ArticlePloS one2017
Prevalence and determinants of non-alcoholic fatty liver disease in lifelines: A large Dutch population cohort.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 4 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 4 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- The relationship between tobacco and non-alcoholic fatty liver disease incidence: a systematic review and meta-analysis of observational studies.Frontiers in medicine · 2025Pooled it
- Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis.BMC medicine · 2024Pooled it
- Prevalence of clinical signs, symptoms and comorbidities at diagnosis of acromegaly: a systematic review in accordance with PRISMA guidelines.Pituitary · 2023Pooled it
- Sugar-sweetened beverages, low/no-calorie beverages, fruit juice and non-alcoholic fatty liver disease defined by fatty liver index: the SWEET project.Nutrition & diabetes · 2023Pooled it
- Predictive factors of metabolic dysfunction associated steatotic liver disease (MASLD) among individuals with cardio-metabolic risk factors, multicenter cross-sectional study, North East Ethiopia.BMC gastroenterology · 2026Article
- Analysis of risk factors and establishment of a predictive model for liver disease severity in metabolic dysfunction-associated fatty liver disease.Frontiers in medicine · 2026Article
- Cross-sectional analysis of adult fatty liver prevalence in Wenshan, China: an epidemiologic study using ultrasound and laboratory assessments.Frontiers in cardiovascular medicine · 2026Article
- Evaluation of the prevalence of MASLD, MASH and liver fibrosis in a Dutch bariatric cohort.PloS one · 2025Article
- Genome-wide Studies Reveal Genetic Risk Factors for Hepatic Fat Content.Genomics, proteomics & bioinformatics · 2024Article
- Association of Aortic Stiffness and Pressure Pulsatility With Noninvasive Estimates of Hepatic Steatosis and Fibrosis: The Framingham Heart Study.Arteriosclerosis, thrombosis, and vascular biology · 2024Article
- Antibody against apolipoprotein-A1, non-alcoholic fatty liver disease and cardiovascular risk: a translational study.Journal of translational medicine · 2023Article
- Serum Level of Cytokeratin 18 (M65) as a Prognostic Marker of High Cardiovascular Disease Risk in Individuals with Non-Alcoholic Fatty Liver Disease.Biomolecules · 2023Article
- Effect of bariatric surgery on NAFLD/NASH: a single-centre observational prospective cohort study.BMJ open · 2023Observational
- Prevalence of nonalcoholic fatty liver disease and the related risk factors among healthy adults: A cross-sectional study in Chongqing, China.Frontiers in public health · 2023Article
- Plasma Calprotectin Levels Associate with Suspected Metabolic-Associated Fatty Liver Disease and All-Cause Mortality in the General Population.International journal of molecular sciences · 2022Article
- Multidisciplinary lifestyle intervention is associated with improvements in liver damage and in surrogate scores of NAFLD and liver fibrosis in morbidly obese patients.European journal of nutrition · 2022Article
- Causal associations between changes in lipid profiles and risk of gallstone disease: a two-sample Mendelian randomization study.Annals of translational medicine · 2022Article
- Value of the triglyceride glucose index combined with body mass index in identifying non-alcoholic fatty liver disease in patients with type 2 diabetes.BMC endocrine disorders · 2022Article
- Nonalcoholic fatty liver disease, circulating ketone bodies and all-cause mortality in a general population-based cohort.European journal of clinical investigation · 2021Article
- Circulating trimethylamine-N-oxide is associated with all-cause mortality in subjects with nonalcoholic fatty liver disease.Liver international : official journal of the International Association for the Study of the Liver · 2021Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsNon-alcoholic fatty liver disease is an increasing health issue that develops rather unnoticed with obesity, type 2 diabetes mellitus and metabolic syndrome. We investigated prevalence, determinants and associated metabolic abnormalities of non-alcoholic fatty liver disease in the largest population-based cohort to date.
methodsBiochemical characteristics, type 2 diabetes mellitus and metabolic syndrome were determined in the Lifelines Cohort Study (N = 167,729), a population-based cohort in the North of the Netherlands. Non-alcoholic fatty liver disease was defined as Fatty Liver Index (FLI)≥60. Exclusion criteria were age <18 years, immigrants, missing data to assess FLI and metabolic syndrome, excessive alcohol use, previous-diagnosed hepatitis or cirrhosis and non-fasting blood sampling.
resultsOut of 37,496 included participants (median age 44 years, 62.1% female), 8,259 (22.0%) had a FLI≥60. Individuals with a FLI≥60 were more often male, older, obese, had higher levels of hemoglobinA1c, fasting glucose, liver enzymes, total cholesterol, low-density lipoprotein cholesterol, triglycerides, c-reactive protein and leucocytes and lower high-density lipoprotein cholesterol (all P<0.0001). Participants with a FLI≥60 showed higher prevalence of type 2 diabetes mellitus (9.3% vs. 1.4%), metabolic syndrome (54.2% vs. 6.2%), impaired renal function (20.1% vs. 8.7%) and cardiovascular disease (4.6% vs. 1.6%) (all P<0.0001). Multivariable logistic analysis showed that smoking, hemoglobin, leucocytes, c-reactive protein, platelets, alanine aminotransferase, alkaline phosphatase, albumin, impaired renal function (OR 1.27, 95%CI 1.15-1.41), metabolic syndrome (OR 11.89, 95%CI 11.03-12.82) and its individual components hyperglycemia (OR 2.53, 95%CI 2.34-2.72), hypertension (OR 1.89, 95%CI 1.77-2.01) and reduced high-density lipoprotein cholesterol (OR 3.44, 95%CI 3.22-3.68) were independently associated with suspected non-alcoholic fatty liver disease (all P<0.0001).
conclusionTwenty-two percent (22.0%) of the population in the North of the Netherlands is suspected to suffer from non-alcoholic fatty liver disease, coinciding with a significant increased risk of type 2 diabetes mellitus, metabolic syndrome, cardiovascular disease and impaired renal function.
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