[70] This meta-analysis found that prevalence of NAFLD increased with age: 9.22% for 18–30, 16.77% for 40, 23.50% check details for 50, and 26.89% for

60. However, a compelling observation in this study concerned the decrease prevalence of NAFLD after 60 years of age. On the one hand, the low prevalence of NAFLD at old age may be the result of selective mortality. NAFLD was linked to an increased morbidity and mortality of cardiovascular disease.[4, 5] On the other hand, the lower prevalence may be attributed to a lower prevalence of insulin resistance and metabolic syndrome in this population. The previous studies have demonstrated that there is a lower prevalence of insulin resistance and metabolic syndrome in the elderly.[71] Overweight and obesity are important risk factors of NAFLD. The results of meta-analysis suggested that the prevalence of NAFLD increases as prevalence of overweight and obesity grow. According to the year 2000 population census data, the overall prevalence was 17.6% for overweight and 5.6% for obesity. The combined prevalence of overweight and obesity was 23.2%. Overweight and obesity should have affected nearly one quarter of the total population, and became a threatening hazard to resident’s health. With the urbanization progress and the change of lifestyle, overweight and obesity

doubly increased. Prevention and control of NAFLD should be urgently needed. Besides, the study found that Opaganib in vivo other constituents of metabolic syndrome, including high triglycerides and insulin resistance, are associated with NAFLD.[72, 73] Our study suggested that the pooled prevalence of NAFLD in northern part of China is higher than in the southern, 18.21% and 21.87%, respectively. This may be explained due to the different eating habits in different places. The southerners prefer rice, and the northerners prefer food made from flour in China. The NAFLD prevalence (21.83%) from urban is almost equal to that (20.43%) from rural while 25 reports from the mixed of urban and rural is slightly lower (18.08%) because of the heterogeneity in these studies. An epidemiology survey with greater sample size should be carried out to confirm the difference. Although this meta-analysis

includes Tenofovir 48 studies encompassing a larger number of sample sizes than individual studies. However, there are still some limitations. Firstly, the heterogeneity of total and subgroup was high. Most of the studies included in this review had large sample sizes that produced very precise estimates. In addition, meta-regression analysis showed that age and ration of male may be associated with the prevalence of NAFLD; we still assumed that there were other factors influencing heterogeneity, such as genetic and environment factors, smoking, and physical activity. Unfortunately, we do not get any information about these aspects. Secondly, the modified Egger’s linear regression test (P = 0.145) showed no significant publication bias while Begg’s test (P = 0.