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Observational Study
. 2020 Aug 3;10(8):e036663.
doi: 10.1136/bmjopen-2019-036663.

Prevalence trends in non-alcoholic fatty liver disease at the global, regional and national levels, 1990-2017: a population-based observational study

Xiaojun Ge #  1 , Limei Zheng #  2 , Mei Wang  2 , Yuxuan Du  2 , Junyao Jiang  2
Affiliations
Observational Study

Prevalence trends in non-alcoholic fatty liver disease at the global, regional and national levels, 1990-2017: a population-based observational study

Xiaojun Ge et al. BMJ Open. .

Abstract

Objective: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of end-stage liver diseases worldwide. Understanding NAFLD prevalence and trends over time at the global, regional and national levels is critical to understanding the NAFLD disease burden and creating more tailored prevention strategies.

Design: Population-based observational study.

Setting: The study was global, including 21 regions and 195 countries or territories.

Main outcomes measure: The estimated annual percentage change for NAFLD prevalence.

Results: Worldwide, cases of NAFLD have increased from 391.2 million in 1990 to 882.1 million in 2017, with the prevalence rate increasing from 8.2% to 10.9% during the same period. The increasing trends were consistent across sexes. Case numbers were highest in East Asia, followed by South Asia, then North Africa and the Middle East. The highest prevalence of NAFLD was observed in North Africa and the Middle East, while the greatest increase was detected in Western Europe, followed by Tropical Latin America, then high-income North America.

Conclusion: Nearly all countries or territories worldwide have experienced a significant increase in NAFLD prevalence. The greatest increase was observed in Oman. Almost all countries showed a significant increasing trend in NAFLD prevalence over the past three decades. This drastic increase is alarming and suggests that NAFLD has emerged as a new public health concern worldwide. As such, more efficient prevention strategies are urgently needed.

Keywords: adult gastroenterology; epidemiology; hepatobiliary disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Changing trends in case numbers for non-alcoholic fatty liver disease between 1990 and 2017, by sex and SDI. SDI, Sociodemographic Index.
Figure 2
Figure 2
Temporal trends in the prevalence of non-alcoholic fatty liver disease between 1990 and 2017, by sex and SDI. SDI, Sociodemographic Index.
Figure 3
Figure 3
Prevalence trends in non-alcoholic fatty liver disease at the Global Burden of Disease regional level. The error bar denotes a 95% CI. EAPCs, estimated annual percentage changes.
Figure 4
Figure 4
Age-standardised prevalence rates (A), case numbers (B) and trends (C) in non-alcoholic fatty liver disease between 1990 and 2017 at the national level. EAPC, estimated annual percentage change.
Figure 5
Figure 5
Association of prevalence trends in non-alcoholic fatty liver disease (NAFLD), quantified by estimated annual percentage changes (EAPCs), with Human Development Index (HDI) (A), trends in overweight prevalence (B) and trends in diabetes prevalence (C) at the national level. The correlation coefficient was derived from a Pearson correlation test.
See this image and copyright information in PMC

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