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Meta-Analysis
. 2024 Mar 6;22(1):101.
doi: 10.1186/s12916-024-03315-0.

Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis

Limin Cao #  1 , Yu An #  2 , Huiyuan Liu  3   4 , Jinguo Jiang  3   4 , Wenqi Liu  3   4 , Yuhan Zhou  3   4 , Mengyuan Shi  3   4 , Wei Dai  3   4 , Yanling Lv  5 , Yuhong Zhao  3   4 , Yanhui Lu  6 , Liangkai Chen  7 , Yang Xia  8   9
Affiliations
Meta-Analysis

Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis

Limin Cao et al. BMC Med. .

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD) shares common pathophysiological mechanisms with type 2 diabetes, making them significant risk factors for type 2 diabetes. The present study aimed to assess the epidemiological feature of type 2 diabetes in patients with NAFLD or MAFLD at global levels.

Methods: Published studies were searched for terms that included type 2 diabetes, and NAFLD or MAFLD using PubMed, EMBASE, MEDLINE, and Web of Science databases from their inception to December 2022. The pooled global and regional prevalence and incidence density of type 2 diabetes in patients with NAFLD or MAFLD were evaluated using random-effects meta-analysis. Potential sources of heterogeneity were investigated using stratified meta-analysis and meta-regression.

Results: A total of 395 studies (6,878,568 participants with NAFLD; 1,172,637 participants with MAFLD) from 40 countries or areas were included in the meta-analysis. The pooled prevalence of type 2 diabetes among NAFLD or MAFLD patients was 28.3% (95% confidence interval 25.2-31.6%) and 26.2% (23.9-28.6%) globally. The incidence density of type 2 diabetes in NAFLD or MAFLD patients was 24.6 per 1000-person year (20.7 to 29.2) and 26.9 per 1000-person year (7.3 to 44.4), respectively.

Conclusions: The present study describes the global prevalence and incidence of type 2 diabetes in patients with NAFLD or MAFLD. The study findings serve as a valuable resource to assess the global clinical and economic impact of type 2 diabetes in patients with NAFLD or MAFLD.

Keywords: Incidence density; Metabolic-associated fatty liver disease; Non-alcoholic fatty liver disease; Prevalence; Type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The prevalence of type 2 diabetes among patients with NAFLD—stratified by age, region, publication year, sample size, and diagnosis of NAFLD. Mixed diagnostic methods refer to the definition of NAFLD in a study using more than one diagnostic method
Fig. 2
Fig. 2
The prevalence of type 2 diabetes among patients with NAFLD across 40 countries
Fig. 3
Fig. 3
The incidence density of type 2 diabetes among patients with NAFLD—stratified by age, region, publication year, sample size, and diagnosis of NAFLD. Mixed diagnostic methods refer to the definition of NAFLD in a study using more than one diagnostic method
Fig. 4
Fig. 4
The incidence density of type 2 diabetes among patients with NAFLD across 8 countries
See this image and copyright information in PMC

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