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. 2024 Jun 24:9:33.
doi: 10.21037/tgh-23-118. eCollection 2024.

Global burden of adult non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has been steadily increasing over the past decades and is expected to persist in the future

Xuan Dong #  1   2   3 , Jing-Mao Li #  4 , Xiao-Ling Lu #  1   3   5 , Xiao-Yun Lin #  1   3   5 , Mei-Zhu Hong  6 , Shangeng Weng  7 , Jin-Shui Pan  1   2   3
Affiliations

Global burden of adult non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has been steadily increasing over the past decades and is expected to persist in the future

Xuan Dong et al. Transl Gastroenterol Hepatol. .

Abstract

Background: At present, there is a dearth of comprehensive data at the global, national, and regional levels regarding the adult non-alcoholic fatty liver disease (NAFLD) prevalence. This cross-sectional study aims at ascertaining the prevalence of NAFLD and non-alcoholic steatohepatitis (NASH), utilizing body mass index (BMI) as a determining factor.

Methods: Based on the NHANES database, sigmoidal fitting curves were generated to establish the relationship between BMI and the risk of NAFLD/NASH. Utilizing BMI data from the NCD Risk Factor Collaboration (NCD-RisC) database at both global and regional levels, the prevalence of NAFLD/NASH among adults was estimated from 1975 to 2016, encompassing global, regional, and national perspectives. Additionally, projections were made to forecast the prevalence of adult NAFLD/NASH from 2017 to 2030.

Results: In 2016, the global prevalence of NAFLD was 41.12% for males and 37.32% for females, while the global prevalence of NASH was 15.79% for males and 16.48% for females. The prevalence of NAFLD/NASH increased with higher BMI in both genders. Over the period from 1975 to 2016, there has been a gradual increase in the global prevalence of NAFLD/NASH in adults, and this trend is expected to continue between 2017 and 2030. In males, the prevalence of adult NAFLD/NASH was found to be highest in High-income Western countries, while it was highest in Central Asia, Middle East, and North African countries after 1995.

Conclusions: The prevalence of adult NAFLD/NASH has been observed to increase annually, with significant variations in burden across different countries and regions.

Keywords: Epidemiology; body mass index (BMI); model simulation; non-alcoholic fatty liver disease (NAFLD); non-alcoholic steatohepatitis (NASH).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-23-118/coif). M.Z.H. reports the funding from the Natural Science Foundation of Fujian Province of China (No. 2020J011218). J.S.P. reports the funding from the National Natural Science Foundation of China (No. 82372318), Natural Science Foundation of Fujian Province of China (No. 2022J02030), and Major Research Project for Young and Middle-aged People of the Health Commission of Fujian Province (No. 2022ZQNZD004). The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Displays the algorithm utilized in the present study. NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; BMI, body mass index.
Figure 2
Figure 2
The correlation between BMI and the risk of NAFLD/NASH. (A) Exhibits sigmoidal fitting curves that simulate the correlation between BMI and the risk of NAFLD in males. (B) Exhibits sigmoidal fitting curves that simulate the correlation between BMI and the risk of NAFLD in females. (C) Exhibits sigmoidal fitting curves that simulate the correlation between BMI and the risk of NASH in males. (D) Exhibits sigmoidal fitting curves that simulate the correlation between BMI and the risk of NASH in females. NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; BMI, body mass index.
Figure 3
Figure 3
The estimated global prevalence of NAFLD/NASH in adults from 1975 to 2030. (A) The estimated global prevalence of NAFLD in males is increasing. (B) The estimated global prevalence of NAFLD in females is increasing. (C) The estimated global prevalence of NASH in males is increasing. (D) The estimated global prevalence of NASH in females is increasing. NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis.
Figure 4
Figure 4
The estimated regional prevalence of NAFLD/NASH in adults from 1975 to 2030. (A) The estimated regional prevalence of NAFLD in males. (B) The estimated regional prevalence of NAFLD in females. (C) The estimated regional prevalence of NASH in males. (D) The estimated regional prevalence of NASH in females. NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis.
Figure 5
Figure 5
The estimated national or regional prevalence of adult NAFLD/NASH in 2016. (A) The estimated prevalence of adult NAFLD in males. (B) The estimated prevalence of adult NAFLD in females. (C) The estimated prevalence of adult NASH in males. (D) The estimated prevalence of adult NASH in females. NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis.
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