Table 1 Characteristics of studies included in the meta-analysis Study
Study | Year | Country | Sample size | Sample | mean age | Gender (male/female) | BMI (kg/m2) | TNF (pg/ml) | NOS | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Case | Control | Case | Control | Case | Control | Case | Control | Case | Control | |||||
Ming | 2019 | China | 876 | 684 | 192 | 51.34 ± 5.16 | 52.18 ± 4.51 | 446/238 | 128/64 | 24.1 to 30.5 | NR | 31.2 ± 5.3 | 12.1 ± 1.1 | 9 |
Sundbom | 2018 | Sweden | 333 | 109 | 224 | 55.6 ± 8.8 | 47.7 ± 11.3 | 0/109 | 0/224 | 28.2 ± 4.8 | 25.4 ± 4.1 | Mean (95%CI) 2.1 (1.8, 2.4) | Mean (95%CI) 2.0 (1.8, 2.2) | 7 |
Bhatt | 2018 | India | 240 | 47 (without NAFLD) | 25 (without NAFLD) | 44.2 ± 9.1 | 41 ± 8.5 | 25/22 | 17/8 | 32.5 ± 6.9 | 28.5 ± 8.6 | Log (3.6 ± 0.14) | Log(2.86 ± 0.2) | 8 |
124 (with NAFLD) | 44 (with NAFLD) | 44.8 ± 9.1 | 39.5 ± 10.5 | 64/60 | 26/18 | 33.3 ± 7.9 | 31.0 ± 8.3 | Log (3.86 ± 0.18) | Log(3.2 ± 0.06) | |||||
Kong | 2018 | China | 90 | 50 (Mild 10, Moderate 15, Severe 25) | 40 | 54.34 ± 14.38 (Mild 59.60 ± 15.13, Moderate 56.73 ± 15.93, Severe 52.27 ± 13.54) | 50.42 ± 8.35 | 34/16 | 31/9 | 26.86 ± 3.12 (Mild 27.04 ± 2.58, Moderate 26.81 ± 3.80, Severe 27.28 ± 3.16) | 22.26 ± 3.54 | 327.34 ± 46.81 (Mild 274.64 ± 4.91, Moderate 308.75 ± 42.48, Severe 341.28 ± 44.80) | 307.95 ± 27.15 | 7 |
Bozic | 2018 | Croatia | 75 | 50 (Moderate 25, Severe 25) | 25 | Moderate 53.92 ± 10.75, Severe 52.04 ± 13.11 | 52.52 ± 10.18 | 50/0 | 25/0 | Moderate 28.42 ± 2.57, Severe 29.30 ± 2.74 | 27.78 ± 2.23 | Moderate 5.79 ± 1.44, Severe 8.67 ± 2.41 | 2.35 ± 1.25 | 7 |
Ugur | 2018 | Turkey | 108 | 63 | 45 | median (range) 46 (20–81) | median (range) 45 (20–70) | NR | NR | median (range) 25 (17–49) | median (range) 24.8 (15–33) | median (range) 2710 (80–59,520) | median (range) 660 (80–23,140) | 8 |
Heizati | 2017 | China | 159 | 28 | 54 | 44.00 ± 8.26 | 44.94 ± 8.33 | 28/0 | 54/0 | 26.09 ± 1.75 | 25.30 ± 1.79 | median (interquartile) 0.302 (0.177–0.436) | median (interquartile) 0.298 (0.182–0.481) | 8 |
40 (obese) | 37 (obese) | 44.40 ± 8.47 | 47.35 ± 6.75 | 40/0 | 37/0 | 30.69 ± 2.03 | 30.30 ± 1.97 | median (interquartile) 0.281 (0.149–0.470) | median (interquartile) 0.281 (0.185–0.426) | |||||
Jin | 2017 | China | 150 | 100 | 50 | 55.284 ± 7.128 | 56.131 ± 6.210 | 82/18 | 37/13 | 26.746 ± 3.500 | 25.196 ± 2.449 | 37.67 ± 0.21 | 29.15 ± 1.74 | 6 |
Hirotsu | 2017 | Brazil | 1042 | 193 | 275 | 47.0 ± 1.0 | 36.2 ± 0.8 | 193/0 | 275/0 | 29.0 ± 0.4 | 24.9 ± 0.2 | 10.91 ± 0.44 | 10.84 ± 0.38 | 5 |
149 | 425 | 55.7 ± 1 | 39.5 ± 0.6 | 0/149 | 0/425 | 30.4 ± 0.5 | 25.8 ± 0.2 | 10.95 ± 0.52 | 9.2 ± 0.29 | |||||
Tirado* | 2017 | Spain | 66 | Mild 20, Moderate 16, severe 30 | NO | Mild 35.8 ± 8.43 Moderate 45.6 ± 9.08 Severe 44.5 ± 11.0 | NO | Mild 2/18, Moderate 2/14, Severe 8/22 | NO | Mild 46.3 ± 7.05, Moderate 43.1 ± 4.43, Severe 46.4 ± 6.18 | NO | Mild 2.33 ± 0.72, Moderate 3.57 ± 2.55, Severe 2.33 ± 1.04 | NO | 5 |
Gamsiz-Isik | 2016 | Turkey | 163 | 83 (Mild 16, Moderate to severe 67) | 80 | 46.87 ± 8.21 | 44.23 ± 9.83 | 65/18 | 57/23 | 30.91 ± 3.31 | 31.53 ± 3.44 | 11.5 ± 3.11 (Mild 11.5 ± 4.60, Moderate to severe 10.3 ± 2.59) | 11.25 ± 4.0 | 6 |
Vicente | 2016 | Spain | 115 | 89 (Mild to Moderate 42 Severe 47) | 26 | median (interquartile) 44(36–56) | median (interquartile) 44(38–53) | 62/27 | 16/10 | median (interquartile)29.1 (27.1, 33.9) | median (interquartile) 27.9 (25.2, 31.1) | median (interquartile) Mild to Moderate: Plasma 4.54 (4.09–5.25), Lavage 1.8 (1.1–3.2); Severe: Plasma 4.46 (4.21–5.06), Lavage 2.1 (1.7–4.2) | median (interquartile) Plasma 4.35 (4.01–4.99); Lavage 1.2 (0.8–2.1) | 5 |
Ifergane | 2016 | Israel | 43 | 21 | 22 | 66.0 ± 9.9 | 66.1 ± 13.1 | 8/13 | 5/17 | 29.6 ± 4.3 | 26.8 ± 4.3 | 6.39 ± 5.00 | 3.57 ± 1.87 | 5 |
Nizam | 2015 | Turkey | 52 | 39 (Mild to Moderate 17, Severe 22) | 13 | Mild to Moderate 49.88 ± 11.47, Severe 45.36 ± 9.81 | 43.23 ± 9.08 | Mild to Moderate 9/8, Severe 18/4 | 5/8 | Mild to Moderate 31.85 ± 5.32 Severe34.18 ± 7.24 | 31.71 ± 4.56 | Mild to Moderate: Serum 86.7 ± 40.5, Saliva 10.6 ± 10.1; Severe Serum 99.5 ± 64.63, Saliva 10.2 ± 9.8 | Serum 91.3 ± 64.6; Saliva 6.8 ± 2.2 | 9 |
Leon-Cabrera | 2015 | Mexico | 39 | 29 | 10 | 37.2 ± 11.4 | 43.4 ± 11.5 | 4/25 | 8/2 | 45.2 ± 8.4 | 23.6 ± 2.1 | 337.9 ± 67.8 | 270.2 ± 31.7 | 9 |
Jiang | 2015 | China | 229 | 135 | 94 | 48.7 ± 12.1 | 47.2 ± 13.5 | 80/55 | 55/39 | 27.48 ± 2.56 | 27.52 ± 2.58 | 765.77 ± 64.04(Mild 545.36 ± 54.06, Moderate 764.48 ± 63.28; Severe 836.72 ± 71.06) | 232.24 ± 31.5 | 6 |
Thunström | 2015 | Sweden | 329 | Moderate to Severe 234 | 95 | 65.3 ± 7.1 | 61.4 ± 9.5 | 204/30 | 71/24 | 26.8 ± 2.1 | 25.2 ± 2.5 | median (interquartile) 5.0 (3.4–7.0) | median (interquartile) 4.2 (3.0–6.0) | 8 |
De Santis | 2015 | Italy | 50 | 26 | 24 | 41.8 ± 7.4 | 43.7 ± 8.2 | 17/9 | 16/8 | 33.0 ± 5.2 | 30.8 ± 4.3 | 122.2 ± 12.0 | 80.2 ± 18.3 | 4 |
Salord | 2014 | Spain | 39 | 26 | 13 | median (interquartile) 45(39–51) | median (interquartile) 39(31–46) | 6/20 | 4/9 | median (interquartile) 45.1(42–45) | median (interquartile) 44.4(41–47) | median (interquartile) 9.8 (8.0, 12.3) | median (interquartile) 9.1 (7.5, 11.5) | 5 |
Ciccone | 2014 | Italy | 120 | 80 (Mild26,moderteto Severe 54) | 40 | Mild 53.65 ± 11.47, Moderate to Severe 52.33 ± 10.19 | 52.27 ± 10.52 | Mild 23/3, Moderate to Severe 45/9 | 34/6 | Mild 28.13 ± 2.7, Moderate to Severe 28.8 ± 3.03 | 28.24 ± 2.7 | Mild 14.42 ± 3.29, Moderate to Severe 22.83 ± 3.85 | 12.53 ± 3.48 | 5 |
Yadav | 2014 | UK | 41 | 20 | 21 | 49 ± 10 | 45 ± 9 | 3/17 | 5/16 | 52 ± 6 | 50 ± 8 | median (interquartile) 87.2 (12.4, 133.8) | median (interquartile) 15.5 (7.2, 38.2) | 6 |
Chen | 2013 | China | 64 | 44 (Mild23; Moderate 21) | 20 | Mild 40 ± 11, Moderate 45 ± 13 | 42 ± 11 | Mild 17/6, Moderate 16/5 | 15/5 | Mild 27.5 ± 4.2, Moderate 26.7 ± 2.8 | 26 ± 3.3 | median (interquartile) Mild 2.8 (0.8, 4.1), Moderate 3.8 (2.5, 9.9) | median (interquartile) 1.2 (0.5,1.7) | 7 |
Doufas | 2013 | USA | 48 | 33 | 15 | median (range) 34(19–54) | median (range) 31(19–52) | 33/0 | 15/0 | median (range) 26(20–33) | median (range) 24(20–32) | median (range) 7.88 (5.39, 31.69) | median (range) 7.77 (4.57,14.57) | 5 |
Hargens | 2013 | USA | 30 | 12 (obese) | 18 (obese) | 22.8 ± 0.8 | 22.5 ± 0.7 | 12/0 | 18/0 | 32.4 ± 1.0 | 31.6 ± 1.1 | 0.95 ± 0.07 | 0.86 ± 0.05 | 6 |
Yang | 2013 | China | 50 | 25 | 25 | 54 ± 7 | 53 ± 7 | 23/2 | 23/2 | 27.39 ± 2.91 | 26.27 ± 1.9 | 12.55 ± 8.09 | 5.12 ± 1.23 | 7 |
Fornadi | 2012 | Germany | 100 | 25 | 75 | 54 ± 12 | 50 ± 13 | 20/5 | 60/15 | 29 ± 5 | 26 ± 5 | median (interquartile) 2.2 (1.5–2.8) | median (interquartile) 1.9 (1.3–2.6) | 6 |
Medeiros | 2012 | Brazil | 65 | 50 (Mild to Moderate 15; Severe 35) | 15 | Mild to Moderate 62.62 ± 9, Severe 65 ± 7.2 | 62.5 ± 8.4 | Mild to Moderate 11/4;Severe 20/15 | 6/9 | Mild to Moderate 24.5 ± 3.8, Severe25.9 ± 4.1 | 25.81 ± 4.04 | Mild to Moderate 0.84 ± 1.8, Severe 2.09 ± 7.3 | 0.32 ± 0.77 | 6 |
Qian | 2012 | China | 110 | 70 (40 with hypertension; 30 without) | 40 | With hyperten 46.9 ± 7.0, without 45.0 ± 9.0 | 46.3 ± 8.1 | 70/0 | 40/0 | With hyperten 28.2 ± 2.5, without 29.4 ± 2.1 | 24.1 ± 2.3 | With hyperten 1290 ± 220, without 1150 ± 370 | 1140 ± 400 | 6 |
Kim | 2010 | Korea | 59 | 37 (Moderate 9, Severe 28) | 22 | Moderate 38 ± 15.04, Severe 42 ± 10.77 | 26 ± 6.91 | 37/0 | 22/0 | Moderate 24.43 ± 2.45, Severe 28.69 ± 4.05 | 23.88 ± 2.30 | Moderate 14.56 ± 5.61, Severe 15.32 ± 6.8 | 14.4 ± 4.13 | 5 |
Li | 2010 | China | 417 | Normotensive 113; hypertension 134 | 97; 73 | 45.45 ± 8.63; 46.10 ± 9.41 | 44.16 ± 8.59; 45.97 ± 9.06 | 85/28; 101/33 | 74/23; 54/19 | 27.84 ± 3.44;28.91 ± 3.24 | 26.85 ± 3.78;27.7 ± 3.01 | 19,980 ± 8480; 22,850 ± 8980 | 13,100 ± 4280; 17,320 ± 7020 | 8 |
Steiropoulos | 2010 | Greece | 61 | 38 | 23 | 45.5 ± 10.5 | 43.7 ± 6.7 | 33/5 | 17/6 | 36.4 ± 7.4 | 34.5 ± 3.7 | 6.72 ± 3.72 | 3.94 ± 1.34 | 8 |
Tamaki | 2009 | Japan | 46 | 33 (Mild to Moderate 13, Severe 20) | 13 | Mild to Moderate 56.1 ± 8.7, Severe 50.5 ± 12.2 | 35.5 ± 9.7 | Mild to Moderate 11/2, Severe 19/1 | 12/1 | Mild to Moderate 24.6 ± 2.7, Severe 30.7 ± 5.8 | 23.6 ± 2.6 | Mild to Moderate 22,700 ± 4100, Severe 30,200 ± 6900 | 17,300 ± 4400 | 6 |
Sahlman | 2009 | Finland | 124 | 84 | 40 | 50.4 ± 9.3 | 45.6 ± 11.5 | 64/20 | 25/15 | 32.5 ± 3.3 | 31.5 ± 3.5 | 1.54 ± 1.75 | 1.17 ± 1.58 | 8 |
Bhushan | 2009 | India | 207 | 104 | 103 | 46.18 ± 10.7 | 44 ± 10 | 84/20 | 65/38 | 31.48 ± 4.26 | 30.94 ± 4.27 | Log (3.6 ± 0.8) | Log (3.3 ± 0.6) | 7 |
Carneiro | 2009 | Brazil | 29 | 16 | 13 | 40.1 ± 2.8 | 38.8 ± 3.3 | 16/0 | 13/0 | 46.9 ± 2.0 | 42.8 ± 1.3 | 10.7 ± 0.44 | 7.5 ± 0.44 | 7 |
Thomopoulos | 2009 | Greece | 132 | 62 (hypertension) | 70 (hypertension) | 48.1 ± 7.6 | 48.1 ± 3.9 | 49//13 | 56/14 | 31.9 ± 4.9 | 32.1 ± 3.0 | Log(0.33 ± 0.27) | Log(0.10 ± 0.23) | 5 |
Li | 2009 | China | 90 | 68 (Mild 22, Moderate 22, Severe 24) | 22 | Mild 48 ± 12, Moderate 44 ± 13, Severe 44 ± 8 | 43 ± 9.3 | Mild 15/7, Moderate 18/4, Severe 17/7 | 14/8 | Mild 25.7 ± 4.2, Moderate 28.8 ± 5.3, Severe 28.67 ± 4.2 | 23.3 ± 2.0 | Serum: Mild 102.3 ± 11.3, Moderate 125 ± 11.9, Severe 132.1 ± 10.8 EBC: Mild 96.1 ± 8.2, Moderate 116.7 ± 11.1, Severe 128.2 ± 8.8 | Serum: 87.3 ± 6.1; EBC: 83.7 ± 4.1 | 9 |
Antonopoulou | 2008 | Greece | 70 | 45 | 25 | 52 ± 12 | 51 ± 7 | 37/18 | 18/7 | 33.5 ± 7 | 31 ± 3 | 1.4 ± 0.9 | 0.64 ± 0.3 | 7 |
Arias | 2008 | Spain | 45 | 30 | 15 | 48 ± 10 | 52 ± 13 | 30/0 | 15/0 | 30.5 ± 4.0 | 28.7 ± 4.7 | 18.5 ± 13.4 | 11.4 ± 12.2 | 6 |
Constantinidis | 2008 | Greece | 51 | obses 13; overweighted 11 | obses 12; overweighted 15 | Mean (range) 45.1 (26–54) | Matched | 13/0; 11/0 | 12/0; 15/0 | 33.4 ± 1.5; 26.1 ± 1.1 | 34.9 ± 1.8; 27.4 ± 0.8 | 124.64 ± 96.7;105 ± 88.7 | 78.8 ± 50.1;48.5 ± 36.7 | 5 |
Kanbay | 2008 | Turkey | 138 | 106 | 32 | 51.39 ± 10.37 | 44.79 ± 13.35 | NR | NR | 31.06 ± 5.87 | 28.85 ± 5.49 | 114.15 ± 144.15 | 34.25 ± 13.1 | 7 |
Bravo | 2007 | Spain | 70 | with EDS 28; without EDS 22 | 20 | 51.3 ± 1.4;52.3 ± 2.4 | 47.4 ± 1.2 | 28/0; 22/0 | 20/0 | 33.3 ± 1.0; 30.9 ± 1.4 | 28.4 ± 0.6 | 0.82 ± 0.11;0.89 ± 0.37 | 0.42 ± 0.11 | 7 |
Kobayashi | 2006 | Japan | 51 | 35 | 16 | 51.4 ± 13.1 | 41 ± 13.1 | 30/5 | 13/3 | 27.9 ± 3.6 | 27.4 ± 3.7 | 1.11 ± 0.46 | 0.62 ± 0.44 | 5 |
Ryan | 2006 | Ireland | 96 | 66 (Mild to Moderate 35, Severe 31) | 30 | Mild to Moderate 42 ± 8, Severe 43 ± 9 | 41 ± 8 | Mild to Moderate 35/0, Severe 31/0 | 30/0 | Mild to Moderate 32.9 ± 6.03, Severe 32.1 ± 3.5 | 30.7 ± 3.1 | median (interquartile) Mild to Moderate 4.15 (2.71,6.05), Severe 6.19(4.9,7.99) | median (interquartile)3.21 (1.91,3.90) | 5 |
Ciftci | 2004 | Turkey | 65 | obese 43 | obese 22 | 49.6 ± 9.1 | 47.2 ± 10.3 | 43/0 | 22/0 | 31.86 ± 4.11 | 31.03 ± 3.1 | 4.6 ± 3.39 | 3.29 ± 2.13 | 5 |
Imagawa | 2004 | Japan | 69 | 24 Severe | 45 | NR | NR | NR | NR | 28.5 ± 3.6 | 22.9 ± 2.9 | AHI 70–89, 28.6 ± 27.9 | 25 ± 26.4 | 4 |
Minoguchi | 2004 | Japan | 36 | 24 (Mild 12; Moderate to Severe 12) | 12 | Mild 51 ± 14.8; Moderate to Severe 49.2 ± 11.7 | 47.5 ± 11.2 | Mild 12/0; Moderate to Severe 12/0 | 12/0 | Mild 26.1 ± 1.3; Moderate to Severe 29.1 ± 2.2 | 22.3 ± 0.9 | Mild 104.2 ± 139.2; Moderate to Severe 501.3 ± 378.8 | 61.7 ± 40.3 | 6 |
Teramoto | 2003 | Japan | 80 | 40 | 40 | NR | NR | 34/6 | NR | NR | NR | 9500 ± 2200 | 4400 ± 900 | 3 |
Alberti | 2003 | Italy | 38 | 18 | 20 | 52.7 ± 12.0 | 51.3 ± 13.2 | 13/5 | 14/6 | 26.5 ± 2.2 | 22.1 ± 3.4 | 9.7 ± 8.5 | 6.3 ± 3.0 | 5 |
Liu | 2000 | China | 38 | 22 | 16 | 47.4 ± 13.6 | 47.6 ± 14.7 | 15/7 | 11/5 | 27.58 ± 3.28 | 23.11 ± 2.96 | Plasma 299.09 ± 43.57, PBMC 4165.45 ± 1501.43 | Plasma 101.88 ± 21.27, PBMC 1596.25 ± 403.08 | 4 |
Vgotzas | 1997 | USA | 22 | 12 | 10 | 40.9 ± 2.2 | 24.1 ± 0.8 | 11/1 | 10/0 | 40.5 ± 3.2 | 24.6 ± 0.7 | 2.51 ± 0.13 | 1.17 ± 0.1 | 4 |