BACKGROUND ALT value is often used to reflect the hepatic inflammation and injury in NAFLD patients, but many studies proved that ALT values were normal in many NAFLD patients. The aim of this study was to identify the summarized proportion of NAFLD patients with normal ALT value in the overall NAFLD patients. METHODS Electronic databases PubMed, EMBASE, Ovid, and the Cochrane Library were searched for potential studies published from January 1, 2000 to September 30, 2019. Studies that have reported the number of NAFLD or NASH patients with normal and abnormal ALT value were included and analyzed. Abstracts, reviews, case reports, and letters were excluded. RESULTS A total of 11 studies with 4084 patients were included for assessing the summarized proportion of NAFLD patients with normal ALT in overall NAFLD patients. As the results shown, the summarized proportion of NAFLD patients with normal ALT value in overall NAFLD patients was 25% (95%CI: 20-31%) which was calculated by the random-effects model. The summarized proportion of NASH patients with normal ALT value in overall NASH patients was 19% (95%CI: 13-27%). Subgroup analysis includes region, study type, diagnostic method, and group size were conducted to investigate the resource of heterogeneity in the summarized proportion of NAFLD and NASH patients with normal ALT value. CONCLUSIONS 25% NAFLD patients and 19% NASH patients possess the normal ALT value in the clinical manifestation. The value of ALT in the clinical diagnosis of NAFLD and NASH remains need be further testified.

中文翻译：

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ALT值正常的NAFLD患者在整个NAFLD患者中的比例：系统评价和荟萃分析。

背景技术ALT值通常用于反映NAFLD患者的肝脏炎症和损伤，但是许多研究证明ALT值在许多NAFLD患者中是正常的。这项研究的目的是确定总的NAFLD患者中ALT值正常的NAFLD患者的汇总比例。方法检索电子数据库PubMed，EMBASE，Ovid和Cochrane库，以查找从2000年1月1日至2019年9月30日发布的潜在研究。包括报告ALT值正常和异常的NAFLD或NASH患者的数量的研究，以及分析。摘要，评论，案例报告和信件均被排除在外。结果共纳入11项研究，涉及4084名患者，以评估总NAFLD患者中ALT正常的NAFLD患者的汇总比例。结果显示，根据随机效应模型计算，ALT值正常的NAFLD患者在总NAFLD患者中的总比例为25％（95％CI：20-31％）。ALT总值正常的NASH患者在总的NASH患者中所占的比例为19％（95％CI：13-27％）。进行亚组分析，包括区域，研究类型，诊断方法和组规模，以调查ALT值正常的NAFLD和NASH患者的汇总比例中的异质性资源。结论25％的NAFLD患者和19％的NASH患者在临床表现中具有正常的ALT值。ALT在NAFLD和NASH的临床诊断中的价值仍有待进一步证实。20-31％），由随机效应模型计算得出。ALT总值正常的NASH患者在总的NASH患者中所占的比例为19％（95％CI：13-27％）。进行亚组分析，包括区域，研究类型，诊断方法和组规模，以调查ALT值正常的NAFLD和NASH患者的汇总比例中的异质性资源。结论25％的NAFLD患者和19％的NASH患者在临床表现中具有正常的ALT值。ALT在NAFLD和NASH的临床诊断中的价值仍有待进一步证实。20-31％），由随机效应模型计算得出。ALT总值正常的NASH患者在总的NASH患者中所占的比例为19％（95％CI：13-27％）。进行亚组分析，包括区域，研究类型，诊断方法和组规模，以调查ALT值正常的NAFLD和NASH患者的汇总比例中的异质性资源。结论25％的NAFLD患者和19％的NASH患者在临床表现中具有正常的ALT值。ALT在NAFLD和NASH的临床诊断中的价值仍有待进一步证实。对不同年龄组的NAFLD和NASH ALT值正常的患者进行调查，并按组数进行调查。结论25％的NAFLD患者和19％的NASH患者在临床表现中具有正常的ALT值。ALT在NAFLD和NASH的临床诊断中的价值仍有待进一步证实。对不同年龄组的NAFLD和NASH ALT值正常的患者进行调查，并按组数进行调查。结论25％的NAFLD患者和19％的NASH患者在临床表现中具有正常的ALT值。ALT在NAFLD和NASH的临床诊断中的价值仍有待进一步证实。