Digestive Diseases and Sciences

, Volume 60, Issue 11, pp 3194–3202 | Cite as

Prevalence of Nonalcoholic Fatty Liver Disease and Economy

  • Jin-Zhou Zhu
  • Yi-Ning Dai
  • Yu-Ming Wang
  • Qin-Yi Zhou
  • Chao-Hui Yu
  • You-Ming LiEmail author



Nonalcoholic fatty liver disease (NAFLD) is a growing health issue around the world.


This study is to investigate whether adult prevalence of NAFLD correlates with national economic status.


Literature search on PubMed database was conducted to identify eligible records fully published before September 2014. Gross national income (GNI) per capita was chosen to evaluate national economic status. Pearson coefficient, linear regression, and unpaired t test were performed in the statistical analyses.


Twenty-one population-based surveys (seven in East Asia, five in South Asia, three in Middle East, and six in Europe) were included. The pooled prevalence of NAFLD was 24.24 %, and the global prevalence was positively correlated with GNI per capita (r = 0.4782, P = 0.0283). Europe witnessed a higher prevalence (28.04 %) than Middle East (12.95 %, P = 0.0092) and East Asia (19.24 %, P = 0.0083). Male presented a higher prevalence than female (P = 0.019), especially in Europe (P = 0.0132) and in Caucasians (P = 0.0383). Furthermore, male prevalence and rural prevalence individually were correlated with economic status (r = 0.5725, P = 0.0257 and r = 0.7389, P = 0.0060). Lastly, the urban (23.93 %) witnessed a higher prevalence than the rural or the urban + rural (12.65 %, P = 0.0141) in the countries of GNI per capita <$10,000.


This study suggested that countries with higher economic status tend to present a higher prevalence of NAFLD. It is believed to provide a distinctive epidemiologic perspective to global situation of NAFLD.


Nonalcoholic fatty liver disease (NAFLD) Prevalence Epidemiology Gross national income (GNI) per capita Economy 


Conflict of interest


Supplementary material

10620_2015_3728_MOESM1_ESM.docx (107 kb)
Supplementary material 1 (DOCX 107 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jin-Zhou Zhu
    • 1
  • Yi-Ning Dai
    • 1
  • Yu-Ming Wang
    • 1
  • Qin-Yi Zhou
    • 2
  • Chao-Hui Yu
    • 1
  • You-Ming Li
    • 1
    Email author
  1. 1.Department of Gastroenterology, The First Affiliated Hospital, College of MedicineZhejiang UniversityHangzhouChina
  2. 2.Department of Statistics, Columbian College of Arts and ScienceThe George Washington UniversityWashingtonUSA

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