School of Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-Sen University, No. 70, Lianhai Rd, Gushan District, Kaohsiung City, Taiwan, 804

Ming-Lung Yu & Chung-Feng Huang

Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Shihcyuan 1st Rd, Sanmin District, Kaohsiung City, Taiwan, 807

Ming-Lung Yu, Jee-Fu Huang, Ming-Lun Yeh, Chia-Yen Dai & Wan-Long Chuang

Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, No. 100, Shihcyuan 1st Rd, Sanmin District, Kaohsiung City, Taiwan, 807

Ming-Lung Yu, Jee-Fu Huang, Ming-Lun Yeh, Chia-Yen Dai & Wan-Long Chuang

Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd, Niaosong District, Kaohsiung City, Taiwan, 833

Ming-Lung Yu & Chao-Hung Hung

Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, No. 1, Section 1, Xuecheng Rd, Dashu District, Kaohsiung City, Taiwan, 840

Chi‐Ming Tai

School of Medicine for International Students, College of Medicine, I-Shou University, No. 1, Section 1, Xuecheng Rd, Dashu District, Kaohsiung City, Taiwan, 840

Chi‐Ming Tai

Division of Gastroenterology, Tainan Municipal Hospital (Managed By Show Chwan Medical Care Corporation), No. 670, Chongde Rd, East District, Tainan City, Taiwan, 701

Lein-Ray Mo

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, No. 901, Zhonghua Rd, Yongkang District, Tainan City, Taiwan, 710

Hsing-Tao Kuo & Pei-Lun Lee

School of Medicine, College of Medicine, National Sun Yat-Sen University, No. 70, Lianhai Rd, Gushan District, Kaohsiung City, Taiwan, 804

Hsing-Tao Kuo

Ph.D. Program in Translational Medicine, College of Medicine, Kaohsiung Medical University and Academia Sinica, No. 128, Section 2, Academia Rd, Nangang District, Taipei City, Taiwan, 115

Chung-Feng Huang

Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Rd, Dalin Township, Chiayi County, Taiwan, 622

Kuo-Chih Tseng

School of Medicine, Tzuchi University, No. 701, Section 3, Zhongyang Rd, Hualien City, Hualien County, Taiwan, 970

Kuo-Chih Tseng

Division of Gastroenterology, Department of Internal Medicine, St. Martin De Porres Hospital, No. 60, Minquan Rd, East District, Chiayi City, Taiwan, 600

Ching-Chu Lo

Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, No. 1, Lane 303, Zhangsha St, Taitung City, Taitung County, Taiwan, 950

Ming-Jong Bair

Mackay Medical College, No. 46, Section 3, Zhongzheng Rd, Sanzhi District, New Taipei City, Taiwan, 252

Ming-Jong Bair

Division of Gastroenterology, Department of Internal Medicine, Yuan’s General Hospital, No. 162, Chenggong 1st Rd, Lingya District, Kaohsiung City, Taiwan, 802

Szu-Jen Wang

Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Chenggong Rd, Neihu District, Taipei City, Taiwan, 114

Chun-Ting Chen & Tsai-Yuan Hsieh

Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital Penghu Branch, National Defense Medical Center, No. 90, Qianliao, Magong City, Penghu County, Taiwan, 880

Chun-Ting Chen

School of Medicine, Chung Shan Medical University, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N Rd, South District, Taichung City, Taiwan, 402

Ming-Chang Tsai

Division of Gastroenterology, Kaohsiung Armed Forces General Hospital, No. 2, Zhongzheng 1st Rd, Lingya District, Kaohsiung City, Taiwan, 802

Chien-Wei Huang

Lotung Poh-Ai Hospital, No. 83, Nanchang St, Luodong Township, Yilan County, Taiwan, 265

Tzeng-Hue Yang

Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Rd, Beitou District, Taipei City, Taiwan, 112

Yi-Hsiang Huang & Han-Chieh Lin

Institute of Clinical Medicine, School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Section 2, Linong St, Beitou District, Taipei City, Taiwan, 112

Yi-Hsiang Huang & Han-Chieh Lin

Division of Hepatology and Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Shilin District, Taipei City, Taiwan, 111

Lee-Won Chong

School of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Rd, Xinzhuang District, New Taipei City, Taiwan, 242

Lee-Won Chong

Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, No. 701, Section 3, Zhongyang Rd, Hualien City, Hualien County, Taiwan, 970

Chien-Lin Chen

Department of Gastroenterology, Division of Internal Medicine, Show Chwan Memorial Hospital, No. 542, Section 1, Zhongshan Rd, Changhua City, Changhua County, Taiwan, 500

Chi-Chieh Yang

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Xitun District, Taichung City, Taiwan, 407

Sheng‐Shun Yang

Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, Dasyue Rd, East District, Tainan City, Taiwan, 701

Pin-Nan Cheng

Liver Center, Cathay General Hospital, No. 280, Section 4, Ren’ai Rd, Da’an District, Taipei City, Taiwan, 106

Jui-Ting Hu

Wen-Chih Wu Clinic, Fengshan, Kaohsiung, Taiwan, 830

Wen-Chih Wu

Division of Infectious Diseases, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, No. 1492, Zhongshan Rd, Taoyuan District, Taoyuan City, Taiwan, 330

Chien-Yu Cheng

Institute of Public Health, School of Medicine, National Yang-Ming Chiao Tung University, No. 155, Section 2, Linong St, Beitou District, Taipei City, Taiwan, 112

Chien-Yu Cheng

Penghu Hospital, Ministry of Health and Welfare, No. 10, Zhongzheng Rd, Magong City, Penghu County, Taiwan, 880

Guei-Ying Chen

Zhou Guoxiong Clinic, Penghu, Taiwan, 880

Guo-Xiong Zhou

Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd, Zuoying District, Kaohsiung City, Taiwan, 813

Wei-Lun Tsai

National Taiwan University Hospital Hsin-Chu Branch, No. 25, Lane 442, Section 1, Jingguo Rd, North District, Hsinchu City, Taiwan, 300

Chien-Neng Kao

Liver Research Unit, Department of Hepato-Gastroenterology and Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, College of Medicine, Chang Gung University, No. 222, Maijin Rd, Anle District, Keelung City, Taiwan, 204

Chih-Lang Lin

Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, No. 289, Jianguo Rd, Xindian District, New Taipei City, Taiwan, 231

Chia-Chi Wang

Cishan Hospital, Ministry of Health and Welfare, No. 60, Zhongxue Rd, Qishan District, Kaohsiung City, Taiwan, 842

Ta-Ya Lin

Department of Gastroenterology, Renai Branch, Taipei City Hospital, No. 10, Section 4, Ren’ai Rd, Da’an District, Taipei City, Taiwan, 106

Chih‐Lin Lin

Department of Gastroenterology and Hepatology, Changhua Christian Hospital, No. 176, Zhonghua Rd, Changhua City, Changhua County, Taiwan, 500

Wei-Wen Su

Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S Rd, Banqiao District, New Taipei City, Taiwan, 220

Tzong-Hsi Lee

Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan and College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd, Guishan District, Taoyuan City, Taiwan, 333

Te-Sheng Chang

Hepatitis Research Center and Department of Internal Medicine, National Taiwan University Hospital, No. 1, Section 4, Roosevelt Rd, Da’an District, Taipei City, Taiwan, 106

Chun-Jen Liu & Jia-Horng Kao

Division of Gastroenterology and Hepatology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, No. 539, Zhongxiao Rd, East District, Chiayi City, Taiwan, 600

Chi-Yi Chen

Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Rd, North District, Taichung City, Taiwan, 404

Cheng-Yuan Peng

School of Medicine, China Medical University, No. 91, Xueshi Rd, North District, Taichung City, Taiwan, 404

Cheng-Yuan Peng

MLY, CMT, LRM, HTK, CFH, WLC, and CYP contributed to study conception and design. All authors contributed to provision of study materials or patients and data acquisition. MLY, CMT, LRM, HTK, CFH, WLC, and CYP contributed to data analysis and interpretation. All authors contributed to drafting the work or revising it critically for important intellectual content. All authors approved the final version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors confirm that they had full access to all the data in the study and accept responsibility to submit for publication.