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 ).