title: Natural course of nonalcoholic fatty liver disease in southern China: a prospective cohort study.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease, the natural course of which has not been well documented. This study aimed to perform a prospective cohort study to investigate NAFLD in a Chinese population.
  
  
  METHODS
  Using our previous epidemiological survey, 3543 patients were followed-up for a median of 4 years (range 3.6-4.8 years). Of these patients, 624 participated in a new survey. Interviews, physical examinations, biochemical tests and abdominal ultrasonography were repeated for these patient.
  
  
  RESULTS
  The annual incidence of NAFLD was 9.1% (male 7.3% vs female 9.7%, P=0.047). Among 117 NAFLD patients at baseline, 51 (43.6%) remained unchanged, 26 (22.2%) became worse, and 40 (34.2%) improved. Patients with simultaneous metabolic syndrome (MS) showed accelerated progression (P=0.026). For the NAFLD patients, both general annual mortality rates and cardiovascular disease deaths (both 0.54%) were significantly higher than those of patients without NAFLD (0.19% and 0.17%, P=0.005). Age and several variables related to MS were risk factors for NAFLD progression.
  
  
  CONCLUSIONS
  The incidence of NAFLD in southern China is relatively lower in comparison with that of the developed countries. Patients with NAFLD have a benign prognosis. Variables related to MS are risk factors for NAFLD occurrence and progression.
authors.affiliation: Department of Gastroenterology and Hepatology, Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangzhou, Guangdong Province, China.
authors.forename: Yong Jian
authors.initials: YJ
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology and Hepatology, Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangzhou, Guangdong Province, China.
authors.forename: Yu Yuan
authors.initials: YY
authors.lastname: Li
authors.affiliation: Department of Gastroenterology and Hepatology, Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangzhou, Guangdong Province, China.
authors.forename: Yu Qiang
authors.initials: YQ
authors.lastname: Nie
authors.affiliation: Department of Gastroenterology and Hepatology, Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangzhou, Guangdong Province, China.
authors.forename: Chun Ming
authors.initials: CM
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology and Hepatology, Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangzhou, Guangdong Province, China.
authors.forename: Chuang Yu
authors.initials: CY
authors.lastname: Cao
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D016009:Chi-Square Distribution; D002648:Child; D002681:China / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood; D018450:Disease Progression; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL; D014280:Triglycerides