Changing epidemiology, global trends and implications for outcomes of NAFLD
Open accessAbstract
Non-alcoholic fatty liver disease (NAFLD) has rapidly become the most common liver disease globally and is currently estimated to affect 38% of the global population. Only a minority of patients with NAFLD will progress to cirrhosis or hepatocellular carcinoma, but from this vast population the total number of patients who are at risk of such severe outcomes is increasing. Worryingly, individuals are increasingly being affected by NAFLD at an earlier age, meaning there is more time for them to develop severe complications. With considerable changes in dietary composition and urbanisation, alongside the growth in obesity and type 2 diabetes in the global population, in particular in developing countries, the global proportion of persons affected by NAFLD is projected to increase further. Yet, there are large geographical discrepancies in the prevalence rates of NAFLD and its inflammatory component non-alcoholic steatohepatitis (NASH). Such differences are partly related to differing socio-economic milieus, but also to genetic predisposition. In this narrative review, we discuss recent changes in the epidemiology of NAFLD and NASH from regional and global perspectives, as well as in special populations. We also discuss the potential consequences of these changes on hepatic and extrahepatic events.
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The natural history of MASLD is relatively well-defined, though there is substantial individual variability in disease trajectories.
“The natural history of MASLD is relatively well-de fi ned, though there is substantial individual variability in disease trajectories.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [119]
MASLD is highly prevalent, but the absolute risk of liver-related events from MASLD in the general population is very low.
“While there is no doubt that MASLD is highly prevalent, 119 the absolute risk of liver-related events from MASLD in the general population is very low.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [119]
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Self-citation
- Authors
- Wong, V. W.-S., Ekstedt, M., Wong, G. L.-H., & Hagström, H.
- Affiliations
- Chinese University of Hong Kong (HK)
- Linköping University (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Ekstedt, Mattias
- Wong, Grace Lai-Hung
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2023-09
- Volume
- 79
- Issue
- 3
- Pages
- 842-852
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W4376224284
- Cited by
- 765
- References
- 123
- Citations by year
- 2026: 237 · 2025: 317 · 2024: 183 · 2023: 28
- FWCI
- 29.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Hepatology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA (Linkoping University) (submittedVersion, cc-by)
- Funders
- Vetenskapsrådet (2021-01293)
- Chinese University of Hong Kong (2021.027)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, global prevalence, liver cirrhosis, hepatocellular carcinoma, obesity, type 2 diabetes, urbanization, diet composition, genetic susceptibility, socioeconomic factors
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Liver Cirrhosis, Liver Neoplasms, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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