Participants
This retrospective study was performed in accordance with the ethical
guidelines of the Declaration of Helsinki and approved by the ethics
committee of The First Affiliated Hospital of Guangdong Pharmaceutical
University (No. 20176601). Informed consent was obtained from all
patients. We followed the STROBE (Strengthening the Reporting of
Observational Studies in Epidemiology) statement in reporting this
study. The sample size was estimated using an online software (Power and
Sample Size Calculation; HyLown Consulting LLC, Atlanta, GA, USA).
Patients with NAFLD who were hospitalized at The First Affiliated
Hospital of Guangdong Pharmaceutical University for metabolic therapy
between October 2017 and October 2019 and tested for D-lactate were
eligible for inclusion. Patients with carcinoma; severe heart, brain, or
kidney disease; other chronic liver diseases such as viral, alcoholic,
autoimmune, and Wilson’s disease; and those with missing important
medical data were excluded.
Data of all enrolled patients were used to analyze the association
between intestinal permeability and severity of NAFLD. Data of those
patients who completed a one-month follow-up after metabolic therapy
were used to analyze the value of intestinal permeability for predicting
the efficacy of metabolic therapy for NAFLD (Figure 1 ).