Changing epidemiology, global trends and implications for outcomes of NAFLD

Vincent Wai-Sun Wong; Mattias Ekstedt; Grace Lai-Hung Wong; Hannes Hagström

doi:10.1016/j.jhep.2023.04.036

Changing epidemiology, global trends and implications for outcomes of NAFLD

J Hepatol. 2023 Sep;79(3):842-852. doi: 10.1016/j.jhep.2023.04.036. Epub 2023 May 9.

Authors

Vincent Wai-Sun Wong¹, Mattias Ekstedt², Grace Lai-Hung Wong³, Hannes Hagström⁴

Affiliations

¹ Medical Data Analytics Center, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
² Department of Gastroenterology and Hepatology, Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.
³ Medical Data Analytics Center, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong. Electronic address: wonglaihung@cuhk.edu.hk.
⁴ Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden; Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden. Electronic address: hannes.hagstrom@ki.se.

PMID: 37169151
DOI: 10.1016/j.jhep.2023.04.036

Abstract

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.

Keywords: Epidemic; Metabolic syndrome; NASH; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Obesity; diabetes.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / epidemiology
Humans
Liver Cirrhosis / complications
Liver Neoplasms* / complications
Non-alcoholic Fatty Liver Disease* / complications