{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T05:39:45Z","timestamp":1793338785228,"version":"4.5.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>NAFLD is emerging as an important cause of liver disease in India. It is estimated that 16-32% of general population in India (nearly 120 million) has NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>This study aimed to identify the risk factors of NAFLD and to identify the association of lifestyle (dietary and physical activity), genetic, and environmental factors with NAFLD in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>\n                      A systematic literature search was conducted using an international electronic database: PubMed (MEDLINE) and Google Scholar from the date of inception 31\n                      <jats:sup>st<\/jats:sup>\n                      March 2021 to 28\n                      <jats:sup>th<\/jats:sup>\n                      September 2021. We included studies examining patients with NAFLD: Adults above 18 years of age. Studies with or without a control population were both eligible. The studies with a diagnosis of NAFLD based solely on abnormal liver tests were excluded. We tried to get unpublished data but they were not of the quality of inclusion. Meta-analysis was performed using the software STATA 14.2 (StataCorp, College Station, TX, USA). For each of the studies, the standard error was calculated using the reported number of outcomes and the sample size. A forest plot was used to graphically represent the study-specific and pooled prevalence estimates for overall and subgroup analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>In a systematic review and meta-analysis of 8 studies including data from over 1800 individuals, we found that among components of lipid profile, LDL and HDL had a negative effects on NAFLD while triglycerides had a positive effect on NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Type 2 Diabetes Mellitus, Hypertension, and Obesity were the potential risk factors for NAFLD but the evidence generated was only from single studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jehp.jehp_208_23","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T10:00:27Z","timestamp":1705917627000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of risk factors for non-alcoholic fatty liver disease in India: A systematic review and meta-analysis"],"prefix":"10.4103","volume":"12","author":[{"given":"Suthanthira","family":"Kannan","sequence":"first","affiliation":[{"name":"Department of Community Medicine, ESIC Medical College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nelliyanil","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, AJ Institute of Medical Sciences and Research Center, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopa","family":"Mendagudli","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, MR Medical College, Kalaburgai, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swetha","family":"Rajeshwari","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, ESIC Medical College, Sanathnagar, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandralekha","family":"Kona","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Family Medicine, AIIMS Bibinagar, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Kundapur","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Family Medicine, AIIMS Bibinagar, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyaswi","family":"Sathyanath","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, AJ Institute of Medical Sciences and Research Center, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaman","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Family Medicine, AIIMS Bibinagar, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Scientist and Program Officer, ICMR, Headquarters, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,12]]},"reference":[{"key":"R1-20240829","first-page":"76","article-title":"Non-alcoholic fatty liver disease: Growing burden, adverse outcomes and associations","volume":"8","author":"Kumar","year":"2020","journal-title":"J ClinTranslHepatol"},{"key":"R2-20240829","doi-asserted-by":"crossref","first-page":"15080.","DOI":"10.1038\/nrdp.2015.80","article-title":"Nonalcoholic fatty liver disease","volume":"1","author":"Brunt","year":"2015","journal-title":"Nat Rev Dis Primer"},{"key":"R3-20240829","doi-asserted-by":"crossref","first-page":"e1003100","DOI":"10.1371\/journal.pmed.1003100","article-title":"Metabolic risk factors and incident advanced liver disease in non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis of population-based observational studies","volume":"17","author":"Jarvis","year":"2020","journal-title":"PLoS Med"},{"key":"R4-20240829","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1002\/hep.28785","article-title":"The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"R5-20240829","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/j.1475-6773.2006.00607.x","article-title":"The boomers are coming: A total cost of care model of the impact of population aging on health care costs in the United States by major practice category","volume":"42","author":"Mary Martini","year":"2007","journal-title":"Health Serv Res"},{"key":"R6-20240829","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1007\/s40273-015-0316-5","article-title":"Economic and quality-of-life implications of non-alcoholic fatty liver disease","volume":"33","author":"Younossi","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"R8-20240829","article-title":"Management of NAFLD & NASH\u2013Nash24\u00d77.com"},{"key":"R9-20240829","first-page":"142","article-title":"Nonalcoholic fatty liver disease in India--is it different?","volume":"27","author":"Duseja","year":"2006","journal-title":"Trop Gastroenterol"},{"key":"R10-20240829","doi-asserted-by":"crossref","first-page":"e0208798","DOI":"10.1371\/journal.pone.0208798","article-title":"Local care and treatment of liver disease (LOCATE) \u2013 A cluster-randomized feasibility study to discover, assess and manage early liver disease in primary care","volume":"13","author":"El-Gohary","year":"2018","journal-title":"PLoS One"},{"key":"R11-20240829","doi-asserted-by":"crossref","first-page":"e007516","DOI":"10.1136\/bmjopen-2014-007516","article-title":"Direct targeting of risk factors significantly increases the detection of liver cirrhosis in primary care: Across-sectional diagnostic study utilising transient elastography","volume":"5","author":"Harman","year":"2015","journal-title":"BMJ Open"},{"key":"R12-20240829","doi-asserted-by":"crossref","first-page":"e015659","DOI":"10.1136\/bmjopen-2016-015659","article-title":"Economic evaluation of a community-based diagnostic pathway to stratify adults for non-alcoholic fatty liver disease: A Markov model informed by a feasibility study","volume":"7","author":"Tanajewski","year":"2017","journal-title":"BMJ Open"},{"key":"R14-20240829","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"R15-20240829","doi-asserted-by":"crossref","first-page":"e0142260","DOI":"10.1371\/journal.pone.0142260","article-title":"Phenotype, body composition, and prediction equations (Indian fatty liver index) for non-alcoholic fatty liver disease in non-diabetic Asian Indians: A case-control study","volume":"10","author":"Bhatt","year":"2015","journal-title":"PLoS One"},{"key":"R16-20240829","first-page":"351","article-title":"Prevalence of non-alcoholic fatty liver disease and its correlation with coronary risk factors in patients with type 2 diabetes","volume":"59","author":"Agarwal","year":"2011","journal-title":"J Assoc Physicians India"},{"key":"R17-20240829","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4103\/0019-557X.177295","article-title":"Prevalence of nonalcoholic fatty liver disease in an adult population in a rural community of Haryana, India","volume":"60","author":"Majumdar","year":"2016","journal-title":"Indian J Public Health"},{"key":"R18-20240829","first-page":"448","article-title":"Study of prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes patients in India (SPRINT)","volume":"61","author":"Kalra","year":"2013","journal-title":"J Assoc Physicians India"},{"key":"R19-20240829","doi-asserted-by":"crossref","first-page":"18","DOI":"10.7869\/tg.2012.86","article-title":"Insulin resistance and metabolic syndrome in nonobese Indian patients with non-alcoholic fatty liver disease","volume":"34","author":"Bhat","year":"2013","journal-title":"Trop Gastroenterol"},{"key":"R20-20240829","first-page":"152","article-title":"The Prevalence and predictors of non-alcoholic fatty liver disease in morbidly obese women-A cross-sectional study from Southern India","volume":"16","author":"Atri","year":"2020","journal-title":"Eur Endocrinol"},{"key":"R21-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fnut.2021.655032","article-title":"Variation in lifestyle-related behavior among obese Indian patients with non-alcoholic fatty liver disease","volume":"8","author":"Arora","year":"2021","journal-title":"Front Nutr"},{"key":"R22-20240829","doi-asserted-by":"crossref","first-page":"5589","DOI":"10.14260\/jemds\/2017\/1213","article-title":"Prevalence of non-alcoholic fatty liver disease in hypothyroidism in a tertiary care hospital in Eastern India","volume":"6","author":"Mohanty","year":"2017","journal-title":"J Evol Med Dent Sci"},{"key":"R23-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.20517\/2394-5079.2020.16","article-title":"Emerging risk factors for nonalcoholic fatty liver disease associated hepatocellular carcinoma","volume":"2020","author":"Benhammou","year":"2020","journal-title":"Hepatoma Res"},{"key":"R24-20240829","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/apt.14112","article-title":"Systematic review with meta-analysis: Risk factors for non-alcoholic fatty liver disease suggest a shared altered metabolic and cardiovascular profile between lean and obese patients","volume":"46","author":"Sookoian","year":"2017","journal-title":"Aliment Pharmacol Ther"},{"key":"R25-20240829","doi-asserted-by":"crossref","first-page":"774.","DOI":"10.3390\/ijms17050774","article-title":"The natural course of non-alcoholic fatty liver disease","volume":"17","author":"Bertot","year":"2016","journal-title":"Int J Mol Sci"},{"key":"R26-20240829","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1002\/ijc.30818","article-title":"The association between individual metabolic syndrome components, primary liver cancer and cirrhosis: A study in the Swedish AMORIS cohort","volume":"141","author":"Nderitu","year":"2017","journal-title":"Int J Cancer"},{"key":"R27-20240829","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1155\/2022\/8463640","article-title":"Bidirectional association between hypertension and NAFLD: A systematic review and meta-analysis of observational studies","volume":"2022","author":"Li","year":"2022","journal-title":"Int J Endocrinol"},{"key":"R28-20240829","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/jgh3.12044","article-title":"Prevalence and risk factors of non-alcoholic fatty liver disease in Bangladesh","volume":"2","author":"Alam","year":"2018","journal-title":"JGH Open"},{"key":"R29-20240829","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1002\/jgh3.12658","article-title":"Risk factors of nonalcoholic fatty liver disease in lean body mass population: A systematic review and meta-analysis","volume":"5","author":"Alam","year":"2021","journal-title":"JGH Open"},{"key":"R30-20240829","doi-asserted-by":"crossref","first-page":"3194","DOI":"10.1007\/s10620-015-3728-3","article-title":"Prevalence of nonalcoholic fatty liver disease and economy","volume":"60","author":"Zhu","year":"2015","journal-title":"Dig Dis Sci"}],"container-title":["Journal of Education and Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_208_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:15:23Z","timestamp":1787768123000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_208_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jehp.jehp_208_23","relation":{},"ISSN":["2277-9531","2319-6440"],"issn-type":[{"value":"2277-9531","type":"print"},{"value":"2319-6440","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]},"assertion":[{"value":"2023-02-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}