Epidemiology Survey Of Obesity And Non-alcoholic Fatty Liver Disease In Jilin Province

At present,the growing prevalence of obesity/overweight has now become an important global public health issue and has been recognized as a global epidemic.With the increasing prevalence obesity/overweight,the prevalence of obesity-related diseases including type 2 diabetes、nonalcoholic fatty liver disease、hypertension and dyslipidemia are also rising.We conducted two independent cross-sectional surveys to investigate the epidemiological status of obesity and its related diseases in 2007 and 2013 respectively in Dehui of Jilin Province.The study was divided into three parts.The first part: Aims:Obesity and its related diseases are currently important public health issues.In this study,we aimed to provide updated trends in the prevalence of these conditions in Jilin Province.Method:We conducted two independent cross-sectional surveys of the general population aged 20-75 years in 2007 and 2013 in Jilin,China.A total of 3636(1719 males)and 1359(602 males)participants were enrolled in the 2007 and 2013 surveys,respectively.Obesity-related diseases were defined as type 2 diabetes,hypertension,dyslipidemia and non-alcoholic fatty liver disease(NAFLD).The prevalences of obesity and its related diseases were compared after age-standardized.Results:1.The age-standardized prevalence of obesity,overweight,diabetes,pre-diabetes,dyslipidemia and NAFLD increased from 2007 to 2013 from 15.82% to 19.41%,35.85% to 41.80%,6.37% to 9.23%,16.77% to 23.49%.,53.46% to 65.50%,and 23.48% to 44.31% in males,respectively,and from 13.18% to 18.77%,31.11% to 37.54%,4.41% to 8.48%,8.10% to 16.49%,41.96% to 54.70%,and 17.56% to 43.06% in females,respectively.However,the prevalence of hypertension remained stable(males: 38.10% vs.38.63% and females: 33.04% vs.33.01% in 2007 and 2013,respectively).2.Men had a higher prevalence of obesity and obesity-related diseases than women in both two surveys.Conclusion:The prevalence of obesity and obesity-related diseases,except for hypertension,increased significantly in the general population in Jilin Province.More targeted measures should be implemented to address the serious challenges presented by these diseases.The second part: Aims:Non-alcoholic fatty liver disease(NAFLD)is an important health issue worldwide.We aimed to develop a metabolic-scoring system model to predict onset of NAFLD in Jilin.Methods:A cross-sectional study was performed in 3399 subjects aged 20-75 years after excluding those with viral hepatitis and other known liver diseases in Jilin Province in 2007.512 individuals without NAFLD at baseline were rolled for 6-year longitudinal study and reassessed in 2013.Potential metabolic predictors of NAFLD at baseline obtained the model which was validated in 118 patients with liver biopsies.The metabolic-scoring-system model then predicted the onset of NAFLD in the longitudinal study.Results:Five metabolic risk factors at baseline including body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),fasting blood glucose(FBG),and blood pressure(BP)were incorporated into the final model.The model was well validated in 118 patients with liver biopsies.The area under the AUROC curve was 0.875(95% CI:0.809-0.941)and the cut-off value was 3.4.512 subjects were simply divided into high risk and low risk of NAFLD according to the cut-off value.The subjects of high risk at baseline and with weight gain after 6 years were tend to develop NAFLD.Conclusions:Our simple metabolic-scoring-system model could well predict the incidence of NAFLD among individuals in Jilin.Thus,it is a helpful model for community physicians who can educate and monitor the general population to prevent from NAFLD in China,especially controlling weight.The third part: Aims:This study aimed to investigate the incidence,remission and risk factors of non-alcoholic fatty liver disease(NAFLD)among general population with a 6-year follow-up in Jilin Province.Methods:In total,691 individuals from the general population in Jilin,China aged 20-75 years participated in two independent cross-sectional surveys carried out in 2007 and 2013.After excluding patients with alcoholism,viral hepatitis and other liver diseases,646 individuals were finally enrolled in our study.Of the 646 subjects,512 did not have NAFLD at baseline,while 134 did.Of the 512 individuals without NAFLD at baseline,188(36.7%)developed NAFLD during the six-year follow-up period.The baseline body mass index(BMI,OR=1.49,1.36-1.64),high-density lipoprotein cholesterol level(HDL-C)(OR=0.35,0.16-0.76)and weight gain(OR=1.22,1.16-1.29)were independent predictors for NAFLD incidence.Of the 134 subjects with NAFLD at baseline,33(24.6%)had no evidence of NAFLD after 6 years.Males(OR=4.85,1.98-11.92)and baseline BMI levels(OR=0.81,0.70-0.94)were associated with NAFLD remission.Results:Of the 512 individuals without NAFLD at baseline,188(36.7%)developed NAFLD during the six-year follow-up period.The higher baseline body mass index(BMI,OR=1.49,1.36-1.64),lower high-density lipoprotein cholesterol level(HDL-C)(OR=0.35,0.16-0.76)and weight gain(OR=1.22,1.16-1.29)were independent predictors for NAFLD incidence.Of the 134 subjects with NAFLD at baseline,33(24.6%)had no evidence of NAFLD after 6 years.Males(OR=4.85,1.98-11.92)and lower baseline BMI levels(OR=0.81,0.70-0.94)were associated with NAFLD remission.Six years later,we found that subjects without NAFLD at baseline had higher weight gain than those with NAFLD.Conclusion:Among general population,the incidence of NAFLD mainly depended on baseline weight and weight gain.The subjects with mild baseline weight and males were prone to NAFLD remission.The awareness of the controlling weight among NAFLD patients at baseline had improved,comparing with the subjects without NAFLD at baseline.