Global burden of metabolic dysfunction-associated steatotic liver disease from 1990 to 2021 and the prediction for the next 10 years

Objective

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. Although the update of the MASLD practice guidelines and the approval of Resmetirom have brought new progress in the prevention and treatment of MASLD, this disease still has not received sufficient attention and remains a major public health issue.

Methods

Age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (ASDR) rates of MASLD from 1990 to 2021 were extracted from the Global Burden of Disease 2021. The estimated annual percentage change was calculated using linear regression. Six time-series models were used for training and comparison, and the optimal model was selected to predict the disease burden from 2022 to 2031.

Results

Globally, the ASIR, ASPR, ASMR, and ASDR all exhibited upward trends. Regionally, Western Europe showed the fastest growth in ASIR and ASPR. Eastern Europe showed the fastest growth in ASMR and ASDR, whereas the high-income Asia Pacific demonstrated the most pronounced decline. The hybrid model best predicted ASIR (615.70/100,000) and ASPR (15,275.60/100,000) for 2031, the Neural Network Autoregressive model optimized ASMR (1.64/100,000), and Prophet projected ASDR to decline to 42.08/100,000.

Conclusions

The MASLD burden has increased globally and is projected to continue escalating. It is suggested that the MASLD screening be integrated into the non-communicable diseases program and be prioritized for monitoring in high-burden areas.