Summary
Traditionally, obesity and its related diseases have been considered a problem in
Western countries. However, in the past two decades, urbanisation in many Asian countries
has led to a sedentary lifestyle and overnutrition, setting the stage for the epidemic
of obesity. This article reviews the epidemiological trend of obesity in Asia, with
special emphasis on the emerging condition of non-alcoholic fatty liver disease (NAFLD).
Currently, the population prevalence of NAFLD in Asia is around 25%, like many Western
countries. While hepatocellular carcinoma and end-stage liver disease secondary to
NAFLD remain uncommon, a rising trend has emerged. Around 8–19% of Asians with body
mass indexes less than 25 kg/m2 are also found to have NAFLD, a condition often described as “lean” or “non-obese”
NAFLD. Although this condition is generally less severe than that in more obese patients,
steatohepatitis and fibrotic disease are well recognized. Central adiposity, insulin
resistance and weight gain are major risk factors, and genetic predisposition, such
as the PNPLA3 polymorphism appears to be more important in the development of NAFLD in the non-obese
population. Lifestyle modification remains the cornerstone of management for obesity
and NAFLD, but few patients can achieve adequate weight reduction and even fewer can
maintain the weight in the long run. While pharmacological agents have entered phase
III development for steatohepatitis, Asian patients are under-represented in most
drug trials. Future studies should define the optimal management of obesity and NAFLD
in Asia.
Keywords
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Reference
- Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes.Hepatology. 2016; 64: 73-84
- Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States.Gastroenterology. 2015; 148: 547-555
- Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009.Hepatology. 2015; 62: 1723-1730
- Epidemiology of non-alcoholic fatty liver disease in China.J Hepatol. 2009; 50: 204-210
World Health Organization. http://www.who.int/mediacentre/factsheets/fs311/en/, accessed on 2 Feb 2017.
- Diabetes in Asia: epidemiology, risk factors, and pathophysiology.JAMA. 2009; 301: 2129-2140
- Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.Lancet. 2004; 363: 157-163
- A comparison of body mass index, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: the Rotterdam study.Int J Obes Relat Metab Disord. 2001; 25: 1730-1735
- Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.Circulation. 2009; 120: 1640-1645
Organization WH. Global Health Observatory (GHO) data – Overweight and obesity; 2014.
- Prevalence and associated metabolic factors of nonalcoholic fatty liver disease in the general population from 2009 to 2010 in Japan: a multicenter large retrospective study.J Gastroenterol. 2012; 47: 586-595
- Prevalence of and risk factors for non-alcoholic fatty liver disease in a non-obese Japanese population, 2011–2012.J Gastroenterol. 2015; 50: 95-108
- Non-alcoholic steatohepatitis: what is it, and why is it important in the Asia-Pacific region?.J Gastroenterol Hepatol. 2003; 18: 124-138
- End-stage nonalcoholic fatty liver disease: evaluation of pathomorphologic features and relationship to cryptogenic cirrhosis from study of explant livers in a living donor liver transplant program.Hum Pathol. 2010; 41: 425-430
- Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in Japan.J Gastroenterol Hepatol. 2011; 26: 153-162
- Incidence of obesity and its modifiable risk factors in Chinese adults aged 35-74 years: a prospective cohort study.Zhonghua Liu Xing Bing Xue Za Zhi. 2014; 35: 349-353
- Overweight and obesity trends among Japanese adults: a 10-year follow-up of the JPHC Study.Int J Obes. 2008; 32: 1861-1867
- Prevalence and risk factors for the development of nonalcoholic fatty liver disease in a nonobese Chinese population: the Zhejiang Zhenhai Study.Am J Gastroenterol. 2013; 108: 1299-1304
- National, regional, and global trends in adult overweight and obesity prevalences.Popul Health Metr. 2012; 10: 22
- Dynamics of diabetes and obesity: an alarming situation in the developing countries in Asia.Mini Rev Med Chem. 2016; 16: 1258-1268
- Prevalence of generalized & abdominal obesity in urban & rural India–the ICMR-INDIAB Study (Phase-I).Indian J Med Res. 2015; 142: 139-150
- Prevalence of nonalcoholic fatty liver disease in mainland of China: a meta-analysis of published studies.J Gastroenterol Hepatol. 2014; 29: 42-51
- Hepatic steatosis is highly prevalent in hepatitis B patients and negatively associated with virological factors.Dig Dis Sci. 2014; 59: 2571-2579
- Prevalence of nonalcoholic fatty liver disease in an adult population in a rural community of Haryana, India.Indian J Public Health. 2016; 60: 26-33
- Non-alcoholic fatty liver disease prevalence and associated risk factors–A study from rural sector of Maharashtra.Trop Gastroenterol. 2015; 36: 25-30
- Obesity and its relation with diabetes and hypertension: a cross-sectional study across 4 geographical regions.Glob Heart. 2016; 11 (e74): 71-79
- The prevalence of non-alcoholic fatty liver disease in children and adolescents: a systematic review and meta-analysis.PLoS One. 2015; 10e0140908
- The global NAFLD epidemic.Nat Rev Gastroenterol Hepatol. 2013; 10: 686-690
- Associations of physical activity and sitting time with the metabolic syndrome among Omani adults.Obesity. 2012; 20: 2290-2295
- Amount of time spent in sedentary behaviors and cause-specific mortality in US adults.Am J Clin Nutr. 2012; 95: 437-445
- Relationship of sitting time and physical activity with non-alcoholic fatty liver disease.J Hepatol. 2015; 63: 1229-1237
- Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA).Diabetes Care. 2010; 33: 1652-1654
- Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: Nationwide surveys (KNHANES 2008–2011).J Hepatol. 2015; 63: 486-493
- Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease: Nationwide surveys (KNHANES 2008–2011).Hepatology. 2016; 63: 776-786
- Sarcopenia is an independent risk factor for non-alcoholic steatohepatitis and significant fibrosis.J Hepatol. 2017; 66: 123-131
- The relationship between hepatic steatosis and skeletal muscle mass index in men with type 2 diabetes.Endocr J. 2016; 63: 877-884
- Sarcopenia is associated with severe liver fibrosis in patients with non-alcoholic fatty liver disease.Aliment Pharmacol Ther. 2017; 45: 510-518
- Diet patterns, adipokines, and metabolism: where are we and what is next?.Metabolism. 2014; 63: 168-177
- The role of diet and nutrient composition in nonalcoholic Fatty liver disease.J Acad Nutr Diet. 2012; 112: 401-409
- Role of diet and nutritional management in non-alcoholic fatty liver disease.J Gastroenterol Hepatol. 2013; 28: 81-87
- The role of nutrients in the development, progression, and treatment of nonalcoholic fatty liver disease.J Clin Gastroenterol. 2012; 46: 457-467
- Intake of n-3 polyunsaturated fatty acids and non-alcoholic fatty liver disease: a cross-sectional study in Japanese men and women.Eur J Clin Nutr. 2010; 64: 1179-1185
- Efficacy of poly-unsaturated fatty acid therapy on patients with nonalcoholic steatohepatitis.World J Gastroenterol. 2015; 21: 7008-7013
- Dietary patterns modulate the risk of non-alcoholic fatty liver disease in Chinese adults.Nutrients. 2015; 7: 4778-4791
- Diet-quality scores and prevalence of nonalcoholic fatty liver disease: a population study using proton-magnetic resonance spectroscopy.PLoS One. 2015; 10e0139310
- Associations between intakes of individual nutrients or whole food groups and non-alcoholic fatty liver disease among Korean adults.J Gastroenterol Hepatol. 2014; 29: 1265-1272
- Long term nutritional intake and the risk for non-alcoholic fatty liver disease (NAFLD): a population based study.J Hepatol. 2007; 47: 711-717
- Dietary patterns are associated with prevalence of fatty liver disease in adults.Eur J Clin Nutr. 2015; 69: 914-921
- Genetic variation in PNPLA3 confers susceptibility to nonalcoholic fatty liver disease.Nat Genet. 2008; 40: 1461-1465
- Genetic variant in PNPLA3 is associated with nonalcoholic fatty liver disease in China.Hepatology. 2012; 55: 327-328
- PNPLA3 gene polymorphism accounts for fatty liver in community subjects without metabolic syndrome.Aliment Pharmacol Ther. 2014; 39: 532-539
- Genetic polymorphisms of the human PNPLA3 gene are strongly associated with severity of non-alcoholic fatty liver disease in Japanese.PLoS One. 2012; 7e38322
- Interactions of a PPARGC1A variant and a PNPLA3 variant affect nonalcoholic steatohepatitis in severely obese Taiwanese patients.Medicine. 2016; 95e3120
- I148 M variant in PNPLA3 reduces central adiposity and metabolic disease risks while increasing nonalcoholic fatty liver disease.Liver Int. 2014; 35: 2537-2546
- Serum ferritin is an independent predictor of histologic severity and advanced fibrosis in patients with nonalcoholic fatty liver disease.Hepatology. 2012; 55: 77-85
- Hepatic iron loading in mice increases cholesterol biosynthesis.Hepatology. 2010; 52: 462-471
- Nonalcoholic steatohepatitis in Asian Indians is neither associated with iron overload nor with HFE gene mutations.World J Gastroenterol. 2005; 11: 393-395
- HFE genotype, parenchymal iron accumulation, and liver fibrosis in patients with nonalcoholic fatty liver disease.Gastroenterology. 2010; 138: 905-912
- APOC3 promoter polymorphisms C-482T and T-455 C are associated with the metabolic syndrome.Arch Med Res. 2007; 38: 444-451
- Apolipoprotein C3 gene variants in nonalcoholic fatty liver disease.N Engl J Med. 2010; 362: 1082-1089
- Dissociation between APOC3 variants, hepatic triglyceride content and insulin resistance.Hepatology. 2011; 53: 467-474
- The APOC3T-455 C and C-482T promoter region polymorphisms are not associated with the severity of liver damage independently of PNPLA3 I148M genotype in patients with nonalcoholic fatty liver.J Hepatol. 2011; 55: 1409-1414
- Prevalence of the TM6SF2 variant and non-alcoholic fatty liver disease in Chinese.J Hepatol. 2014; 61: 708-709
- The dual and opposite role of the TM6SF2-rs58542926 variant in protecting against cardiovascular disease and conferring risk for nonalcoholic fatty liver: A meta-analysis.Hepatology. 2015; 62: 1742-1756
- Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese: a population study using proton-magnetic resonance spectroscopy and transient elastography.Gut. 2012; 61: 409-415
- High prevalence of non-alcoholic fatty liver disease in the Chinese - results from the Hong Kong liver health census.Liver Int. 2015; 35: 542-549
- Prevalence and risk factors of non-alcoholic fatty liver disease in a multiracial suburban Asian population in Malaysia.Hepatol Int. 2013; 7: 548-554
- Obstructive sleep apnea is associated with liver disease: a population-based cohort study.Sleep Med. 2015; 16: 955-960
- Metabolic syndrome is related to nonalcoholic steatohepatitis in severely obese subjects.Obes Surg. 2007; 17: 1457-1463
- Insulin resistance and C-reactive protein as independent risk factors for non-alcoholic fatty liver disease in non-obese Asian men.J Gastroenterol Hepatol. 2004; 19: 694-698
- Cohort study of non-alcoholic fatty liver disease, NAFLD fibrosis score, and the risk of incident diabetes in a Korean population.Am J Gastroenterol. 2013; 108: 1861-1868
- Severe vitamin D deficiency is not associated with liver damage in morbidly obese patients.Obes Surg. 2016; 26: 2138-2143
- Thyroid function is associated with non-alcoholic fatty liver disease in euthyroid subjects.Endocr Res. 2015; 40: 74-78
- Impact of hypothyroidism on the development of non-alcoholic fatty liver disease: A 4-year retrospective cohort study.Clin Mol Hepatol. 2015; 21: 372-378
- Prevalence of and risk factors for fatty liver in a general population of Shanghai, China.J Hepatol. 2005; 43: 508-514
- Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease.Hepatology. 2010; 51: 1593-1602
- Association of nonalcoholic fatty liver disease with components of metabolic syndrome according to body mass index in Korean adults.Am J Gastroenterol. 2012; 107: 1852-1858
- Prevalence and severity of nonalcoholic fatty liver disease in non-obese patients: a population study using proton-magnetic resonance spectroscopy.Am J Gastroenterol. 2015; 110 ([Quiz 1315]): 1306-1314
- Nonalcoholic fatty liver disease in lean individuals in the United States.Medicine. 2012; 91: 319-327
- Characteristics and long-term prognosis of lean patients with nonalcoholic fatty liver disease.Gastroenterology. 2014; 146: S-909
- Histological severity and clinical outcomes of nonalcoholic fatty liver disease in nonobese patients.Hepatology. 2017; 65: 54-64
- Incidence of non-alcoholic fatty liver disease in Hong Kong: a population study with paired proton-magnetic resonance spectroscopy.J Hepatol. 2015; 62: 182-189
- The association of PNPLA3 variants with liver enzymes in childhood obesity is driven by the interaction with abdominal fat.PLoS One. 2011; 6e27933
- PNPLA3 gene-by-visceral adipose tissue volume interaction and the pathogenesis of fatty liver disease: the NHLBI family heart study.Int J Obes. 2013; 37: 432-438
- Clinical and metabolic characterization of lean Caucasian subjects with non-alcoholic fatty liver.Am J Gastroenterol. 2017; 112: 102-110
- Prevalence of undiagnosed diabetes and postchallenge hyperglycaemia in Chinese patients with non-alcoholic fatty liver disease.Aliment Pharmacol Ther. 2006; 24: 1215-1222
- Large-scale long-term follow-up study of Japanese patients with non-alcoholic Fatty liver disease for the onset of hepatocellular carcinoma.Am J Gastroenterol. 2012; 107: 253-261
- Long-term clinical outcomes after fatty liver screening in patients undergoing coronary angiogram: A prospective cohort study.Hepatology. 2016; 63: 754-763
- Changing epidemiology of hepatocellular carcinoma in Asia.Best Pract Res Clin Gastroenterol. 2015; 29: 919-928
- Clinical characteristics, treatment, and prognosis of non-B, non-C hepatocellular carcinoma: a large retrospective multicenter cohort study.J Gastroenterol. 2015; 50: 350-360
- Management of hepatocellular carcinoma: an update.Hepatology. 2011; 53: 1020-1022
- EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma.J Hepatol. 2012; 56: 908-943
- Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma.Hepatol Int. 2010; 4: 439-474
- Characteristics of patients with nonalcoholic steatohepatitis who develop hepatocellular carcinoma.Clin Gastroenterol Hepatol. 2011; 9 ([Quiz e450]): 428-433
- Hepatocellular carcinoma in the absence of cirrhosis in United States veterans is associated with nonalcoholic fatty liver disease.Clin Gastroenterol Hepatol. 2016; 14 (e121): 124-131
- Steatotic hepatocellular carcinoma: a variant associated with metabolic factors and late tumour relapse.Histopathology. 2016; 69: 971-984
- Steatohepatitic hepatocellular carcinoma (SH-HCC): a distinctive histological variant of HCC in hepatitis C virus-related cirrhosis with associated NAFLD/NASH.Am J Surg Pathol. 2010; 34: 1630-1636
- The association between continuous positive airway pressure therapy and liver disease development in obstructive sleep apnea/hypopnea syndrome patients: a nationwide population-based cohort study in Taiwan.Sleep Breath. 2017; 21: 461-467
- High prevalence of colorectal neoplasm in patients with non-alcoholic steatohepatitis.Gut. 2011; 60: 829-836
- Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases.Gut. 2017; 66: 1138-1153
- Non-alcoholic fatty liver disease: an expanding problem with low levels of awareness in Hong Kong.J Gastroenterol Hepatol. 2009; 24: 1786-1790
- Non-alcoholic fatty liver disease: confronting the global epidemic requires better awareness.J Gastroenterol Hepatol. 2009; 24: 1705-1707
- Screening for hepatitis B, C and non-alcoholic fatty liver disease: a survey of community-based physicians.Aliment Pharmacol Ther. 2009; 29: 1019-1024
- Improving nonalcoholic fatty liver disease management by general practitioners: a critical evaluation and impact of an educational training program.J Gastrointestin Liver Dis. 2008; 17: 389-394
- Community-based lifestyle modification programme for non-alcoholic fatty liver disease: a randomized controlled trial.J Hepatol. 2013; 59: 536-542
- Exercise and diet modification in non-obese non-alcoholic fatty liver disease: analysis of biopsies of living liver donors.J Gastroenterol Hepatol. 2012; 27: 1341-1347
- Simple resistance exercise helps patients with non-alcoholic fatty liver disease.Int J Sports Med. 2015; 36: 848-852
- Effects of moderate and vigorous exercise on nonalcoholic fatty liver disease: a randomized clinical trial.JAMA Intern Med. 2016; 176: 1074-1082
- Long-term effect of exercise on improving fatty liver and cardiovascular risk factors in obese adults: A 1-year follow-up study.Diabetes Obes Metab. 2017; 19: 284-289
- High-intensity aerobic exercise improves both hepatic fat content and stiffness in sedentary obese men with nonalcoholic fatty liver disease.Sci Rep. 2017; 7: 43029
- Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: A systematic review.J Hepatol. 2017; 66: 142-152
- Effectiveness of exercise in hepatic fat mobilization in non-alcoholic fatty liver disease: Systematic review.World J Gastroenterol. 2016; 22: 6318-6327
- Behavior therapy for nonalcoholic fatty liver disease: The need for a multidisciplinary approach.Hepatology. 2008; 47: 746-754
- Government’s role in promoting healthy living.Prog Cardiovasc Dis. 2017; 59: 492-497
Xinhua News Agency. Healthy China 2030 Project. http://news.xinhuanet.com/health/2016-10/25/c_1119786029.htm (accessed on 31 May 2017).
- The Seoul metropolitan lifestyle intervention program and metabolic syndrome risk: a retrospective database study.Int J Environ Res Public Health. 2016; 13: E667
- EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease.J Hepatol. 2016; 64: 1388-1402
- Bariatric surgery for nonalcoholic steatohepatitis: A clinical and cost-effectiveness analysis.Hepatology. 2016; 65: 1156-1164
- IFSO-APC consensus statements 2011.Obes Surg. 2012; 22: 677-684
- Bariatric surgery worldwide 2013.Obes Surg. 2015; 25: 1822-1832
- Treating morbid obesity in cirrhosis: A quest of holy grail.World J Hepatol. 2015; 7: 2819-2828
- The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association.Hepatology. 2012; 55: 2005-2023
- Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up.Hepatology. 2015; 61: 1547-1554
- Epidemiology of hepatitis B virus infection and impact of vaccination on disease.Clin Liver Dis. 2016; 20: 607-628
- Hepatic steatosis in chronic hepatitis B patients is associated with metabolic factors more than viral factors.J Gastroenterol Hepatol. 2008; 23: 1082-1088
- Prevalence and risk factors of hepatic steatosis and its impact on liver injury in Chinese patients with chronic hepatitis B infection.J Gastroenterol Hepatol. 2008; 23: 1419-1425
- Liver steatosis in patients with chronic hepatitis B infection: host and viral risk factors.Eur J Gastroenterol Hepatol. 2009; 21: 512-516
- Hepatic steatosis and fibrosis in young men with treatment-naive chronic hepatitis B.Liver Int. 2009; 29: 878-883
- [Relationship of fatty liver with HBV infection, hyperlipidemia and abnormal alanine aminotransferase].Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2009; 23: 141-143
- Interaction of adipokines and hepatitis B virus on histological liver injury in the Chinese.Am J Gastroenterol. 2010; 105: 132-138
- Predictors of hepatic steatosis in HBeAg-negative chronic hepatitis B patients and their diagnostic values in hepatic fibrosis.Int J Med Sci. 2010; 7: 272-277
- Steatosis in chronic hepatitis B: prevalence and correlation with biochemical, histologic, viral, and metabolic parameters.Indian J Pathol Microbiol. 2011; 54: 454-459
- Hepatitis B virus infection and fatty liver in the general population.J Hepatol. 2012; 56: 533-540
- Inverse association between hepatitis B virus infection and fatty liver disease: a large-scale study in populations seeking for check-up.PLoS One. 2013; 8e72049
- Thyroid function is associated with non-alcoholic fatty liver disease in chronic hepatitis B-infected subjects.J Gastroenterol Hepatol. 2015; 30: 1753-1758
- The prevalence of steatohepatitis in chronic hepatitis B patients and its impact on disease severity and treatment response.Liver Int. 2016; 37: 542-551
- Hepatitis B virus infection and decreased risk of nonalcoholic fatty liver disease: A cohort study.Hepatology. 2017; 65: 828-835
- NAFLD in Asia–as common and important as in the West.Nat Rev Gastroenterol Hepatol. 2013; 10: 307-318
- Association of metabolic syndrome and hepatitis B infection in a Chinese population.Clin Chim Acta. 2007; 380: 238-240
- Hepatic steatosis in hepatitis B virus infected patients: meta-analysis of risk factors and comparison with hepatitis C infected patients.J Gastroenterol Hepatol. 2011; 26: 1361-1367
- Association of chronic hepatitis B virus infection with insulin resistance and hepatic steatosis.J Gastroenterol Hepatol. 2008; 23: 779-782
- Hepatitis B virus X protein induces hepatic steatosis via transcriptional activation of SREBP1 and PPARgamma.Gastroenterology. 2007; 132: 1955-1967
- Concurrent fatty liver increases risk of hepatocellular carcinoma among patients with chronic hepatitis B.J Gastroenterol Hepatol. 2017; 32: 667-676
- Metabolic syndrome increases the risk of liver cirrhosis in chronic hepatitis B.Gut. 2009; 58: 111-117
- Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B.Clin Mol Hepatol. 2016; 22: 339-349
- Metabolic factors and risk of hepatocellular carcinoma by chronic hepatitis B/C infection: a follow-up study in Taiwan.Gastroenterology. 2008; 135: 111-121
- Type 2 diabetes and hepatocellular carcinoma: a case-control study in patients with chronic hepatitis B.Int J Cancer. 2012; 131: 1197-1202
- Diabetes, hepatitis virus infection and hepatocellular carcinoma: A case-control study in hepatitis endemic area.Hepatol Res. 2012; 42: 774-781
- Insulin resistance and the risk of hepatocellular carcinoma in chronic hepatitis B patients.J Gastroenterol Hepatol. 2017; 32: 1100-1106
- Low vitamin D levels and non-alcoholic fatty liver disease, evidence for their independent association in men in East China: a cross-sectional study (Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China)).Br J Nutr. 2016; 115: 1352-1359
Article info
Publication history
Published online: June 19, 2017
Accepted:
June 7,
2017
Received in revised form:
May 31,
2017
Received:
March 24,
2017
Identification
Copyright
© 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
