Materiały źródłowe

• #1 The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36626630/

  NAFLD is a leading cause of liver-related morbidity and mortality. We assessed the global and regional prevalence, incidence, and mortality of NAFLD using an in-depth meta-analytic approach. […] Across the study period (1990-2019), meta-analytic pooling of NAFLD prevalence estimates and ultrasound-defined NAFLD yielded an overall global prevalence of 30.05% (95% CI: 27.88%-32.32%) and 30.69% (28.4-33.09), respectively. Global NAFLD prevalence increased by +50.4% from 25.26% (21.59-29.33) in 1990-2006 to 38.00% (33.71-42.49) in 2016-2019 ( p 0.001); ultrasound-defined NAFLD prevalence increased by +38.7% from 25.16% (19.46-31.87) in 1990-2006 to 34.59% (29.05-40.57) ( p =0.029). The highest NAFLD prevalence was in Latin America 44.37% (30.66%-59.00%), then Middle East and North Africa (MENA) (36.53%, 28.63%-45.22%), South Asia (33.83%, 22.91%-46.79%), South-East Asia (33.07%, 18.99%-51.03%), North America (31.20%, 25.86%-37.08%), East Asia (29.71%, 25.96%-33.76%), Asia Pacific 28.02% (24.69%-31.60%), Western Europe 25.10% (20.55%-30.28%). […] NAFLD global prevalence is 30% and increasing which requires urgent and comprehensive strategies to raise awareness and address all aspects of NAFLD on local, regional, and global levels.

• #2 Global incidence and prevalence of nonalcoholic fatty liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10029957/

  Nonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease worldwide. The estimated global incidence of NAFLD is 47 cases per 1,000 population and is higher among males than females. The estimated global prevalence of NAFLD among adults is 32% and is higher among males (40%) compared to females (26%). The global prevalence of NAFLD has increased over time, from 26% in studies from 2005 or earlier to 38% in studies from 2016 or beyond. The prevalence of NAFLD varies substantially by world region, contributed by differing rates of obesity, and genetic and socioeconomic factors. The prevalence of NAFLD exceeds 40% in the Americas and South-East Asia. The prevalence of NAFLD is projected to increase significantly in multiple world regions by 2030 if current trends are left unchecked.

• #3

  https://journals.lww.com/hep/fulltext/2023/04000/the_global_epidemiology_of_nonalcoholic_fatty.27.aspx

  NAFLD is a leading cause of liver-related morbidity and mortality. We assessed the global and regional prevalence, incidence, and mortality of NAFLD using an in-depth meta-analytic approach. […] Global NAFLD prevalence increased by +50.4% from 25.26% (21.59-29.33) in 1990-2006 to 38.00% (33.71-42.49) in 2016-2019 (p<0.001); ultrasound-defined NAFLD prevalence increased by +38.7% from 25.16% (19.46-31.87) in 1990-2006 to 34.59% (29.05-40.57) (p=0.029). [...] NAFLD global prevalence is 30% and increasing which requires urgent and comprehensive strategies to raise awareness and address all aspects of NAFLD on local, regional, and global levels. [...] The most recent data from the United States United Network of Organ Sharing (UNOS) indicates that currently NAFLD is the second indication for all liver transplants and is rapidly becoming the top indication for liver transplant among those who are listed for hepatocellular carcinoma.

• #4

  https://journals.lww.com/hep/fulltext/2023/04000/the_global_epidemiology_of_nonalcoholic_fatty.27.aspx

  Recent data from the GBD related to mortality and disability adjusted years suggest that the burden of NAFLD is experienced across the globe and this burden is rapidly increasing. […] Our estimates suggest a +58.0% increase in the incidence of NAFLD from 1994-2006 to 2010-2014. […] Our data showed that pooled mortality rate for NAFLD was 12.60 per 1000 PY for all-cause mortality, 4.20 per 1000 PY for cardiac-specific mortality, 2.83 per 1000 PY for extrahepatic cancer-specific mortality, and 0.92 per 1000 PY for liver-specific mortality. […] Our additional analysis also showed that the global pooled prevalence of NAFLD had increased by +50.4% from 25.26% (21.59-29.33) in 1990-2006 to 38.2% (33.72-42.89) in 2016-2019 (pairwise p<0.001). [...] Our data shows that about one-third of the world population has NAFLD. These rates have increased from 25% to 38% over the past 3 decades.

• #5 The Epidemiology, Risk Profiling and Diagnostic Challenges of Nonalcoholic Fatty Liver Disease

  https://www.mdpi.com/2305-6320/6/1/41

  Nonalcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of liver damage from the more prevalent (75%–80%) and nonprogressive nonalcoholic fatty liver (NAFL) category to its less common and more ominous subset, nonalcoholic steatohepatitis (NASH). NAFLD is now the most common cause of chronic liver disease in the developed world and is a leading indication for liver transplantation in United States (US). The global prevalence of NAFLD is estimated to be 25%, with the lowest prevalence in Africa (13.5%) and highest in the Middle East (31.8%) and South America (30.4%). The increasing incidence of NAFLD has been associated with the global obesity epidemic and manifestation of metabolic complications, including hypertension, diabetes, and dyslipidemia. […] The worldwide increase in the prevalence of well-established risk factors for NAFLD, such as diabetes, obesity, and age, has had an accompanying increase in the prevalence of NAFLD. The global prevalence of NAFLD is estimated to be around 25%. In a recent meta-analysis, NAFLD was found to be most prevalent in the Middle East (31.8%), followed by South America (30.4%). NAFLD was also found to be least prevalent in Africa (13.5%).

• #6 Global incidence and prevalence of nonalcoholic fatty liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10029957/

  A meta-analysis comprising 19 studies (5,626 individuals) by Rojas et al. estimated the prevalence of NAFLD in South America at up to 59%. […] There is a paucity of data from Africa on the epidemiology of NAFLD. A meta-analysis estimated the prevalence of NAFLD in Africa at 13.5%, ranging from 9% in Nigeria to 20% in Sudan. […] Likewise, there is scarce data from Oceania on the incidence and prevalence of NAFLD. Population-based studies using fatty liver index have demonstrated NAFLD prevalence of 35.738% in Australia. […] Based on mathematical modeling studies, the burden of NAFLD and NASH will continue to increase over the next 10 years worldwide. The global prevalence of NAFLD is forecasted to reach 55.4% by 2040. […] In summary, the global burden of NAFLD is substantial and is projected to increase. It is important to maintain and increase data collection from all world regions to improve the understanding of the burden of disease associated with NAFLD and NASH worldwide.

• #7 Epidemiology and natural history of non-alcoholic fatty liver disease (NAFLD) | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-epidemiology-natural-history-non-alcoholic-fatty-S1665268119318204

  Epidemiology and natural history of non-alcoholic fatty liver disease (NAFLD) […] The authors summarize and update the most recent knowledge in the field of prevalence, natural history and incidence of Non Alcoholic Fatty Liver Disease (NAFLD) and Non Alcoholic Steatohepatitis (NASH). […] NAFLD is now the most common liver disease in the United States and possibly worldwide. Furthermore, the number of affected patients is growing rapidly, and the disease has reached epidemic proportions. […] NAFLD has also reached epidemic proportions among populations typically considered at low risk for this liver condition, with a prevalence in China and Japan of 15 and 14%, respectively, among adults. […] The prevalence of NAFLD among children is unknown, but some data indicate that 2.6-9.6% of children have NAFLD, increasing up to 38-53% among obese children.

• #8 Global incidence and prevalence of nonalcoholic fatty liver disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10029957/

  A recent meta-analysis by Riazi et al. estimated the incidence of NAFLD at 46.9 cases per 1,000 person-years. The incidence of NAFLD was higher in males (70.8 cases per 1,000 person-years) vs. females (26.9 cases per 1,000 person-years, P0.0001). However, all included studies were conducted in Asia, hence it is unclear whether these data are generalizable to other parts of the world. […] Riazi et al. pooled data from 72 studies (1,030,160 individuals) and estimated that the global prevalence of NAFLD in adults was 32% (Table 2). The prevalence was higher in males than females (40% vs. 26%, P0.0001). The prevalence of NAFLD increased from 26% in studies from 2005 or earlier to 38% in studies from 2016 or beyond. However, data from this study by Riazi et al. requires cautious interpretation, as data were available from only 17 countries, hence it is unclear if the estimates from this study are a true reflection of global prevalence.

• #9 Clinical epidemiology and disease burden of nonalcoholic fatty liver disease

  https://www.wjgnet.com/1007-9327/full/v23/i47/8263.htm

  Nonalcoholic fatty liver disease (NAFLD) has become a common cause of chronic liver disease in the world since its first description in 1980 as the unnamed disease. It is currently estimated that the global prevalence of NAFLD is as high as one billion. In the United States, NAFLD is estimated to be the most common cause of chronic liver disease, affecting between 80 and 100 million individuals, among whom nearly 25% progress to NASH. A study from Japan which followed 3147 patients over 414 d found a 10% annual incidence rate. Another Japanese study evaluated elevated aminotransferase levels, weight gain and insulin resistance development over 5 years to classify patients with NAFLD and their incidence was reported as 31 per 1000 person-years. A recent extensive meta-analysis described a pooled regional incidence of NAFLD in Asia and Israel to be 52 per 1000 person-years and 28 per 1000 person-years, respectively. In general, the prevalence of NAFLD has increased over the last 20 years. The difference in sensitivity of diagnostic modalities may account for the discrepancy in prevalence data for NAFLD. Prevalence of ultrasonographic diagnosis of NAFLD ranged between 17% in India to 46% in the United States. The Middle East and South America have the highest NAFLD prevalence at 31% and 32% respectively with the lowest prevalence in Africa at 13.5%. Recently, Asia has been facing the highest obesity epidemic and thus not surprisingly has been experiencing a rapid rate of increase in the prevalence of NAFLD. A recent United States-based study using the National Health and Nutrition Examination Surveys (NHANES) conducted between 1988 and 2008 found that the prevalence of NAFLD using elevated alanine aminotransferese (ALT) doubled in the United States during this time period (5.5% to 11.0%). Meta-regression of studies done globally also displayed an increased prevalence of NAFLD from 15% in 2005 to 25% in 2010. The current annual medical and societal costs of NAFLD are estimated at $292 billion in the United States. The projected cost of caring for patients is expected to increase by 18% from 2000 to 2035 and health-related quality of life of NAFLD patients is described as declining.

• #10 Recent Epidemiology of Nonalcoholic Fatty Liver Disease

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl20127

  Based on the United States (US) Third National Health and Nutrition Examination Survey (NHANES III), an extensive representative survey of the US civilian population, the prevalence of NAFLD by ultrasonography is estimated to be 34.0% in the US. […] According to numerous studies which combined liver biopsy, noninvasive radiologic modalities as well as liver enzymes, 3% to 5% of NAFLD can progress to NASH with advanced fibrosis or cirrhosis, which is 1.25% of all population. […] A recent study using the Markov prediction model reported that NAFLD is projected to increase by 21% from 83 million in 2015 to 101 million in 2030. […] NASH is forecasted to grow 63% from 17 million in 2015 to 27 million in 2030. […] The burden of NAFLD on healthcare costs and resource utilization remains significant nowadays.

• #11 Recent Epidemiology and Risk Factors of Nonalcoholic Fatty Liver Disease

  https://www.jomes.org/journal/view.html?doi=10.7570/jomes22021

  Because of the global obesity epidemic, the incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) have increased worldwide, including among Koreans. Recently, the incidence rate of NAFLD in Korea was reported to be 45.1 per 1,000 person-years, and the prevalence as approximately 30% depending on the diagnostic methods used. […] The global epidemics of obesity and type 2 diabetes have led to a dramatic increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) both in Korea and worldwide. Recently, NAFLD has been reported to afflict more than 25% of the general population worldwide, and the prevalence has been estimated to be up to 30% in Korea. […] The incidence of NAFLD shows an increasing trend worldwide. According to a cohort study in the United States, the age- and sex-adjusted incidence of NAFLD increased from 62 per 100,000 person-years in 1997 to 329 per 100,000 person-years in 2014.

• #12 Recent Epidemiology of Nonalcoholic Fatty Liver Disease

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl20127

  There are scattered and limited data regarding the incidence of NAFLD in the general population. […] A meta-analysis published in 2016 showed that the pooled regional incidence rate estimates for Israel and Asia were 28.0 per 1,000 person-years (95% confidence interval [CI], 19.3 to 40.6) and 52.3 per 1,000 person-years (95% CI, 28.3 to 96.8) and respectively. […] A recent meta-analysis in Asia during 1999 to 2019, described the overall pooled incidence rate was 50.9 per 1,000 person-years (95% CI, 44.8 to 57.4). […] The true prevalence of NAFLD is hard to measure accurately due to the lack of consistent diagnostic criteria. […] A systemic review and meta-analysis on the global epidemiology of NAFLD estimated prevalence of NAFLD by imaging to be 25.2% (95% CI, 22.1 to 28.7) with an estimated prevalence of NASH to be lower ranging from 3 to 5%.

• #13 Epidemiology of fatty liver: An update

  https://www.wjgnet.com/1007-9327/full/v20/i27/9050.htm

  We provide a concise review of the main epidemiological literature on fatty liver (FL) published between January 2011 and October 2013. The findings from the literature will be considered in light of the already available knowledge. […] FL is the most common liver disease in Western countries, and NAFLD is the most common reason for altered liver enzymes in primary care. […] Systematic reviews estimate that about 20%-30% of individuals in Western countries have NAFLD and similar figures are being increasingly provided for Eastern countries. The prevalence of NAFLD increases with age, is highest in males between 40 and 65 years and is higher in Hispanics and lower in African-Americans. The prevalence of NAFLD is increasing rapidly among children in parallel with the current epidemic of obesity.

• #14 Epidemiology of non alcoholic fatty liver disease (NAFLD) – GPnotebook

  https://gpnotebook.com/pages/general-information/non-alcoholic-steatosis/epidemiology-of-non-alcoholic-fatty-liver-disease-nafld

  With the rapid rise in sedentary life style, metabolic syndrome and obesity, prevalence of NAFLD amongst the general population has increased considerably. […] worldwide prevalence of NAFLD is thought to be 20% in the general population and up to 70% in patients with type 2 diabetes mellitus. […] the community-based Framingham heart study population has reported a prevalence of 17% (19% in men and 15% in women) with the prevalence approaching 90% in patients considering bariatric surgery. […] NAFLD is the most common cause of chronically elevated LFTs in the United States in both diabetic and nondiabetic individuals. […] with respect to patients with NAFLD, 60-95% are obese, 28-55% have type 2 diabetes, and 20-92% have hyperlipidemia. […] Prevalence of NAFLD increases with age. […] is higher in men than in women.

• #15 Epidemiology of non alcoholic fatty liver disease (NAFLD) – GPnotebook

  https://gpnotebook.com/pages/general-information/non-alcoholic-steatosis/epidemiology-of-non-alcoholic-fatty-liver-disease-nafld

  in a study of 26,527 subjects undergoing medical checkups, the prevalence of NAFLD was 31% in men and 16% in women. […] in hispanic individuals is significantly higher and in non-hispanic blacks is significantly lower when compared to non-hispanic whites. […] patients with severe obesity undergoing bariatric surgery, the prevalence of NAFLD can exceed 90%. […] up to 5% of patients may have unsuspected cirrhosis. […] ultrasonographic studies have reported a 69% prevalence of NAFLD in type 2 diabetes patients. […] the prevalence of NAFLD was estimated to be 50% in patients attending lipid clinics.

• #16 Epidemiology of non-alcoholic fatty liver disease and risk of hepatocellular carcinoma progression

  https://www.termedia.pl/Epidemiology-of-non-alcoholic-fatty-liver-disease-and-risk-of-hepatocellular-carcinoma-progression,80,42838,0,1.html

  Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. Its incidence has grown alongside the increasing global prevalence of type 2 diabetes, obesity, and metabolic syndrome. […] The risk of progression to hepatocellular carcinoma for nonalcoholic steatohepatitis patients over 5 years is 8%, and despite targeted and immunotherapy treatment advances, HCC maintains a bleak 5-year survival of 19%. […] NAFLD’s primary risk factors are components of metabolic syndrome as well as possible sleep disturbances. […] NAFLD is most common among men 50-60 years of age, though incidence in women catches up after menopause. […] In the US, Hispanics are most likely to develop NAFLD and African Americans least likely, in part due to the prevalence of the PNPLA3 gene variant. […] With NAFLD risk factors especially prevalent in underserved populations and developing nations, public health interventions, earlier diagnosis, and novel treatments could curb the growing disease burden.

• #17 Fatty Liver: Overview, Etiology, Epidemiology

  https://emedicine.medscape.com/article/175472-overview

  Fatty liver has been found across all races, but NAFLD is most common in white persons, and it is in this population that most of the research has been done. […] It has been observed that Asian patients often develop NAFLD and NASH at BMIs that are in the normal range for the patients ethnicity but tend toward the higher end of the range.

• #18 The Epidemiology, Risk Profiling and Diagnostic Challenges of Nonalcoholic Fatty Liver Disease

  https://www.mdpi.com/2305-6320/6/1/41

  The US population has seen a similar trend with the National Health and Nutrition Examination Survey (NHANES), demonstrating a doubling in the prevalence of NAFLD in the US from 5.5% (1988–1994) to 11% (2005–2008). In a study using the fatty liver index to diagnose NAFLD, the prevalence of NAFLD increased from 18% in 1988–1991 to 31% in 2011–2012. […] A recent systematic review estimated the global prevalence of NAFLD in diabetic patients to be around 58%. Specifically, the prevalence of NASH in diabetic patients has been demonstrated to be close to 65%. Furthermore, NAFLD is also highly prevalent in the overweight and obese population. The prevalence of NAFLD in morbidly obese patients who undergo bariatric surgery has been reported to be as high as 95%. […] The prevalence of NAFLD also varies with gender and ethnicity, with there being a greater prevalence in males and individuals of Hispanic descent.

• #19 PanNASH Initiative | Epidemiology

  https://pannash.org/epidemiology/

  The global epidemiology of NASH, : Discover the last update regarding the prevalence and variation of Nonalcoholic Steatohepatitis. […] In 2021, it is estimated that 25% of the global adult population is potentially affected by non-alcoholic fatty liver disease (NAFLD), with the highest prevalence in the Middle East (31,8%) and South America (30,5%) and the lowest in Africa (13,5%). […] A recent study by Harrison et al. used a combination of state-of-the-art liver imaging methods and liver biopsy to prospectively determine the prevalence of NAFLD and NASH in asymptomatic middle-aged Americans. In this study, the prevalence of NAFLD was 38% (95% CI 34-41%) and the prevalence of NASH was 14% (95% CI 12-17%). […] A systematic review and meta-analysis by Rich et al. in 2018, showed significant racial disparities in NAFLD prevalence and severity in the United States, with NAFLD prevalence being highest in Hispanics, intermediate in Whites, and lowest in Blacks.

• #20 PanNASH Initiative | Epidemiology

  https://pannash.org/epidemiology/

  Among patients with NAFLD, risk for progression to NASH was higher in Hispanics and lower in Blacks than in Whites. […] However, the proportion of patients with significant fibrosis did not significantly differ among racial groups. […] Furthermore, the prevalence of NAFLD among children and adolescents is increasing, affecting approximately 3% to 10% of all children and over one-third of obese children in developed countries. […] The increasing prevalence of NAFLD is linked to a rise in other non-communicable diseases such as type-2 diabetes mellitus (T2DM), obesity and cardiovascular disease (CVD), which are primarily related to unhealthy lifestyles and diet. […] However, ageing and genetics might also play an important role, particularly in Native American and Hispanic populations.

• #21 Marshall Digital Scholar

  https://mds.marshall.edu/int_med/63/

  Background: Non-alcoholic fatty liver disease (NAFLD) is a clinical syndrome predicted to be the next global epidemic affecting millions of people worldwide. The natural course of this disease including its subtype, non-alcoholic steatohepatitis (NASH), is not clearly defined especially in the African-American segment of the US population. […] Aims: To conduct a review of the global epidemiology of NAFLD with emphasis on US minority populations. […] Results: NAFLD and its subtype NASH are becoming the principal cause of chronic liver disease across the world. In the US, Hispanics are the most disproportionately affected ethnic group with hepatic steatosis, and elevated aminotransferase levels, whereas African-Americans are the least affected. Genetic disparities involved in lipid metabolism seem to be the leading explanation for the lowest incidence and prevalence of both NAFLD and NASH in African-Americans.

• #22

  https://journals.lww.com/transplantjournal/fulltext/2019/01000/epidemiology_of_nonalcoholic_fatty_liver_disease.11.aspx

  Nonalcoholic fatty liver disease (NAFLD) affects 25% of the global adult population with a range of 13.5% in Africa and 31.8% in the Middle East. Nonalcoholic fatty liver disease is closely associated with a constellation of metabolic comorbidities which include: obesity, type 2 diabetes mellitus, hypertension, and hypercholesteremia. In fact, the increasing number of metabolic comorbidities not only increases the prevalence of NAFLD but also places patients at higher risk for progressive liver disease. As such, NAFLD is presently among the top etiologies for hepatocellular carcinoma and an indication for liver transplantation (LT) in the United States. […] Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming the most common cause of chronic liver disease. In fact, NAFLD is now among the top indications for LT in United States and is rapidly growing in the rest of the world.

• #23 Fatty Liver: Overview, Etiology, Epidemiology

  https://emedicine.medscape.com/article/175472-overview

  Steatosis affects approximately 25%-30% of the general population. […] Nonalcoholic fatty liver disease (NAFLD) is found in over 80% of patients who are obese, and more than 50% of patients undergoing bariatric surgery have NASH. […] Worldwide, the prevalence of NAFLD and NASH continues to increase in parallel with that of obesity and metabolic comorbid disease (insulin resistance, dyslipidemia, central obesity, hypertension). […] NAFLD is the most common liver disease among adolescents in the United States, including about 8% of lean teens. […] NASH is the most common cause of chronic liver disease in adults in the United States (followed by ALD and hepatitis C). […] Findings from a 2016 study demonstrated that the causes and prevalence of chronic liver disease and cirrhosis vary widely among different racial/ethnic groups.

• #24 Recent Epidemiology and Risk Factors of Nonalcoholic Fatty Liver Disease

  https://www.jomes.org/journal/view.html?doi=10.7570/jomes22021

  In the case of children and adolescents, the prevalence of NAFLD is also increasing with rising childhood obesity. […] The prevalence of NAFLD is 50%90% among individuals with obesity, and the prevalence of obesity in NAFLD is 51%. […] The ongoing obesity epidemic has led to a significant increase in NAFLD prevalence. Obesity is an established risk factor for NAFLD and NAFLD prevalence increases as body mass index (BMI) rises. […] Although NAFLD is significantly associated with obesity, the prevalence of NAFLD in lean individuals is 5%10% of NAFLD. […] NAFLD is the most common chronic liver disease with an increasing prevalence globally. Various risk factors such as genetic predisposition and health-related behaviors are associated with the incidence and progression of NAFLD.

• #25 Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis

  https://www.e-dmj.org/journal/view.php?number=629

  Nonalcoholic fatty liver disease (NAFLD) and diabetes are common metabolic disorders whose prevalence rates are expected to rise worldwide, corresponding to aging and increasingly obese populations. […] Compared to the general population (around 25%), 50% to 70% of people with diabetes have NAFLD, and NAFLD severity (including fibrosis) tends to be worsened by the presence of diabetes. […] NAFLD is considered an emerging risk factor for type 2 diabetes mellitus and a contributor to the development of chronic diabetes-related complications. […] This reciprocal relationship demonstrates the importance of confirming suspected NAFLD in patients with diabetes. […] The prevalence of NAFLD in patients with T2DM is much higher than in the general population. […] In a systemic review by Lonardo et al., the NAFLD incidence rate in patients with T2DM is 50% to 75%, according to ethnicity, across studies.

• #26 Epidemiology and lifestyle survey of non-alcoholic fatty liver disease in school-age children and adolescents in Shenyang, Liaoning | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03351-w

  The global prevalence of NAFLD in children is 7.6%. The prevalence of NAFLD is different in children of different genders and ages, and even the prevalence of obese children is as high as 34.2%. At the same time, the prevalence of NAFLD in children in different regions is still different. The prevalence rate in Asia is 5.9%. Among obese children, the prevalence rate of NAFLD in Asia is higher than that in Europe and North America. […] This study found that 64.93% of overweight children and adolescents in Shenyang had fatty liver, which is significantly higher than that of non-overweight people. The results of these studies indicated that overweight and obese individuals had a higher probability of developing fatty liver. […] We found that boys showed a higher prevalence of NAFLD than girls did, and this conclusion is the same as that of most studies. Although there was no significant difference in the overall prevalence among junior school students, middle school students, and high school students, the prevalence of severe fatty liver increased significantly as the rise of the learning stage.

• #27 Prevalence of nonalcoholic fatty liver disease in pediatrics and adolescents: a systematic review and meta-analysis – Childrens Liver Disease Foundation

  https://childliverdisease.org/prevalence-of-nonalcoholic-fatty-liver-disease-in-pediatrics-and-adolescents-a-systematic-review-and-meta-analysis/

  Background: As childhood obesity escalates worldwide, the prevalence of nonalcoholic fatty liver disease (NAFLD) in pediatric and adolescent populations is also increasing. […] The worldwide pooled prevalence of pediatric NAFLD was 13% [95% confidence interval (CI) 9-18%] in the general population and 47% (95% CI 41%-53%) in the obese population. […] The global prevalence of pediatric NAFLD is rising in both the general and obese populations. Given the increasing rates of childhood obesity, epidemiological studies on the prevalence and incidence of NAFLD are needed.

• #28 Epidemiology and lifestyle survey of non-alcoholic fatty liver disease in school-age children and adolescents in Shenyang, Liaoning | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03351-w

  Some studies have reported that NAFLD will appear in a family aggregation situation. A high BMI among parents will increase the risk of fatty liver in children. […] Our study also showed that children with fatty liver appear to engage in less exercise, which is consistent with the results of Mansour-Ghanaei R’s study on adults. […] The prevalence of NAFLD among school-aged children and adolescents aged 7 to 18 in Shenyang is higher than the national average. Through questionnaires, our study confirmed that NAFLD was closely related to lifestyle habits and parental factors.

• #29 Nonalcoholic Fatty Liver Disease: Common Questions and Answers on Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p603.html

  The American Association for the Study of Liver Diseases (AASLD) recommends biopsy when the etiology of liver disease is unclear and in those who are at increased risk of NASH or advanced fibrosis. […] Most patients with NAFL will have a benign, nonprogressive disease course. Only 20% develop NASH, and 20% of those with NASH develop cirrhosis. […] Patients with a higher degree of fibrosis have a higher risk of death, mainly from cardiovascular disease, cancer, and end-stage liver disease. […] Referral to gastroenterology should be considered in patients who have a high likelihood of NASH fibrosis because of the presence of metabolic syndrome or type 2 diabetes.

• #29 Nonalcoholic Fatty Liver Disease: Common Questions and Answers on Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p603.html

  Routine screening for NAFLD is not recommended, even in high-risk adults, because of uncertainties surrounding diagnostic tests and treatment options, and the lack of knowledge related to the long-term benefits and cost-effectiveness of screening. […] Routine screening is not recommended in the United States, even in high-risk patients, because liver enzyme levels are often normal in patients with NAFLD. […] A 2011 meta-analysis concluded that ultrasonography is the imaging test of choice in the evaluation of patients with suspected NAFLD because of its low cost, safety, and accessibility, although sensitivity and specificity of ultrasonography, computed tomography, and magnetic resonance imaging are similar. […] Liver biopsy should be considered for patients with NAFLD who are at increased risk of NASH or advanced fibrosis based on noninvasive test results.

• #29 Nonalcoholic Fatty Liver Disease: Common Questions and Answers on Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/1115/p603.html

  Nonalcoholic fatty liver disease (NAFLD) is the most common form of liver disease in the United States, affecting up to 30% of adults. […] It is projected that 100 million people in the United States will have nonalcoholic fatty liver disease by 2030, with direct medical costs of about $103 billion annually. […] By 2030, nonalcoholic steatohepatitis is predicted to become the leading indication for liver transplantation in U.S. adults, surpassing hepatitis C. […] NAFLD is the most common form of liver disease in the United States and other developed countries, with rates in the adult population estimated to be between 10% and 30%. […] About one-third of people with NAFLD have NASH. […] The prevalence of NAFLD increases with age, and it is more common in males and those of Hispanic descent.

• #30 NASH Definition & Progression

  https://liverfoundation.org/liver-diseases/fatty-liver-disease/nonalcoholic-steatohepatitis-nash/nash-definition-prevalence/

  NAFLD is the most common chronic liver condition in the United States. Its estimated that about 25 percent of adults in the U.S. have NAFLD. Of those with NAFLD, about 20 percent have NASH (5% of adults in the U.S.). Most people with NAFLD have simply fatty liver. […] The reason some people with NAFLD have simple fatty liver and others get NASH isnt known, although research suggests that certain genes may play a role. […] NAFLD is newly renamed metabolic dysfunction-associated steatotic liver disease or MASLD. […] NASH has been newly renamed metabolic dysfunction associated steatohepatitis or MASH. […] Fatty liver disease is newly renamed steatotic liver disease.

• #31 Non-alcoholic fatty liver disease-related hepatocellular carcinoma

  https://www.e-jlc.org/journal/view.php?number=514

  Non-alcoholic fatty liver disease (NAFLD), one of the most common causes of liver disease, is an increasingly common cause of hepatocellular carcinoma (HCC). […] NAFLD currently accounts for approximately 20% of HCC, although this is anticipated to increase in most countries over the next decade. […] The prevalence of NAFLD is highest in North America and Europe, with nearly one-third of people having NAFLD, including 64 million people in the United States. […] Patients with NASH cirrhosis have an annual HCC incidence of 1-2%, although more than one-fourth of NASH-related HCC occur without underlying cirrhosis. […] The incidence of HCC in NAFLD patients without cirrhosis is approximately 23-46 per 100,000 patient-years. […] NAFLD-related HCC is often diagnosed at more advanced stages, typically in context of poor or absent surveillance.

• #32 Nonalcoholic Fatty Liver Disease | Cleveland Clinic

  https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/nonalcoholic-fatty-liver-disease

  While the majority of patients with NAFLD have simple steatosis, 4% develop NASH over at least 10 years. An average of 3% – 6% of patients with NAFLD have NASH, and 22% of patients with NASH progress to cirrhosis over at least a 10-year period. It is also reported that up to 5% of patients with NASH may spontaneously regress over time. In patients with T2D, 37% have NASH and 17% – have advanced fibrosis on liver biopsy. In patients with incidentally discovered steatosis, 11% might be at high risk for advanced hepatic fibrosis. […] The estimated annual incidence of HCC in NASH cirrhosis ranges between 0.5% – 2.6%, and between 0.1 – 1.3 per 1000 person-year in non-cirrhotic individuals. Although these numbers may appear small, the absolute numbers are important considering the prevalence of the disease.

• #33

  https://www.natap.org/2024/HCV/012924_06.htm

  Global prevalence increased by 50% – The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. NAFLD is a leading cause of liver-related morbidity and mortality. We assessed the global and regional prevalence, incidence, and mortality of NAFLD using an in-depth meta-analytic approach. Across the study period (1990-2019), meta-analytic pooling of NAFLD prevalence estimates and ultrasound-defined NAFLD yielded an overall global prevalence of 30.05% (95% CI: 27.88%-32.32%) and 30.69% (28.4-33.09), respectively. Global NAFLD prevalence increased by +50.4% from 25.26% (21.59-29.33) in 1990-2006 to 38.00% (33.71-42.49) in 2016-2019. The highest NAFLD prevalence was in Latin America 44.37% (30.66%-59.00%), then Middle East and North Africa (MENA) (36.53%, 28.63%-45.22%), South Asia (33.83%, 22.91%-46.79%), South-East Asia (33.07%, 18.99%-51.03%), North America (31.20%, 25.86%-37.08%), East Asia (29.71%, 25.96%-33.76%), Asia Pacific 28.02% (24.69%-31.60%), Western Europe 25.10% (20.55%-30.28%). Among the NAFLD cohort diagnosed without a liver biopsy, pooled mortality rate per 1000 PY was 12.60 (6.68-23.67) for all-cause mortality; 4.20 (1.34-7.05) for cardiac-specific mortality; 2.83 (0.78-4.88) for extrahepatic cancer-specific mortality; and 0.92 (0.00-2.21) for liver-specific mortality. NAFLD global prevalence is 30% and increasing which requires urgent and comprehensive strategies to raise awareness and address all aspects of NAFLD on local, regional, and global levels.

• #34 Fatty liver disease A practical guide for GPs

  https://www.racgp.org.au/afp/2013/july/fatty-liver-disease

  Non-alcoholic fatty liver disease (NAFLD), encompassing both simple steatosis and non-alcoholic steato-hepatitis (NASH), is the most common cause of liver disease in Australia. […] The prevalence of NAFLD is estimated to be approximately 30% of adults in developed countries such as Australia and the United States, depending on definition and detection methods. However, NAFLD is also becoming increasingly common in Asia (countries previously thought to be at low risk of NAFLD), where a prevalence of up to 15% has been reported in China. […] Cardiovascular disease is the major cause of death in patients with NAFLD; NAFLD alone is associated with a slightly higher overall mortality. However, when NAFLD occurs in the presence of other features of the metabolic syndrome (MetSy), mortality doubles.

• #35 The Epidemiology, Risk Profiling and Diagnostic Challenges of Nonalcoholic Fatty Liver Disease

  https://www.mdpi.com/2305-6320/6/1/41

  A remodeling study by Estes et al. estimated that the prevalence of NAFLD and NASH in the US will rise by 21% and 63%, respectively, with a correlated increase of 178% in liver-related mortalities to an estimated 78,300 deaths by 2030. For this reason, there is a critical need to identify and treat potentially modifiable risk factors in order to reduce the morbidity and mortality associated with this serious disease.

• #36 Epidemiology and severity of non-alcoholic fatty liver disease in Greek tertiary liver centres

  https://www.oatext.com/epidemiology-and-severity-of-non-alcoholic-fatty-liver-disease-in-greek-tertiary-liver-centres.php

  Even though the exact prevalence of the disease in Greece is largely unknown, it is estimated that NAFLD affects almost one third of modern Greeks following the patterns encountered in the rest of the western world regarding the increasing trends of obesity and diabetes mellitus. […] The majority of NAFLD patients in this cohort were middle-aged, overweight or obese patients with histologically findings of mild non-alcoholic steatohepatitis. […] FibroScan, NAFLD Fibrosis Score (NFS) and Fibrosis-4 (FIB-4) presented high diagnostic accuracy in ruling-out and ruling-in advanced hepatic fibrosis.

• #37 Hepatocellular carcinoma surveillance in patients with non-alcoholic fatty liver disease

  https://www.e-cmh.org/journal/view.php?number=1710&viewtype=pubreader

  Non-alcoholic fatty liver disease (NAFLD) may progress to cirrhotic or non-cirrhotic hepatocellular carcinoma (HCC), and is currently recognized as the fastest growing cause of HCC worldwide. […] HCC surveillance in patients with NAFLD is limited by unique challenges, including increased difficulty recognizing appropriate at-risk patients, a higher proportion of HCC occurring in the absence of cirrhosis compared to other etiologies, unsatisfactory effectiveness of surveillance tools, underuse of HCC surveillance, and higher competing risk of non-HCC-related mortality. […] Multiple professional society guidelines including the American Association for the Study of Liver Disease (AASLD), European Association for the Study of the Liver (EASL), and Asian Pacific Association for the Study of the Liver (APASL) recommend HCC surveillance in at-risk individuals including subsets of chronic hepatitis B virus (HBV) infection and those with cirrhosis from any etiology.

• #38 Hepatocellular carcinoma surveillance in patients with non-alcoholic fatty liver disease

  https://www.e-cmh.org/journal/view.php?number=1710&viewtype=pubreader

  Although clinical benefits were consistent in the subgroup of studies with 20% NAFLD patients, there were only two studies specifically examining the association between HCC surveillance and clinical outcomes in patients with NAFLD-related cirrhosis. […] HCC surveillance is currently recommended in all patients with cirrhosis from any etiology, including those with NAFLD-related cirrhosis. […] While there is general agreement about the application of surveillance programs in patients with NAFLD cirrhosis, there is a lack of consensus regarding the value of HCC surveillance in non-cirrhotic NAFLD. […] HCC surveillance in patients with NAFLD is currently restricted to those with cirrhosis. […] Overall, these data suggest that HCC surveillance is unlikely to be cost effective in non-cirrhotic NAFLD, outside of additional risk stratification tools. […] HCC surveillance should be performed at semi-annual intervals in at-risk patients, including those with NAFLD cirrhosis. […] HCC surveillance is underused in clinical practice, including in patients with NAFLD, related to patient and provider-reported barriers.

• #39 Recent Epidemiology of Nonalcoholic Fatty Liver Disease

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl20127

  A study based on real-world data from a US medical claims determined that the long-term cumulative healthcare cost of NAFLD is 80% higher than that of a non-NAFLD of similar age and metabolic comorbidities. […] This review summarizes the worldwide incidence and prevalence of NAFLD, discusses diagnostic nuances in determining subjects with NAFLD who progress to cirrhosis, and quantifies downstream impacts on the healthcare economy in the context of all-cause and cause-specific mortality.

• #40 Non-alcoholic fatty liver disease-related hepatocellular carcinoma

  https://www.e-jlc.org/journal/view.php?number=514

  Although cirrhosis is the strongest risk factor for HCC in those with NAFLD, there is a wide variation in HCC risk between patients. […] HCC risk factors among those with NAFLD include older age, male sex, Hispanic ethnicity, and metabolic syndrome features like diabetes, obesity, and dyslipidemia. […] Data from European and USA real-world studies with 18 million patients identified diabetes as the strongest independent metabolic risk factor for HCC. […] Clinical risk calculators have been proposed to help stratify NAFLD patients into high- and low-risk groups. […] Although clinical risk scores and this blood-based biomarker are promising and fill an area of need, they require further validation prior to routine use in clinical practice. […] Professional society guidelines, including those from European Association for the Study of Liver (EASL), American Association for the Study of Liver Diseases (AASLD), and Asian Pacific Association for the Study of the Liver recommend HCC surveillance in at-risk populations.

• #41 Sonography in surveillance for HCC in NAFLD patients

  https://www.oaepublish.com/articles/2394-5079.2022.42

  Over the last decade, we have been facing a new aetiology responsible for the development of HCC – the non-alcoholic fatty liver disease (NAFLD). The prevalence of HCC development in this group is higher than that observed in the general population and in non-cirrhotic subjects with other causes of liver disease. […] Cohort studies from Italy and the United States reported that the majority of NAFLD-related HCC patients are not diagnosed through regular surveillance, resulting in a more advanced HCC stage at diagnosis. […] Although NAFLD has a relatively low risk of HCC development, the high prevalence of NAFLD in the population and the impact on health costs underline the importance of this aetiology. […] At present, the European Association for the Study of the Liver (EASL) and the American Gastroenterology Association Clinical Practice (AASLD) Update recommend HCC screening for patients with cirrhosis and consider screening in advanced fibrosis (F3).

• #42 Thieme E-Journals – Seminars in Liver Disease / Abstract

  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0028-1091978

  Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized cause of liver disease in the United States and worldwide. […] Prevalence estimates of this disease vary widely across populations because of differences in methods for diagnosis and/or definition. […] New strategies for the prevention, diagnosis, and management will be required to alter the course of this disease.

• #43 Non-alcoholic fatty liver disease-related hepatocellular carcinoma

  https://www.e-jlc.org/journal/view.php?number=514

  These data highlight a need for novel imaging or biomarker-based strategies for HCC surveillance in patients with NAFLD. […] HCC surveillance underuse was prevalent across subgroups including geographic region and receipt of subspeciality care. […] Several intervention strategies including provider education, electronic medical record alerts, and population-based mailed outreach invitations have been proven efficacious for increasing HCC surveillance use, although studies are needed to evaluate their effectiveness when implemented in clinical practice.

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