Global Prevalence of Nonalcoholic Fatty Liver Disease: An Updated Review Meta-Analysis comprising a Population of 78 million from 38 Countries.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of observational studies
PubMed 39094335 · doi:10.1016/j.arcmed.2024.103043
What was done
Authors searched PubMed, Scopus, and Web of Science through May 2023 for studies evaluating nonalcoholic fatty liver disease (NAFLD) prevalence in adult and pediatric populations. Heterogeneity was assessed using Cochran's Q test and I^2 statistics, and pooled prevalence estimates were calculated using random-effects meta-analysis in STATA version 18.
What was found
A total of 479 studies with 78,001,755 participants across 38 countries were included: - Overall global NAFLD prevalence was 30.2% (95% CI: 28.7–31.7%). - By region: South America 34% (95% CI: 16.9–53.5%), Asia 30.9% (95% CI: 29.2–32.6%), Europe 30.2% (95% CI: 25.6–35.0%), North America 29% (95% CI: 25.8–32.3%), and Australia 16.1% (95% CI: 9.0–24.8%). - By sex: Men had a higher prevalence at 36.6% (95% CI: 34.7–38.4%) compared to women at 25.5% (95% CI: 23.9–27.1%). - By subgroup: Adults 30.2% (95% CI: 28.8–31.7%), adults with obesity 57.5% (95% CI: 43.6–70.9%), children 14.3% (95% CI: 10.3–18.8%), and children with obesity 38.0% (95% CI: 31.5–44.7%). - Countries with higher Human Development Index (HDI) had significantly lower NAFLD prevalence (coefficient = -0.523, p = 0.005).
Why it matters
This provides an updated large-scale global benchmark indicating that roughly three in ten individuals have NAFLD, with a disproportionately high burden among individuals with obesity and in nations with lower development indices.
Limits
The abstract does not report the diagnostic modalities used across the included studies (such as ultrasound, biomarkers, or biopsy), which typically introduce substantial heterogeneity. Data are drawn from 38 countries with no regional estimate reported for Africa, and wide confidence intervals exist in regions such as South America.
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