Menopause is associated with increased prevalence of nonalcoholic fatty liver disease: a systematic review and meta-analysis

Abstract

Importance Data are inconsistent on whether menopause is a risk for nonalcoholic fatty liver disease (NAFLD). Objective Using systematic review and meta-analysis, we aimed to collect all available data to determine the association between menopause and NAFLD. Evidence Review Potentially eligible studies were identified from EMBASE, MEDLINE, and Web of Science databases from inception to December 2021 using a search strategy that was composed of the terms for "NAFLD"and "menopause."Eligible study must contain two groups of participants: one group of postmenopausal women and another group of premenopausal women. Then, the study must report the association between menopause and prevalent NAFLD. We extracted such data from each study and calculated pooled odds ratio (OR) by combining effect estimates of each study using a random-effects model. Funnel plot was used to assess for the presence of publication bias. Findings A total of 587 articles were identified. After two rounds of independent review by two investigators, 12 cross-sectional studies fulfilled the eligibility criteria. The meta-analysis of 12 studies revealed the significant association between menopause and NAFLD with a pooled OR of 2.37 (95% CI, 1.99-2.82; I2 = 73%). The association remained significant in a sensitivity meta-analysis of six studies that reported the association with adjustment for age and metabolic factors with a pooled OR of 2.19 (95% CI, 1.73-2.78; I2 = 74%). The funnel plot was fairly symmetric and was not suggestive of publication bias. Conclusions and Relevance The meta-analysis reveals that menopausal status was associated with approximately 2.4 times higher odds of NAFLD.