Table 1.
Characteristics of the nineteen studies included in meta-analysis.
| First author, publication year [ref] | Country | Ethnicity | Study design | Enrolled study population(case/total) | Outcome | MetS definition | NAFLD diagnose | MetS components | OR/RR/HR | Mean ± SD (case/control) | Calculation method | Adjusted covariates |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chen et al. 2012 (25) | China | East Asian | Cross-sectional | 918/7570 without MetS | MetS | NCEP-ATP-III on the Asia | OR: 1.29(1.09-1.52) | Multivariate logistic regression model | Age | |||
| BMI | 26.3 ± 3.0 25.2 ± 3.4 |
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| WC | 91.6 ± 9.4 87.8 ± 10.7 |
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| SBP | 123.6 ± 14.3 119.8 ± 14.5 |
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| DBP | 74.1 ± 9.8 72.2 ± 10.4 |
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| FBG | 5.39 ± 1.37 5.11 ± 1.04 |
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| TG | 201.1 ± 183.3 183.7 ± 182.7 |
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| Nahum et al. 2005 (29) | USA | Hispanics | Cross-sectional | 65/245 without MetS | MetS | NCEP-ATPIII | OR: 2.79(1.46-5.33) |
Multivariate logistic regression model |
Age and sex | |||
| WC | OR: 3.61(1.95-6.71) |
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| BMI | 28.4 ± 5.7 26.3 ± 4.8 |
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| SBP | 15.7 ± 2.2 14.4 ± 1.9 |
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| Lin et al. 2014 (27) |
China | East Asian | Cross-sectional | 734/12050 without MetS |
MetS | Taiwan criteria | OR: 1.61(1.336-1.898) |
Multivariate logistic regression model | Age and sex | |||
| WC | 84.4 ± 10.1 81.2 ± 9.9 |
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| SBP | 127.8 ± 17.8 122.6 ± 17.1 |
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| DBP | 81.0 ± 11.1 78.8 ± 10.6 |
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| HDL-C | 46.1 ± 12.1 49.2 ± 12.8 |
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| TG | 126.8 ± 111.9 115.1 ± 10.5 |
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| Naim et al. 2011 (28) |
Turkey | Caucasian | Cross-sectional | 217/217 without MetS |
MetS | NCEP-ATPIII | OR: 1.434(1.222-1.846) |
Multivariate logistic regression model | Age, MetS, DM, large WC, HOMA-IR, gallstone size and BMI | |||
| Amit et al. 2019 (24) |
India | East Asian | Prospective cohort | 100/200 without MetS |
MetS | NCEP-ATPIII | RR: 1.313(1.107-1.556) |
Chi- Square test model | ||||
| Kim et al. 2021 (23) |
Korea | East Asian | Prospective cohort | 2929/ 207850 without GSD |
GSD | IDF | HR: 1.39(1.05-1.85) |
Cox proportional hazard model | Age, sex, eGFR, GGT, smoking, alcohol intake and physical activity | |||
| Zhu et al. 2016 (26) |
China | East Asian | Prospective cohort | 873/18291 without GSD |
GSD | CDS | RR: 1.25(1.06-1.49) |
Multiple GEE model | Age | |||
| Kim et al. 2009 (30) |
Korea | East Asian | Cross-sectional | 6085/ 34574 without MetS |
MetS | NCEP-ATPIII | BP | OR: 1.67(1.58-2.00) |
Multivariate logistic regression model | Age, MetS, DM, large WC, HOMA-IR, gallstone size and BMI | ||
| Koller et al 2012 (32) |
Slovakia | Northern European | Cross-sectional | 198/482 without GSD |
GSD | USG | OR: 1.78(1.16-2.73) |
Multivariate logistic regression model | Age, gender, BMI, smoking, alcohol drinking, regular exercise, | |||
| and DM, hypertension, eGFR and HDL-C | ||||||||||||
| Koller et al 2012 (9) |
Slovakia | Northern European | Cross-sectional | 166/482 without NAFLD |
NAFLD | USG | OR: 1.92(1.24-2.96) |
Multivariate logistic regression model | Age, gender, BMI, smoking, alcohol drinking, regular exercise, | |||
| and DM, hypertension, eGFR, total cholesterol, triglyceride, and HDL-C | ||||||||||||
| Chang et al 2018 (31) |
Korea | East Asian | Prospective cohort |
214446/ 283446 without GSD |
GSD | USG | HR: 1.26(1.17-1.35) |
Multivariate logistic regression model | BMI, smoking, alcohol intake, exercise, total calorie intake, hypertension, | |||
| and diabetes, dyslipidemia, LDL-C, HDL-C, triglycerides and HOMA-IR | ||||||||||||
| 4073/ 218519 without NAFLD |
NAFLD | USG | HR: 1.14(1.07-1.22) |
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| Young et al. 2019 (36) |
Korea | East Asian | Cross-sectional | 355/7886 without GSD |
GSD | USG | OR: 1.48(0.875-1.485) |
Binary logistic regression model | Age, sex, grade of fatty liver disease, BMI, fasting blood glucose, and total cholesterol, LDLs, HDLs, triglycerides | |||
| Liu et al. 2014 (34) |
China | East Asian | Prospective cohort | 498/11200 without GSD |
GSD | USG | RR: 1.33(1.00-1.53) |
Multiple GEE model | Age, BMI, SBP, ALB, GLO, TG and GLU | |||
| Qiao et al. 2017 (35) |
China | East Asian | Cross-sectional | 919/7583 without NAFLD |
NAFLD | USG | OR: 1.28(1.07-1.52) |
Multivariate logistic regression model | BMI≥24, hyper- lipidaemia, and hypertension |
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| Lee et al. 2014 (33) |
China | East Asian | Cross-sectional | 768/12033 without NAFLD |
NAFLD | USG | OR: 1.32(1.04-1.69) |
Binary logistic regression model | Age, gender, and BMI, smoking, alcohol drinking, DM and HDL-C | |||
| Yun et al. 2016 (41) |
USA | Hispanics | Cross-sectional | 50/82 without NAFLD |
NAFLD | USG | OR: 2.4(1.8–3.3) |
Multivariate logistic regression model | ||||
| Kwak et al. 2015 (12) |
China | East Asian | Cross-sectional | 149/ 17612 without NAFLD |
NAFLD | USG | OR: 1.35(1.03-1.77) |
Multivariate logistic regression model | Age, sex, hypertension, diabetes, BMI, smoking, physical activity, total cholesterol, triglycerides and HDL-C cholesterol |
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| Yue et al. 2019 (40) |
Britain | Hispanics | Cross-sectional | 772/10074 without NAFLD |
NAFLD | USG | OR: 2.61(1.89-3.61) |
Cox proportional hazard models | Age, sex, ethnicity, smoking and drinking status, SBP, total cholesterol, and HDL-C | |||
| Ruh et al. 2012 (38) |
USA | Hispanics | Cross-sectional | 265/ 12232 without NAFLD |
NAFLD | USG | OR: 2.4(1.8-3.3) |
Cox proportional hazard models | Age, sex, ethnicity, BMI, WC, diabetes, HDL-C, SBP, DBP, smoking, smoking, alcohol intake and physical activity | |||
| Carmen et al. 2009 (37) |
USA | Hispanics | Prospective cohort | 795/4307without NAFLD | NAFLD | USG | OR: 1.04(0.62-1.77) |
Multivariate logistic regression model | Age, sex, education level, physical activity, total energy intake, hypertension, DM and BMI |
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| Chang et al. 2018 (31) |
Korea | East Asian | Prospective cohort | 33506/94865 Men without NAFLD |
NAFLD | USG | HR: 1.29(1.10-1.52) |
Multivariate logistic regression model | Age, sex, BMI, smoking, alcohol intake, exercise, total calorie intake, | |||
| and history of hypertension, history of diabetes, and medication for dyslipidemia | ||||||||||||
| Chang et al. 2018 (31) |
Korea | East Asian | Prospective cohort | 15795/ 121830 Women without NAFLD |
NAFLD | USG | HR: 1.05(0.86-1.28) |
Multivariate logistic regression model | Age, sex, BMI, smoking, alcohol intake, exercise, total calorie intake, | |||
| and history of hypertension, history of diabetes, and medication for dyslipidemia |
GSD, gallstone disease; MetS, metabolic syndrome; NAFLD, nonalcoholic fatty liver disease; IR, insulin resistance; RR, relative ratio; OR: odds ratio; HR: hazard ratio; CI, confidence interval; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; WC, waist circumference; TG, triglyceride; FBG, fasting blood glucose; HDL-C, high density lipoprotein cholesterol; NCEP ATPIII, National Cholesterol Education Progrm Adult treatment Group III; CDS, Chinese Diabetes Society; USG, Ultrasonogram; DM, diabetes mellitus; HOMA-IR, homeostasis model of assessment-insulin resistance; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; GLO, serum globulins; ALB, serum albumin; BUN, blood urea nitrogen; GLU, total glucose.