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. We aim 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 from 1990 to 2019, mainly affecting young adults. Meanwhile, the deaths and DALYs increased significantly as well, dominating the aged group. However, the overall age-standardized death rate (ASDR) and DALY rate presented decreasing trends. 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.