Arising from the accumulation of fat in the liver, NAFLD and its more severe form, non-alcoholic steatohepatitis (NASH), are responsible for a growing proportion of advanced liver disease and liver-related death worldwide. As a result of inflammation, NAFLD can lead to liver fibrosis, cirrhosis (advanced scarring) and even liver cancer. With no effective approved medical therapies, management is dependent on lifestyle change such as weight loss and exercise.
Kiarash Riazi, MD, of the University of Calgary in Canada, and colleagues set out to establish the prevalence of NAFLD using data on its worldwide trends. For their systematic review, the researchers searched the MEDLINE, EMBASE, Scopus and Web of Science databases for all reports published through May 25, 2021.
The researchers focused on observational cross-sectional or longitudinal studies in adult populations representative of the general public. Study participants had NAFLD diagnosed by imaging, without coexisting viral hepatitis or excessive alcohol consumption.
In order to estimate NAFLD prevalence (all existing cases), the team used 72 reports of studies that included a total of 1,030,160 individuals from 17 countries. To estimate NAFLD incidence (new cases), they used 16 reports that included 381,765 participants from five countries.
Globally, the prevalence of NAFLD was 32%. Moreover, the prevalence rose markedly from 26% through 2005 to 38% from 2016 onward. NAFLD prevalence was substantially higher in men (40%) compared with women (26%). The incidence of NAFLD was 46.9 cases per 1,000 person-years overall, with 70.8 cases among men and 29.6 cases among women.
“Worldwide prevalence of NAFLD is considerably higher than previously estimated and is continuing to increase at an alarming rate,” wrote the researchers. “Greater awareness of NAFLD and the development of cost-effective risk stratification strategies are warranted to address the growing burden of NAFLD.”
Click here to read the study abstract in The Lancet Gastroenterology & Hepatology.
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