Portal vein thrombosis (PVT) is a common complication of cirrhosis as a result of portal hypertension and modification in the hemostatic balance. Accumulating evidence now suggests that patients with non-alcoholic fatty liver disease (NAFLD), especially those with advanced forms, have an increased risk of PVT. Hence, we performed a meta-analysis of observational studies to estimate the overall prevalence of PVT in patients with NAFLD and its advanced forms compared with patients with advanced liver diseases from other etiologies. We systematically searched PubMed, Scopus and Web of Science databases from the inception date to December 30th 2022, using predefined keywords, to identify observational studies. Meta-analysis was performed using random-effects modeling. We included five observational studies for a total of 225,571 patients. Of these, 26,840 (11.9%) patients had NAFLD, whereas the PVT prevalence was 8.5% (n = 2,280). When compared with patients with advanced liver diseases from other etiologies, patients with NAFLD and its advanced forms had a higher risk of prevalent PVT (OR 1.34, 100% CI 1.07–1.67 p < 0,01). The between-study heterogeneity was substantial (I² = 88%). This meta-analysis suggests that compared with patients with advanced liver diseases from other etiologies, patient with NAFLD and its advanced forms had a higher risk of prevalent PVT. Further research is required to understand the complex link between NAFLD/NASH and PVT development.

门静脉血栓形成（PVT）是肝硬化的常见并发症，由门静脉高压和止血平衡改变引起。现在越来越多的证据表明，非酒精性脂肪性肝病 (NAFLD) 患者，尤其是晚期患者，发生 PVT 的风险增加。因此，我们对观察性研究进行了荟萃分析，以估计 NAFLD 及其晚期形式患者与其他病因引起的晚期肝病患者相比，PVT 的总体患病率。我们使用预定义的关键词系统地搜索了 PubMed、Scopus 和 Web of Science 数据库，从创建之日到 2022 年 12 月 30 日，以识别观察性研究。使用随机效应模型进行荟萃分析。我们纳入了五项观察性研究，总共涉及 225,571 名患者。其中，26,840 名患者 (11.9%) 患有 NAFLD，而 PVT 患病率为 8.5% (n = 2,280)。与其他病因引起的晚期肝病患者相比，NAFLD 及其晚期形式的患者发生 PVT 的风险较高（OR 1.34，100% CI 1.07–1.67 p < 0.01）。研究间的异质性很大（I ²  = 88%）。这项荟萃分析表明，与其他病因引起的晚期肝病患者相比，NAFLD 及其晚期形式的患者发生流行性 PVT 的风险更高。需要进一步的研究来了解 NAFLD/NASH 和 PVT 发展之间的复杂联系。