Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 9, 2021
Date Accepted: Oct 25, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The global, regional, and national burden and trends of NAFLD in 204 countries and territories: an analysis from Global Burden of Disease 2019
ABSTRACT
Background:
Nonalcoholic fatty liver disease (NAFLD) poses a substantial socioeconomic burden and is becoming the fastest-growing driver of chronic liver disease, potentially accompanied by a poor prognosis.
Objective:
To elucidate the global and regional epidemiologic changes in NAFLD during the past thirty years and explore the relevant causes.
Methods:
Data on NAFLD incidence, prevalence, death, and disability-adjusted life-years (DALYs) were extracted from the Global Burden of Disease Study 2019. In addition, we also investigated the correlation between the NAFLD burden and the social development degree. Finally, the associations of the three common comorbidities with NAFLD were determined.
Results:
Globally, the incidence and prevalence of NAFLD both increased drastically during the past three decades (incidence: from 88,180 in 1990 to 172,330 in 2019, prevalence: from 561,370,000 in 1990 to 1,235,700,000 in 2019), mainly affecting young adults. Meanwhile, the deaths and DALYs increased significantly as well (death: from 93,760 in 1990 to 168,970 in 2019, DALYs: from 2,711,270 in 1990 to 4,417,280 in 2019), dominating the aged group. However, the overall age-standardized death rate (ASDR) and DALY rate presented decreasing trends with values of estimated annual percentage change (EAPC) equaling to -0.67 and -0.82 respectively. Moreover, the sociodemographic index (SDI) appeared to have obvious negative associations with the age-standardized prevalence rate (ASPR), ASDR and age-standardized DALYs, indicating a more serious NAFLD burden in less developed regions. Finally, we found that the incidence and prevalence of NAFLD were positively related to those of diabetes mellitus type 2 (DM2), stroke and ischaemic heart disease (IHD).
Conclusions:
NAFLD is leading to increasingly serious health challenges worldwide. Comprehensive acquisition of the epidemiologic pattern for NAFLD and the identification of high-risk comorbidities may help policy-makers and clinical physicians develop cost-effective prevention and control strategies, especially in countries with a high NAFLD burden.
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