title: Prevalence of Nonalcoholic Fatty Liver Disease and Economy.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is a growing health issue around the world.
  
  
  OBJECTIVE
  This study is to investigate whether adult prevalence of NAFLD correlates with national economic status.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, China. jzzhu@live.com.
authors.forename: Jin-Zhou
authors.initials: JZ
authors.lastname: Zhu
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, China. daiyn@zju.edu.cn.
authors.forename: Yi-Ning
authors.initials: YN
authors.lastname: Dai
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, China. yumingwang@yeah.net.
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Wang
authors.affiliation: Department of Statistics, Columbian College of Arts and Science, The George Washington University, Washington, DC, USA. qyzhou.gwu@live.com.
authors.forename: Qin-Yi
authors.initials: QY
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, China. way2phd@163.com.
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, China. ymli.zju@live.com.
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Li
mesh_terms: D003906:Developing Countries / Q000191:economics*; D005260:Female; D014943:Global Health; D054624:Health Status Disparities; D006801:Humans; D007182:Income; D016014:Linear Models; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D012423:Rural Health / Q000191:economics; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Economy; Epidemiology; Gross national income (GNI) per capita; Nonalcoholic fatty liver disease (NAFLD); Prevalence