Recent Epidemiology of Nonalcoholic Fatty Liver Disease

Abstract

The ongoing obesity epidemic and the increasing recognition of metabolic syndrome have contributed to the growing prevalence of nonalcoholic fatty liver disease (NAFLD), the most common form of liver disease worldwide. It is imperative to understand the incidence and prevalence of NAFLD as it is associated with a profound economic burden of hospitalizations, including the shifting trends in liver transplantation. The long-term cumulative healthcare cost of NAFLD patients has been shown to be 80% higher than that of non-NAFLD patients. We explore diagnostic challenges in identifying those with NAFLD who have a higher predilection to progress to end-stage liver disease. We aim to assess all-cause and cause-specific mortality as it relates to NAFLD.

Keywords: Fatty liver; Mortality; Natural history; Nonalcoholic steatohepatitis; Prevalence.

Fig. 1

Estimated number of individuals in the US population affected by nonalcoholic fatty liver disease (NAFLD). All numbers are estimated by the current prevalence of NAFLD, nonalcoholic steatohepatitis (NASH), NASH cirrhosis.,,

Fig. 2

Recent literature summarizing risk factors for nonalcoholic fatty liver disease (NAFLD) progression.- NASH, nonalcoholic steatohepatitis; NAS, NAFLD activity score; INR, international normalized ratio; AST, aspartate aminotransferase; ALT, alanine transferase; FIB-4, fibrosis-4; NFS, NAFLD fibrosis score; APRI, AST to platelet ratio index; OR, odds ratio; CI, confidence interval.

Fig. 3

All-cause mortality of NAFLD patients with and without NASH by fibrosis stage. NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; RR, relative risk; CI, confidence interval.