Non-alcoholic fatty liver disease prevalence in India: A comprehensive review and meta-analysis

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) contributes to a large proportion of liver disease burden in the world. Several groups have studied the prevalence of NAFLD in the Indian population. Aim: A systematic review of the published literature and meta-analysis was carried out to estimate the prevalence of NAFLD in the Indian population. Methods: English language literature published until April 2021 was searched from electronic databases. Original data published in any form which had reported NAFLD prevalence in the Indian population were included. The subgroup analysis of prevalence was done based on the age (adults or children) and risk category, i.e., average-risk group (community population, participants of control arm, unselected participants, hypothyroidic individuals, athletes, aviation crew, and army personnel) and high-risk group (obesity or overweight, diabetes mellitus, coronary artery disease, etc.). The prevalence estimates were pooled using the random-effects model. Result: There were sixty-two datasets from fifty research (adults, 54, and children, 8). Using data from 23,581 adult participants and 2903 children, the pooled prevalence of NAFLD was calculated. The estimated pooled prevalence among adults was 38.6% (95% CI 32-45.5). It was calculated that the prevalence of NAFLD was 28.1% (95% CI 20.8-36) in the average-risk cohort and 52.8% (95% CI 46.5-59.1) in the high-risk category. Compared to community-based data (28.2% [95% CI 16.9-41%]), hospital-based data had a higher estimated prevalence of NAFLD (40.8% [95% CI 32.6-49.3%]). The estimated pooled prevalence in children was 35.4% (95% CI 18.2-54.7). In youngsters, the prevalence of obesity was 63.4 (95% CI 59.4-67.3) and non-obesity was 12.4 (95% CI 4.4-23.5), respectively.