Mao Yuqin, Du Jiqing, Li Baoguo, Wang Jiong, Xuan Shaoyan, Yang Shu, Tang Zhihua, Wang Minxiu
Department of Pharmacy, Shaoxing People's Hospital, School of Medicine, Shaoxing University, Shaoxing, Zhejiang, People's Republic of China.
School of Life and Health Technology, Dongguan University of Technology, Dongguan, China.
PLoS One. 2025 Aug 22;20(8):e0330504. doi: 10.1371/journal.pone.0330504. eCollection 2025.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. The global burden of NAFLD is increasing. This study used the Global Burden of Disease (GBD) 2021 study data to assess the burden and development trends of NAFLD from 1990 to 2021.
The incidence, prevalence, death and disability-adjusted life years (DALYs) rates of NAFLD in geographic populations worldwide from 1990 to 2021 were extracted from the GBD 2021 study data. The global temporal trend of NAFLD from 1990 to 2021 was evaluated using estimated annual percentage change and age-standardized rate. The Bayesian age-period-cohort model was used to predict NAFLD burden future trends to 2035.
The global age standardized incidence rate (ASIR) of NAFLD among the all-age population increased by 25% and the age standardized prevalence rate (ASPR) increased by 24%. The age standardized mortality rate (ASMR) and age standardized DALYs rate (ASDR) were relatively stable. Countries with middle socio-demographic index (SDI) had the highest ASIR and ASPR from 1990 to 2021, high-middle SDI and high SDI had the lowest ASMR and ASDR. North Africa and Middle East had the highest ASIR and ASPR in 2021, ASIR increased at the greatest rate in East Asia and Western Europe, ASPR increased at the greatest rate in Western Europe. In 2021, the highest number of incidence cases and incidence rates were in 20-24 years group, reflecting a tendency towards a younger onset of NAFLD.
The global burden of NAFLD has risen steadily from 1990 to 2021, and projections to 2035, placing enormous pressure on society. It is necessary to implement measures targeting risk factors such as high fasting plasma glucose and tobacco, including improving lifestyle, adjusting diet, and applying drug intervention.
非酒精性脂肪性肝病（NAFLD）是最常见的慢性肝病。全球NAFLD负担正在增加。本研究使用全球疾病负担（GBD）2021研究数据评估1990年至2021年NAFLD的负担和发展趋势。
从GBD 2021研究数据中提取1990年至2021年全球地理区域人群中NAFLD的发病率、患病率、死亡率和伤残调整生命年（DALY）率。使用估计的年度百分比变化和年龄标准化率评估1990年至2021年NAFLD的全球时间趋势。采用贝叶斯年龄-时期-队列模型预测NAFLD负担至2035年的未来趋势。
全年龄人群中NAFLD的全球年龄标准化发病率（ASIR）增加了25%，年龄标准化患病率（ASPR）增加了24%。年龄标准化死亡率（ASMR）和年龄标准化DALY率（ASDR）相对稳定。社会人口学指数（SDI）中等的国家在1990年至2021年期间ASIR和ASPR最高，高中等SDI和高SDI的ASMR和ASDR最低。2021年，北非和中东的ASIR和ASPR最高，东亚和西欧的ASIR增长速度最快，西欧的ASPR增长速度最快。2021年，发病例数和发病率最高的是20-24岁年龄组，反映出NAFLD发病有年轻化趋势。
1990年至2021年全球NAFLD负担稳步上升，预计到2035年，这将给社会带来巨大压力。有必要针对空腹血糖高和吸烟等危险因素采取措施，包括改善生活方式、调整饮食和进行药物干预。
