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. 2023 Oct 2;7(10):e0251.
doi: 10.1097/HC9.0000000000000251. eCollection 2023 Oct 1.

The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019

James M Paik  1   2 , Linda Henry  1   2   3 , Youssef Younossi  3 , Janus Ong  3   4 , Saleh Alqahtani  3   5 , Zobair M Younossi  1   2   3   6
Affiliations

The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019

James M Paik et al. Hepatol Commun. .

Abstract

Background: The latest meta-analyses suggest NAFLD is increasing globally. Its limitations may preclude accurate estimates. We evaluated the global NAFLD burden and its' trends in prevalence and NAFLD liver-related mortality (LRM) by sex, age, region, and country over the past 3 decades using data from the Global Burden of Disease (GBD) 2019 study.

Methods: Crude and age-standardized NAFLD prevalence and NAFLD-LRM rates were obtained for all-age individuals with NAFLD from 204 countries/territories between 1990 and 2019. Joinpoint trend analysis assessed time trends. Weighted average of the annual percent change (APC) over the period 1990-2019 and 2010-2019 were reported.

Results: All-age (children and adults) crude global NAFLD prevalence increased:10.5% (561 million)-16.0% (1,236 million); an APC increase: + 1.47% (95% CI, 1.44%, 1.50%). Among adults (+20 y), crude NAFLD prevalence increased (1990: 17.6%, 2019:23.4%; APC: + 1.00%, 95% CI: 0.97%, 1.02%). In all-age groups, the crude NAFLD-LRM rate (per 100,000) increased (1990: 1.75%, 2019: 2.18%; APC: + 0.77% (95% CI, 0.70%, 0.84%). By Joinpoint analysis, from 2010 to 2019, worsening all-age trends in NAFLD prevalence and LRM were observed among 202 and 167 countries, respectively. In 2019, there were 1.24 billion NAFLD prevalent cases and 168,969 associated deaths; Asia regions accounted for 57.2% of all-age prevalent cases and 46.2% of all-age NAFLD-LRM. The highest all-age crude NAFLD prevalence rate was the Middle East and North Africa (LRM 26.5%); the highest all-age crude NAFLD-LRM rate was Central Latin America (5.90 per 100,000).

Conclusions: NAFLD is increasing globally in all-age groups-over 80% of countries experienced an increase in NAFLD and NAFLD-LRM. These data have important policy implications for affected countries and for global health.

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Conflict of interest statement

Zobair M. Younossi consulted and received grants from AbbVie, Bristol Myers Squibb, GENFIT, Gilead, Intercept, Madrigal, Merck, Novo Nordisk, Siemens, Terns, and Viking. The remaining authors have no conflicts to report.

Figures

None
Graphical abstract
FIGURE 1
FIGURE 1
All-age crude NAFLD Prevalence and NAFLD-related liver mortality rate in 2019 worldwide. (A) All-age crude NAFLD prevalence rate (%). (B) All-age crude NAFLD-liver mortality rate (per 100,000). Source Data: Global Burden of Disease 2019.
FIGURE 2
FIGURE 2
Trends in global NAFLD prevalence and NAFLD-liver mortality rate from 1990 to 2019. (A) Trends in all-age NAFLD prevalence rate (%). (B) Trends in all-age NAFLD-liver mortality rate. Source Data: Global Burden of Disease 2019.
FIGURE 3
FIGURE 3
Trends in all-age crude NAFLD prevalence and NAFLD-liver deaths from 2010 to 2019 worldwide. (A) Annual percent change (%) in all-age crude NAFLD prevalence rate. (B) Annual percent change (%) in all-age crude NAFLD-liver mortality rate. Source Data: Global Burden of Disease 2019.
FIGURE 4
FIGURE 4
Contribution of cirrhosis and liver cancer for NAFLD-related liver mortality by region, 2019. Source Data: Global Burden of Disease 2019.
FIGURE 5
FIGURE 5
Annual percent chance in age-standardized mortality of liver cancer and cirrhosis by each liver disease from 2010 to 2019. Source Data: Global Burden of Disease 2019.
See this image and copyright information in PMC

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