Obesity is an independent risk factor for non-alcoholic fatty liver disease: evidence from a meta-analysis of 21 cohort studies

Summary Background The association between obesity and nonalcoholic fatty liver disease (NAFLD) has not been fully quantified, and the magnitude of NAFLD risk associated with obesity is still unclear. A meta‐analysis of cohort studies was performed to elucidate the NAFLD risk associated with obesity. Methods Pubmed, Web of Science and Embase were searched for cohort studies assessing NAFLD risk associated with obesity or increased body mass index (BMI). Relative risks (RRs) with 95% confidence intervals (95%CIs) were pooled using random‐effects model of meta‐analysis. Results Twenty‐one cohort studies including 13 prospective studies and 8 retrospective studies were finally included. There were a total of 381,655 participants in the meta‐analysis. Compared with normal weight, obesity independently led to a 3.5‐fold increased risk of developing NAFLD (RR = 3.53, 95%CI 2.48 to 5.03, P