Global burden of metabolic dysfunction-associated steatotic liver disease, 2010 to 2021

Feng G 1 , Targher G 2 , Byrne CD 3 , Yilmaz Y 4 , Wai-Sun Wong V 5 , Adithya Lesmana CR 6 Show all authors , Adams LA 7 , Boursier J 8 , Papatheodoridis G 9 , El-Kassas M 10 , Méndez-Sánchez N 11 , Sookoian S 12 , Castera L 13 , Chan WK 14 , Ye F 15 , Treeprasertsuk S 16 , Cortez-Pinto H 17 , Yu HH 18 , Kim W 19 , Romero-Gómez M 20 , Nakajima A 21 , Win KM 22 , Kim SU 23 , Holleboom AG 24 , Sebastiani G 25 , Ocama P 26 , Ryan JD 27 , Lupșor-Platon M 28 , Ghazinyan H 29 , Al-Mahtab M 30 , Hamid S 31 , Perera N 32 , Alswat KA 33 , Pan Q 34 , Long MT 35 , Isakov V 36 , Mi M 1 , Arrese M 37 , Sanyal AJ 38 , Sarin SK 39 , Leite NC 40 , Valenti L 41 , Newsome PN 42 , Hagström H 43 , Petta S 44 , Yki-Järvinen H 45 , Schattenberg JM 46 , Castellanos Fernández MI 47 , Leclercq IA 48 , Aghayeva G 49 , Elzouki AN 50 , Tumi A 51 , Sharara AI 52 , Labidi A 53 , Sanai FM 54 , Matar K 55 , Al-Mattooq M 56 , Akroush MW 57 , Benazzouz M 58 , Debzi N 59 , Alkhatry M 60 , Barakat S 61 , Al-Busafi SA 62 , Rwegasha J 63 , Yang W 64 , Adwoa A 65 , Opio CK 66 , Sotoudeheian M 67 , Wong YJ 68 , George J 69 , Zheng MH 70

Affiliations 

  • 1 Xi'an Medical University, Xi'an, China
  • 2 Department of Medicine, University of Verona, Verona, Italy
  • 3 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton and University of Southampton, Southampton General Hospital, Southampton, UK
  • 4 Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
  • 5 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
  • 6 Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia
  • 7 Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
  • 8 HIFIH Laboratory, UPRES EA3859, Angers University, Angers, France
  • 9 Department of Gastroenterology, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens, Athens, Greece
  • 10 Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
  • 11 Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
  • 12 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
  • 13 Université Paris Cité, UMR1149 (CRI), INSERM, Paris, France, Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France
  • 14 Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 15 The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
  • 16 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 17 Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
  • 18 Department of Gastroenterology and Hepatology, Kiang Wu Hospital, Macau, China
  • 19 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 20 UCM Digestive Diseases, University Hospital Virgen del Rocio, Institute of Biomedicine of Seville (CSIC/HUVR/US), Ciberehd, University of Seville, Sevilla, Spain
  • 21 Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
  • 22 Department of Medical Research, Union of Myanmar, Naypyidaw, Myanmar
  • 23 Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
  • 24 Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
  • 25 Division of Gastroenterology and Hepatology, Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada
  • 26 Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
  • 27 Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
  • 28 Department of Medical Imaging, "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
  • 29 Gastroenterology and Hepatology Service, Yerevan Scientific Medical Center, Yerevan, Armenia
  • 30 Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 31 Department of Medicine, Aga Khan University, Karachi, Pakistan
  • 32 Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
  • 33 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 34 Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
  • 35 Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
  • 36 Department of Gastroenterology and Hepatology, Federal Research Center for Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
  • 37 Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
  • 38 Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, VCU School of Medicine, Richmond, VA, USA
  • 39 Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
  • 40 Division of Hepatology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
  • 41 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
  • 42 Institute of Hepatology, Faculty of Life Sciences and Medicine, King's College London and King's College Hospital, London, UK
  • 43 Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
  • 44 Sezione di Gastroenterologia, PROMISE, University of Palermo, Palermo, Italy
  • 45 Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
  • 46 Department of Internal Medicine II, Saarland University Medical Center, Homburg, Germany
  • 47 Institute of Gastroenterology, University of Medical Sciences of Havana, Havana, Cuba
  • 48 UCLouvain, Université catholique de Louvain, Institute of Experimental and Clinical Research, Laboratory of Hepato-Gastroenterology, Brussels, Belgium
  • 49 Internal Diseases Department, Baku branch, Sechenov Medical University, Baku, Azerbaijan
  • 50 Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
  • 51 Department of Medicine, Tripoli University, Tripoli, Libya
  • 52 Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  • 53 Department of Gastroenterology and Hepatology, Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
  • 54 Gastroenterology Section, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
  • 55 Gastroenterology Department, European Gaza Hospital, Gaza, Palestine
  • 56 Department of Gastroenterology and Hepatology, Jaber AlAhmad & Farwaniya Hospital, Al Ahmadi, Kuwait
  • 57 Department of Gastroenterology and Hepatology, the Mediterranean Taskforce for Cancer Control (MTCC), Amman, Jordan
  • 58 Service of Medicine C, Centre Hospitalier Universaitaire Ibn Sina, Rabat, Morocco
  • 59 Service d'Hépatologie, CHU Mustapha Bacha, Alger, Algeria
  • 60 Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, Emirates Health Services, Ministry of Health, Ras Al Khaimah, UAE
  • 61 National Center for Gastrointestinal and Liver Diseases, Ibn Sina Hospital, Ministry of Health, Khartoum, Sudan
  • 62 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  • 63 Department of Hepatology and Gastroenterology, Muhimbili National Hospital, Dar es Salaam, Tanzania
  • 64 Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 65 Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
  • 66 Department of Medicine, Aga Khan University, Nairobi, Kenya
  • 67 Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
  • 68 Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore, Singapore
  • 69 Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
  • 70 MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
JHEP Rep, 2025 Mar;7(3):101271.
PMID: 39980749 DOI: 10.1016/j.jhepr.2024.101271

Abstract

BACKGROUND & AIMS: This study used the Global Burden of Disease data (2010-2021) to analyze the rates and trends of point prevalence, annual incidence, and years lived with disability (YLDs) for metabolic dysfunction-associated steatotic liver disease (MASLD) in 204 countries.

METHODS: Total numbers and age-standardized rates per 100,000 population for MASLD prevalence, annual incidence, and YLDs were compared across regions and countries by age, sex, and sociodemographic index (SDI). Smoothing spline models were used to evaluate the relationship between the burden of MASLD and SDI. Estimates were reported with uncertainty intervals (UI).

RESULTS: Globally, in 2021, the age-standardized rates per 100,000 population of point prevalence of MASLD were 15,018.1 cases (95% UI 13,756.5-16,361.4), annual incidence rates were 608.5 cases (598.8-617.7), and YLDs were 0.5 (0.3-0.8) years. MASLD point prevalence was higher in men than women (15,731.4 vs. 14,310.6 cases per 100,000 population). Prevalence peaked at ages 45-49 for men and 50-54 for women. Kuwait (32,312.2 cases per 100,000 people; 95% UI: 29,947.1-34,839.0), Egypt (31,668.8 cases per 100,000 people; 95% UI: 29,272.5-34,224.7), and Qatar (31,327.5 cases per 100,000 people; 95% UI: 29,078.5-33,790.9) had the highest prevalence rates in 2021. The largest increases in age-standardized point prevalence estimates from 2010 to 2021 were in China (16.9%, 95% UI 14.7%-18.9%), Sudan (13.3%, 95% UI 9.8%-16.7%) and India (13.2%, 95% UI 12.0%-14.4%). MASLD incidence varied with SDI, peaking at moderate SDI levels.

CONCLUSIONS: MASLD is a global health concern, with the highest prevalence reported in Kuwait, Egypt, and Qatar. Raising awareness about risk factors and prevention is essential in every country, especially in China, Sudan and India, where disease incidence and prevalence are rapidly increasing.

IMPACT AND IMPLICATIONS: This research provides a comprehensive analysis of the global burden of MASLD, highlighting its rising prevalence and incidence, particularly in countries with varying sociodemographic indices. The findings are significant for both clinicians and policymakers, as they offer critical insights into the regional disparities in MASLD burden, which can inform targeted prevention and intervention strategies. However, the study's reliance on modeling and available data suggests cautious interpretation, and further research is needed to validate these findings in clinical and real-world settings.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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