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Survey of Nonalcoholic Fatty Liver Disease Knowledge, Nutrition, and Physical Activity Patterns Among the General Public in Beijing, China

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Abstract

Background

Despite high prevalence of nonalcoholic fatty liver disease in China, understanding of the disease appears to be low.

Aims

We assessed the knowledge of NAFLD among the public in Beijing, China, as well as diet and physical activity patterns, which may provide information useful for NAFLD prevention and management.

Methods

We surveyed adult patients and family members in the Peking University Health Science Center (PUHSC) ultrasound clinic and office staff in Beijing, China. Participants provided demographic and medical history data. NAFLD-related knowledge and diet and physical activity were assessed.

Results

A total of 1296 participants at the PUHSC clinic (51% female, median age 35, 61% college-educated) and 494 participants in offices (61% female, median age 43, 74% college-educated) completed the survey. Response rate was 68.4% and 96.7%, respectively. In clinic and offices, 44% versus 48% were overweight/obese, 5% had a history of diabetes in both groups, and 14% versus 23% had a personal history of NAFLD. Median knowledge score was 15 out of 25 in clinic versus 16 in offices. 44.9% reported minimal physical activity. Factors associated with higher NAFLD knowledge scores (> 16) on multivariate analysis included college education or higher (OR 1.7, p = 0.01), family history of hyperlipidemia (OR 1.96, p < 0.001), and number of sugary drinks per week (OR 0.74, p = 0.006). No factors were significantly associated with physical activity levels.

Conclusions

Adults in Beijing had low knowledge about NAFLD, and most were not physically active. Programs to increase public awareness of NAFLD and promote physical activity are critical to curb this growing epidemic.

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Abbreviations

NAFLD:

Nonalcoholic fatty liver disease

PUHSC:

Peking University Health Science Center

IPAQ:

International Physical Activity Questionnaire

AFLD:

Alcoholic fatty liver disease

BMI:

Body mass index

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

References

  1. Fan JG. Epidemiology of alcoholic and nonalcoholic fatty liver disease in China. J Gastroenterol Hepatol. 2013;28:11–17.

    Article  Google Scholar 

  2. Zhao J, Su C, Wang H, Wang Z, Zhang B. New evidence on the effect of medical insurance on the obesity risk of rural residents: findings from the China health and nutrition survey. Int J Environ Res Public Health. 2018;15:383.

    Article  Google Scholar 

  3. IDF Western Pacific members. Brussels (Belgium): International Diabetes Federation; 2018. Available at: https://www.idf.org/our-network/regions-members/western-pacific/members/101-china.html. Accessed 1 July 2018.

  4. Lu Y, Wang P, Zhou T, et al. Comparison of prevalence, awareness, treatment, and control of cardiovascular risk factors in China and the United States. J Am Heart Assoc. 2018;7:e007462.

    PubMed  PubMed Central  Google Scholar 

  5. Leung CM, Lai LS, Wong WH, et al. Nonalcoholic fatty liver disease: an expanding problem with low levels of awareness in Hong Kong. J Gastroenterol Hepatol. 2009;24:1786–1790.

    Article  Google Scholar 

  6. Goh GB, Kwan C, Lim SY, et al. Perceptions of nonalcoholic fatty liver disease—an Asian community-based study. Gastroenterol Rep. 2016;4:131–135.

    Article  Google Scholar 

  7. Ghevariya V, Sandar N, Patel K, et al. Knowing what’s out there: awareness of nonalcoholic fatty liver disease. Front Med. 2014;1:4.

    Article  Google Scholar 

  8. Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010;362:1090–1101.

    Article  CAS  Google Scholar 

  9. The International Physical Activity Questionnaire (IPAQ)—Short Form; 2001. Available at: http://www.ipaq.ki.se. Accessed 22 Mar 2017.

  10. Criteria of weight for adults. The National Health and Family Planning Commission of the People’s Republic of China; 2013. Available at: http://ghdx.healthdata.org/organizations/national-health-and-family-planning-commission-china. Accessed 18 Apr 2013.

  11. Guideline for data processing and analysis of the International Physical Activity Questionnaire (IPAQ); 2001. Available at: http://www.ipaq.ki.se/scoring.pdf. Accessed 22 Oct 2017.

  12. Lu ZY, Shao Z, Li YL, Wulasihan M, Chen XH. Prevalence of and risk factors for nonalcoholic fatty liver disease in a Chinese population: An 8-year follow-up study. World J Gastroenterol. 2016;22:3663–3669.

    Article  CAS  Google Scholar 

  13. Gold DT, McClung B. Approaches to patient education: emphasizing the long-term value of compliance and persistence. Am J Med. 2006;119:32S–37S.

    Article  Google Scholar 

  14. Pais R, Barritt AS 4th, Calmus Y, et al. NAFLD and liver transplantation: current burden and expected challenges. J Hepatol. 2016;65:1245–1257.

    Article  Google Scholar 

  15. Said A, Ghufran A. Epidemic of nonalcoholic fatty liver disease and hepatocellular carcinoma. World J Clin Oncol. 2017;8:429–436.

    Article  Google Scholar 

  16. Williams KH, Shackel NA, Gorrell MD, McLennan SV, Twigg SM. Diabetes and nonalcoholic fatty liver disease: a pathogenic duo. Endocr Rev. 2013;34:84–129.

    Article  CAS  Google Scholar 

  17. Ahmed M. Nonalcoholic fatty liver disease in 2015. World J Hepatol. 2015;7:1450–1459.

    Article  Google Scholar 

  18. Mlynarsky L, Schlesinger D, Lotan R, et al. Nonalcoholic fatty liver disease is not associated with a lower health perception. World J Gastroenterol. 2016;22:4362–4372.

    Article  CAS  Google Scholar 

  19. Block JP, Condon SK, Kleinman K, et al. Consumers’ estimation of calorie content at fast food restaurants: cross sectional observational study. Brit Med J. 2013;346:f2907.

    Article  Google Scholar 

  20. Harris CL, George VA. Dietary restraint influences accuracies in estimating energy expenditure and energy intake among physically inactive males. Am J Mens Health. 2010;4:33–40.

    Article  Google Scholar 

  21. Oseini A, Sanyal A. Therapies in nonalcoholic steatohepatitis (NASH). Liver Int. 2017;37:97–103.

    Article  Google Scholar 

  22. Hendricks E. Off-label drugs for weight management. Diabetes Metab Syndr Obes. 2017;10:223–234.

    Article  CAS  Google Scholar 

  23. Walter J, Navarro V, Rossi S. Drug-induced liver injury associated with weight loss supplements. Curr Hepatol Rep. 2018;17:245–253.

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported by the University of Michigan Medical School Global REACH Program, University of Michigan—Peking University Health Science Center Joint Institute for Clinical and Translational Research, and Tuktawa Foundation.

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Authors and Affiliations

  1. University of Michigan Medical School, M4101 Medical Science Building I – C wing, 1301 Catherine Street, Ann Arbor, MI, 48109, USA

    Stephanie Chen & Samantha Chao

  2. Division of Gastroenterology and Hepatology, University of Michigan, 1500 E Medical Center Drive, 3912 Taubman Center, SPC 5362, Ann Arbor, MI, 48109, USA

    Monica Konerman, Wei Zhang, Elizabeth Wu, Andy Lin & Anna S. Lok

  3. Peking University People’s Hospital, Peking University Hepatology Institute, Peking University Health Science Center, 11 South Xizhimen Street, Beijing, 100044, China

    Wei Zhang, Huiying Rao & Lai Wei

Authors
  1. Stephanie Chen
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  2. Samantha Chao
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  3. Monica Konerman
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  4. Wei Zhang
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  5. Huiying Rao
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  6. Elizabeth Wu
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  7. Andy Lin
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  8. Lai Wei
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  9. Anna S. Lok
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Corresponding author

Correspondence to Stephanie Chen.

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Conflict of interest

Anna Lok has received research funding from BMS, Gilead, and TARGET Pharma and serves as an advisor/consultant for Gilead, Reseverlogix, Roche, Spring Bank, and Viravaxx. Lai Wei receives research funding from Abbvie and BMS and serves as an advisor/consultant for Abbvie, Ascletis, BMS, Gilead, and MSD. Stephanie Chen, Samantha Chao, Monica Konerman, Wei Zhang, Huiying Rao, Elizabeth Wu, and Andy Lin declare that they have no conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committees of University of Michigan and Peking University and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Chen, S., Chao, S., Konerman, M. et al. Survey of Nonalcoholic Fatty Liver Disease Knowledge, Nutrition, and Physical Activity Patterns Among the General Public in Beijing, China. Dig Dis Sci 64, 3480–3488 (2019). https://doi.org/10.1007/s10620-019-05709-0

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  • DOI: https://doi.org/10.1007/s10620-019-05709-0

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