Global perspective on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis ‐ prevalence, clinical impact, economic implications and management strategies

• Published in: Alimentary pharmacology & therapeutics 2024-06, Vol.59 (S1), p.S1-S9
• Main Authors: Golabi, Pegah, Owrangi, Soroor, Younossi, Zobair M.
• Format: Article
• Language: English
• Subjects: Algorithms; Cost of Illness; Diabetes mellitus; Endocrinology; Fatty liver; Fibrosis; Geographical variations; Global Health; Health Care Costs - statistics & numerical data; Humans; Liver cancer; Liver diseases; Liver transplantation; Non-alcoholic Fatty Liver Disease - economics; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - therapy; Prevalence; Primary care; Quality of Life; Risk Factors
• ISSN: 0269-2813; 1365-2036; 1365-2036
• DOI: 10.1111/apt.17833

Summary Background The metabolically‐based liver disease, nonalcoholic fatty liver disease (NAFLD), is the most common cause of chronic liver disease currently affecting 38% of the world's adult population. NAFLD can be progressive leading to nonalcoholic steatohepatitis (NASH), liver transplantation, liver cancer, liver‐related mortality and is associated with decreased quality of life from impaired physical functioning and increased healthcare resource utilisation. However, screening for NAFLD is cost‐prohibitive but screening for high risk NAFLD (NAFLD with F2 fibrosis or greater) is imperative. Aim To review the global perspective on NAFLD and NASH Methods We retrieved articles from PubMed using search terms NAFLD, prevalence, clinical burden, economic burden and management strategies. Results NAFLD/NASH shows geographical variation across the globe. Highest prevalence rates are in South America and the Middle East and North Africa; lowest prevalence is in Africa. NAFLD's economic impact is from direct and indirect medical costs and loss in worker productivity. It is projected that, over the next two decades, the total cost of NAFLD and diabetes will exceed $1.5 trillion (USD). Risk stratification algorithms identifying “high risk NAFLD” were made following non‐invasive tests for NAFLD identification and fibrosis development. These algorithms should be used in primary care and endocrinology settings so timely and appropriate interventions (lifestyle and cardiometabolic risk factor management) can be initiated. Conclusions To reduce the burgeoning burden of NAFLD/NASH, management should include risk stratification algorithms for accurate identification of patients, linkage to appropriate settings, and initiation of effective treatment regimens. The comprehensive burden in nonalcoholic fatty liver disease.