drug therapy
• Metabolic Syndrome/pathology
• Metformin/therapeutic use
• Non-alcoholic Fatty Liver Disease
• Pioglitazone
• Thiazolidinediones/therapeutic use

AIM: To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease (NAFLD).

METHODS: Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography. This study involved 11 714 apparently healthy Japanese men and women, 18 to 83 years of age. NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d, known liver disease, or current use of medication. The revised criteria of the National Cholesterol Education Program Adult Treatment Panel III were used to characterize the metabolic syndrome.

RESULTS: NAFLD was detected in 32.2% (95% CI: 31.0%-33.5%) of men (n = 1874 of 5811) and in 8.7% (95% CI: 8.0%-9.5%) of women (n = 514 of 5903). Among obese people, the prevalence of NAFLD was as high as 67.3% (95% CI: 64.8%-69.7%) in men and 45.8% (95% CI: 41.7%-50.0%) in women. Although NAFLD was thought of as being the liver phenotype of metabolic syndrome, the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women. 66.8% of men and 70.4% of women with NAFLD were not diagnosed with the metabolic syndrome. 48.2% of men with NAFLD and 49.8% of women with NAFLD weren’t overweight [body mass index (BMI) ≥ 25 kg/m²]. In the same way, 68.6% of men with NAFLD and 37.9% of women with NAFLD weren’t satisfied with abdominal classification (≥ 90 cm for men and ≥ 80 cm for women). Next, authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome. The sensitivity of the definition “at least 1 criterion” was as good as 84.8% in men and 86.6% in women. Separating subjects by BMI, the sensitivity was higher in obese men and women than in non-obese men and women (92.3% vs 76.8% in men, 96.1% vs 77.0% in women, respectively).

CONCLUSION: Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.

• Nonalcoholic fatty liver
• Metabolic syndrome
• Population based study
• Methodology

• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• Carotid Artery Diseases/epidemiology
• Carotid Artery Diseases/etiology
• Comorbidity
• Fatty Liver/complications
• Fatty Liver/epidemiology
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects
• Hyperlipidemias/complications
• Hyperlipidemias/epidemiology
• Inflammation/epidemiology
• Inflammation/etiology
• Insulin Resistance
• Metabolic Syndrome/epidemiology
• Metabolic Syndrome/etiology
• Non-alcoholic Fatty Liver Disease
• Risk Factors
• Sleep Apnea, Obstructive/epidemiology
• Sleep Apnea, Obstructive/etiology

• Cardiovascular Diseases/epidemiology
• Diabetes Mellitus, Type 2/epidemiology
• Fatty Liver/diagnosis
• Fatty Liver/epidemiology
• Fatty Liver/etiology
• Fatty Liver/therapy
• General Practice/organization & administration
• Humans
• Non-alcoholic Fatty Liver Disease
• Obesity/epidemiology
• Organizational Objectives
• Practice Guidelines as Topic
• Predictive Value of Tests
• Primary Health Care/organization & administration
• Prognosis
• Regional Health Planning/organization & administration
• Risk Factors

• Cause of Death
• Chi-Square Distribution
• Cohort Studies
• Diabetes Mellitus, Type 2/metabolism
• Diabetes Mellitus, Type 2/mortality
• Fatty Liver/metabolism
• Fatty Liver/mortality
• Female
• Follow-Up Studies
• Humans
• Liver Function Tests
• Male
• Middle Aged
• Minnesota/epidemiology
• Proportional Hazards Models
• Risk Factors
• Survival Analysis

• R01 DK82426 NIDDK NIH HHS
• R01 DK082426 NIDDK NIH HHS
• R01 AR030582-43 NIAMS NIH HHS
• R01 DK082426-01A1 NIDDK NIH HHS
• R01 AR030582 NIAMS NIH HHS

• Anthropometry
• Body Mass Index
• China/epidemiology
• Coronary Disease/epidemiology
• Coronary Disease/etiology
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/physiopathology
• Fatty Liver/complications
• Fatty Liver/epidemiology
• Fatty Liver/etiology
• Female
• Humans
• Male
• Middle Aged
• Risk Factors

• visceral fat thickness
• fatty liver
• type 2 diabetes mellitus

• Aged
• Aorta/pathology
• Cohort Studies
• Diabetes Complications/diagnosis
• Diabetes Mellitus, Type 2/diagnosis
• Diabetes Mellitus, Type 2/pathology
• Fatty Liver/complications
• Fatty Liver/diagnosis
• Female
• Humans
• Intra-Abdominal Fat/pathology
• Male
• Middle Aged
• Models, Statistical
• Odds Ratio
• ROC Curve
• Sensitivity and Specificity

• Case-Control Studies
• Cohort Studies
• Diabetes Mellitus, Type 2/epidemiology
• Fatty Liver/complications
• Fatty Liver/epidemiology
• Follow-Up Studies
• Glucose Intolerance
• Humans
• Incidence
• Japan/epidemiology
• Male
• Middle Aged
• Patient Selection
• Prevalence
• Proportional Hazards Models
• Risk Factors

• Fatty Liver/etiology
• Humans
• Insulin Resistance
• Prognosis
• Risk Factors

• 5K23-DK062116 NIDDK NIH HHS
• 5R01-DK053792 NIDDK NIH HHS
• 5U01-DK061713 NIDDK NIH HHS

AIM: To clarify whether nonalcoholic fatty liver disease (NAFLD) increases the risk of cardiovascular disease.

METHODS: We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program. NAFLD was diagnosed by abdominal ultrasonography. The metabolic syndrome (MS) was defined according to the modified National Cholesterol Education Program (NCEP) ATP III criteria. Five years after the baseline evaluations, the incidence of cardiovascular disease was assessed by a self-administered questionnaire.

RESULTS: Among 1221 participants available for outcome analyses, the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline (5 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage) than 990 subjects without NAFLD (3 coronary heart disease, 6 ischemic stroke, and 1 cerebral hemorrhage). Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors (odds ratio 4.12, 95% CI, 1.58 to 10.75, P = 0.004). MS was also independently associated with cardiovascular events. But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.

CONCLUSION: Although both of them were predictors of cardiovascular disease, NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model. NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.

• Nonalcoholic fatty liver disease
• Metabolic syndrome
• Coronary heart disease
• Cardiovascular disease
• Risk factors

• Adult
• Aged
• Aged, 80 and over
• Cardiovascular Diseases/complications
• Cardiovascular Diseases/diagnosis
• Fatty Liver/complications
• Fatty Liver/diagnostic imaging
• Female
• Follow-Up Studies
• Health Surveys
• Humans
• Incidence
• Male
• Metabolic Syndrome/complications
• Middle Aged
• Multivariate Analysis
• Predictive Value of Tests
• Prospective Studies
• Risk Factors
• Ultrasonography

• Cytokines/physiology
• Fatty Acids/analysis
• Fatty Liver/epidemiology
• Fatty Liver/etiology
• Fatty Liver/therapy
• Humans
• Inflammation/complications
• Inflammation/etiology
• Insulin Resistance/physiology
• Liver/chemistry
• Obesity/complications
• Obesity/etiology

• Age Factors
• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/ethnology
• Disease Progression
• Fatty Liver/diagnosis
• Fatty Liver/etiology
• Fatty Liver/therapy
• Humans
• Hypoglycemia/prevention & control
• Metabolic Syndrome/complications
• Thiazolidinediones/therapeutic use