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Nonalcoholic fatty liver disease in Asia: emerging perspectives

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Abstract

As in the West, nonalcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease in Asia, with a prevalence higher than 40 % in some countries. The risk factors for NAFLD development are similar to those in Western countries, including increased body mass index, diabetes, insulin resistance, and metabolic syndrome. NAFLD in Asians is associated with different extrahepatic manifestations involving the cardiovascular, gastrointestinal, and renal systems. A considerable proportion of Asians with NAFLD are described as having “lean” NAFLD. Present in approximately 20 % of the Asian population, lean NAFLD is closely linked with insulin resistance, diabetes, and other metabolic complications, but its association with disease progression to nonalcoholic steatohepatitis and cirrhosis remains to be defined. There is emerging evidence of the interactions of NAFLD with hepatitis B virus and hepatitis C virus infection in Asia. Unlike in Western countries, NAFLD constitutes only a minority of cirrhosis and hepatocellular carcinoma cases in Asia. Possible explanations are the lower prevalence of obesity and the overwhelming problem of viral hepatitis in Asia. With aging of the obesity cohort in Asia, NAFLD-related liver complications are expected to increase.

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Abbreviations

BMI:

Body mass index

DAA:

Direct-acting antiviral

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Pok Fu Lam, Hong Kong

    Wai-Kay Seto & Man-Fung Yuen

  2. State Key Laboratory for Liver Research, The University of Hong Kong, Pok Fu Lam, Hong Kong

    Wai-Kay Seto & Man-Fung Yuen

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  1. Wai-Kay Seto
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  2. Man-Fung Yuen
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Correspondence to Man-Fung Yuen.

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Seto, WK., Yuen, MF. Nonalcoholic fatty liver disease in Asia: emerging perspectives. J Gastroenterol 52, 164–174 (2017). https://doi.org/10.1007/s00535-016-1264-3

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  • DOI: https://doi.org/10.1007/s00535-016-1264-3

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