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. 2025 Jul 3.
doi: 10.1002/ueg2.70072. Online ahead of print.

The Rising Global Burden of MASLD and Other Metabolic Diseases (2000-2021)

Pojsakorn Danpanichkul  1 , Kanokphong Suparan  2 , Luis Antonio Diaz  3   4   5 , Michael B Fallon  6   7 , Vincent L Chen  8 , Kornnatthanai Namsathimaphorn  9 , Krittameth Rakwong  9 , Torlap Inkongngam  9 , Chuthathip Kaeosri  9 , Markos Kalligeros  10 , Phuuwadith Wattanachayakul  11 , Cheng Han Ng  12 , Hirokazu Takahashi  13 , Daniel Q Huang  14 , Mark D Muthiah  14 , Juan Pablo Arab  4   5   15 , Donghee Kim  16 , Trenton M White  17   18 , Mazen Noureddin  19 , Elisabetta Bugianesi  20 , Peter Jepsen  21   22 , Vincent W S Wong  23   24 , Jeffrey V Lazarus  17   18   25 , Karn Wijarnpreecha  6   7   26
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Free article

The Rising Global Burden of MASLD and Other Metabolic Diseases (2000-2021)

Pojsakorn Danpanichkul et al. United European Gastroenterol J. .
Free article

Abstract

Background: Metabolic diseases are a public health threat to diverse populations worldwide. This study aims to update the epidemiological trends of metabolic diseases across regions and sociodemographic stratifications using the Global Burden of Diseases Study 2021.

Methods: This study focused on metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) along with obesity, hypertension, and dyslipidemia. The prevalence and disability-adjusted life years (DALYs) with their age-standardised prevalence rate and DALYs (ASPR and ASDALYs) and uncertainty intervals (UIs) were estimated and stratified by sex, geography, and the Sociodemographic Index (SDI). Epidemiological trends were analysed using the Joinpoint Regression method, which calculated the annual percent change (APC) and confidence intervals (CIs) of age-standardised rates (ASRs) from 2000 to 2021.

Results: In 2021, MASLD had a prevalence of 1.27 billion people (ASPR: 15,018.07, 95% UI: 13,756.47 to 16,361.44; ASDALYs: 42.40, 95% UI: 33.60 to 53.31), while T2DM had a prevalence of 0.51 billion people (ASPR: 5885.40, 95% UI: 5467.62 to 6334.18; ASDALYs: 871.78, 95% UI: 735.05 to 1044.78) worldwide. ASPRs of MASLD and T2DM increased over the 2 decades. ASDALYs decreased over time for dyslipidemia (APC: -1.43%, 95% CI: -1.58 to -1.27%) and hypertension (APC: -1.32%, 95% CI: -1.43 to -1.21%) but increased for T2DM (APC: 1.09%, 95% CI: 1.04 to 1.14%) and obesity (APC: 0.70%, 95% CI: 0.63 to 0.78%), while it remained stable for MASLD. The global burden of metabolic diseases was generally higher in males compared to females. The highest ASDALYs for all these metabolic diseases were observed in low-middle SDI countries.

Conclusion: The global burden of MASLD and other metabolic diseases is substantial. National and global policies must better address metabolic diseases including the MASLD public health threat.

Keywords: MASH; MASLD; dyslipidemia; epidemiology; global health; hypertension; liver disease; non‐alcoholic fatty liver disease (NAFLD); obesity; type 2 diabetes.

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