Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: Data from Global Burden of Disease 2009-2019
Pegah Golabi, James M. Paik, Saleh AlQahtani, Youssef Younossi, Gabriela Tuncer, Zobair M. Younossi
Background & Aim: Non-alcoholic fatty liver disease (NAFLD) has become a major cause of chronic liver disease (CLD) worldwide. Our aim was to assess the burden of liver complications (LC, cirrhosis and liver cancer) related to NAFLD (LC-NAFLD) between 2009-2019 in Asia and the Middle East and North Africa (MENA) region. Methods: We used Global Burden of Disease data to assess incidence, mortality, and disability-adjusted life years (DALYs) for LC-NAFLD from Asia and the MENA region. Annual % change (APC) in rates were computed using a joinpoint regression model. Associations of LC-NAFLD with low physical activity, diet and metabolic risks were determined by partial Spearman correlation coefficients (ρ). Results: Globally in 2019, there were 170,000 incident cases of LC-NAFLD, accounting for 6.6% of LC incident cases from all CLDs. There were 168,969 deaths related to LC-NAFLD, accounting for 8.6% of LC deaths from all CLDs. Asia accounted for 48.3% of the global incidence of LC-NAFLD and for 46.2% of deaths attributable to LC-NAFLD, while MENA accounted for 8.9% and 8.6%, respectively. There were 2.08 million DALYs in Asia and 340,000 DALYs in MENA. From 2009 to 2019, regions in Asia and MENA experienced a rise in DALYs attributable to LC-NAFLD (compared to LC from other CLDs), ranging from South Asia (APC = +2.12% vs. -0.94%) to high-income Asia Pacific (APC = -0.07%, p = 0.646 vs. -0.97%). In Asia, NAFLD-related DALYs were significantly correlated with dietary risks (95% CI 0.280–0.763, p = 0.004), metabolic risks (0.341–0.790, p <0.001) and tobacco use (0.134–0.691, p = 0.007). In MENA, low physical activity (0.557–0.918, p <0.001), metabolic risks (0.432–0.888, p = 0.001), and dietary risks (0.315–0.855, p = 0.001) correlated with DALYs. Conclusions: NAFLD is posing a substantial burden in Asia and MENA. About half of the global burden of LC-NAFLD is accounted for by these regions. Lay summary: Non-alcoholic fatty liver disease (NAFLD) has emerged as one of the most common causes of chronic liver disease worldwide. We used Global Burden of Disease data to assess the incidence, mortality, and disability-adjusted life years attributable to NAFLD-related liver complications in Asia, the Middle East and North Africa. NAFLD is poised to contribute to a substantial liver disease burden in these regions. Regional and global policies are needed to address the increasing burden of complications of NAFLD.
https://doi.org/10.1016/j.jhep.2021.05.022
NAFLD
10.1016/j.jhep.2021.05.022
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Northern Africa Medicine & Life Sciences 100%
Global Burden of Disease Medicine & Life Sciences 98%
Middle East Medicine & Life Sciences 89%
Non-alcoholic Fatty Liver Disease Medicine & Life Sciences 78%
Liver Neoplasms Medicine & Life Sciences 54%
Fibrosis Medicine & Life Sciences 37%
Quality-Adjusted Life Years Medicine & Life Sciences 35%
Liver Diseases Medicine & Life Sciences 11%
Golabi, P., Paik, J. M., AlQahtani, S., Younossi, Y., Tuncer, G., & Younossi, Z. M. (2021). Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: Data from Global Burden of Disease 2009-2019. Journal of Hepatology, 75(4), 795-809. https://doi.org/10.1016/j.jhep.2021.05.022
Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa : Data from Global Burden of Disease 2009-2019. / Golabi, Pegah; Paik, James M.; AlQahtani, Saleh; Younossi, Youssef; Tuncer, Gabriela; Younossi, Zobair M.
In: Journal of Hepatology, Vol. 75, No. 4, 10.2021, p. 795-809.
Golabi, P, Paik, JM, AlQahtani, S, Younossi, Y, Tuncer, G & Younossi, ZM 2021, 'Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: Data from Global Burden of Disease 2009-2019', Journal of Hepatology, vol. 75, no. 4, pp. 795-809. https://doi.org/10.1016/j.jhep.2021.05.022
Golabi P, Paik JM, AlQahtani S, Younossi Y, Tuncer G, Younossi ZM. Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: Data from Global Burden of Disease 2009-2019. Journal of Hepatology. 2021 Oct;75(4):795-809. https://doi.org/10.1016/j.jhep.2021.05.022
Golabi, Pegah ; Paik, James M. ; AlQahtani, Saleh ; Younossi, Youssef ; Tuncer, Gabriela ; Younossi, Zobair M. / Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa : Data from Global Burden of Disease 2009-2019. In: Journal of Hepatology. 2021 ; Vol. 75, No. 4. pp. 795-809.
@article{18c3aa3e4efb43a680bb59a264c808b1,
title = "Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: Data from Global Burden of Disease 2009-2019",
abstract = "Background & Aim: Non-alcoholic fatty liver disease (NAFLD) has become a major cause of chronic liver disease (CLD) worldwide. Our aim was to assess the burden of liver complications (LC, cirrhosis and liver cancer) related to NAFLD (LC-NAFLD) between 2009-2019 in Asia and the Middle East and North Africa (MENA) region. Methods: We used Global Burden of Disease data to assess incidence, mortality, and disability-adjusted life years (DALYs) for LC-NAFLD from Asia and the MENA region. Annual % change (APC) in rates were computed using a joinpoint regression model. Associations of LC-NAFLD with low physical activity, diet and metabolic risks were determined by partial Spearman correlation coefficients (ρ). Results: Globally in 2019, there were 170,000 incident cases of LC-NAFLD, accounting for 6.6% of LC incident cases from all CLDs. There were 168,969 deaths related to LC-NAFLD, accounting for 8.6% of LC deaths from all CLDs. Asia accounted for 48.3% of the global incidence of LC-NAFLD and for 46.2% of deaths attributable to LC-NAFLD, while MENA accounted for 8.9% and 8.6%, respectively. There were 2.08 million DALYs in Asia and 340,000 DALYs in MENA. From 2009 to 2019, regions in Asia and MENA experienced a rise in DALYs attributable to LC-NAFLD (compared to LC from other CLDs), ranging from South Asia (APC = +2.12% vs. -0.94%) to high-income Asia Pacific (APC = -0.07%, p = 0.646 vs. -0.97%). In Asia, NAFLD-related DALYs were significantly correlated with dietary risks (95% CI 0.280–0.763, p = 0.004), metabolic risks (0.341–0.790, p <0.001) and tobacco use (0.134–0.691, p = 0.007). In MENA, low physical activity (0.557–0.918, p <0.001), metabolic risks (0.432–0.888, p = 0.001), and dietary risks (0.315–0.855, p = 0.001) correlated with DALYs. Conclusions: NAFLD is posing a substantial burden in Asia and MENA. About half of the global burden of LC-NAFLD is accounted for by these regions. Lay summary: Non-alcoholic fatty liver disease (NAFLD) has emerged as one of the most common causes of chronic liver disease worldwide. We used Global Burden of Disease data to assess the incidence, mortality, and disability-adjusted life years attributable to NAFLD-related liver complications in Asia, the Middle East and North Africa. NAFLD is poised to contribute to a substantial liver disease burden in these regions. Regional and global policies are needed to address the increasing burden of complications of NAFLD.",
keywords = "Asia, DALY, NAFLD, NASH, cirrhosis, liver cancer, metabolic syndrome, trends",
author = "Pegah Golabi and Paik, {James M.} and Saleh AlQahtani and Youssef Younossi and Gabriela Tuncer and Younossi, {Zobair M.}",
note = "Funding Information: ZMY has received research funds or served as consultant to Gilead Sciences, Intercept, NovoNordisk, Abbvie, Merck, Madrigal, Genfit, Siemens, BMS, Terns and Viking. SAA consults for and received grants from AbbVie, Bristol-Meyers Squibb, Gilead, Janssen, and Merck. All other authors have no conflict of interest to disclose. Publisher Copyright: {\textcopyright} 2021 European Association for the Study of the Liver",
doi = "10.1016/j.jhep.2021.05.022",
journal = "Journal of Hepatology",
T1 - Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa
T2 - Data from Global Burden of Disease 2009-2019
AU - Golabi, Pegah
AU - Paik, James M.
AU - AlQahtani, Saleh
AU - Younossi, Youssef
AU - Tuncer, Gabriela
AU - Younossi, Zobair M.
N1 - Funding Information: ZMY has received research funds or served as consultant to Gilead Sciences, Intercept, NovoNordisk, Abbvie, Merck, Madrigal, Genfit, Siemens, BMS, Terns and Viking. SAA consults for and received grants from AbbVie, Bristol-Meyers Squibb, Gilead, Janssen, and Merck. All other authors have no conflict of interest to disclose. Publisher Copyright: © 2021 European Association for the Study of the Liver
N2 - Background & Aim: Non-alcoholic fatty liver disease (NAFLD) has become a major cause of chronic liver disease (CLD) worldwide. Our aim was to assess the burden of liver complications (LC, cirrhosis and liver cancer) related to NAFLD (LC-NAFLD) between 2009-2019 in Asia and the Middle East and North Africa (MENA) region. Methods: We used Global Burden of Disease data to assess incidence, mortality, and disability-adjusted life years (DALYs) for LC-NAFLD from Asia and the MENA region. Annual % change (APC) in rates were computed using a joinpoint regression model. Associations of LC-NAFLD with low physical activity, diet and metabolic risks were determined by partial Spearman correlation coefficients (ρ). Results: Globally in 2019, there were 170,000 incident cases of LC-NAFLD, accounting for 6.6% of LC incident cases from all CLDs. There were 168,969 deaths related to LC-NAFLD, accounting for 8.6% of LC deaths from all CLDs. Asia accounted for 48.3% of the global incidence of LC-NAFLD and for 46.2% of deaths attributable to LC-NAFLD, while MENA accounted for 8.9% and 8.6%, respectively. There were 2.08 million DALYs in Asia and 340,000 DALYs in MENA. From 2009 to 2019, regions in Asia and MENA experienced a rise in DALYs attributable to LC-NAFLD (compared to LC from other CLDs), ranging from South Asia (APC = +2.12% vs. -0.94%) to high-income Asia Pacific (APC = -0.07%, p = 0.646 vs. -0.97%). In Asia, NAFLD-related DALYs were significantly correlated with dietary risks (95% CI 0.280–0.763, p = 0.004), metabolic risks (0.341–0.790, p <0.001) and tobacco use (0.134–0.691, p = 0.007). In MENA, low physical activity (0.557–0.918, p <0.001), metabolic risks (0.432–0.888, p = 0.001), and dietary risks (0.315–0.855, p = 0.001) correlated with DALYs. Conclusions: NAFLD is posing a substantial burden in Asia and MENA. About half of the global burden of LC-NAFLD is accounted for by these regions. Lay summary: Non-alcoholic fatty liver disease (NAFLD) has emerged as one of the most common causes of chronic liver disease worldwide. We used Global Burden of Disease data to assess the incidence, mortality, and disability-adjusted life years attributable to NAFLD-related liver complications in Asia, the Middle East and North Africa. NAFLD is poised to contribute to a substantial liver disease burden in these regions. Regional and global policies are needed to address the increasing burden of complications of NAFLD.
AB - Background & Aim: Non-alcoholic fatty liver disease (NAFLD) has become a major cause of chronic liver disease (CLD) worldwide. Our aim was to assess the burden of liver complications (LC, cirrhosis and liver cancer) related to NAFLD (LC-NAFLD) between 2009-2019 in Asia and the Middle East and North Africa (MENA) region. Methods: We used Global Burden of Disease data to assess incidence, mortality, and disability-adjusted life years (DALYs) for LC-NAFLD from Asia and the MENA region. Annual % change (APC) in rates were computed using a joinpoint regression model. Associations of LC-NAFLD with low physical activity, diet and metabolic risks were determined by partial Spearman correlation coefficients (ρ). Results: Globally in 2019, there were 170,000 incident cases of LC-NAFLD, accounting for 6.6% of LC incident cases from all CLDs. There were 168,969 deaths related to LC-NAFLD, accounting for 8.6% of LC deaths from all CLDs. Asia accounted for 48.3% of the global incidence of LC-NAFLD and for 46.2% of deaths attributable to LC-NAFLD, while MENA accounted for 8.9% and 8.6%, respectively. There were 2.08 million DALYs in Asia and 340,000 DALYs in MENA. From 2009 to 2019, regions in Asia and MENA experienced a rise in DALYs attributable to LC-NAFLD (compared to LC from other CLDs), ranging from South Asia (APC = +2.12% vs. -0.94%) to high-income Asia Pacific (APC = -0.07%, p = 0.646 vs. -0.97%). In Asia, NAFLD-related DALYs were significantly correlated with dietary risks (95% CI 0.280–0.763, p = 0.004), metabolic risks (0.341–0.790, p <0.001) and tobacco use (0.134–0.691, p = 0.007). In MENA, low physical activity (0.557–0.918, p <0.001), metabolic risks (0.432–0.888, p = 0.001), and dietary risks (0.315–0.855, p = 0.001) correlated with DALYs. Conclusions: NAFLD is posing a substantial burden in Asia and MENA. About half of the global burden of LC-NAFLD is accounted for by these regions. Lay summary: Non-alcoholic fatty liver disease (NAFLD) has emerged as one of the most common causes of chronic liver disease worldwide. We used Global Burden of Disease data to assess the incidence, mortality, and disability-adjusted life years attributable to NAFLD-related liver complications in Asia, the Middle East and North Africa. NAFLD is poised to contribute to a substantial liver disease burden in these regions. Regional and global policies are needed to address the increasing burden of complications of NAFLD.
KW - Asia
KW - DALY
KW - NAFLD
KW - NASH
KW - cirrhosis
KW - liver cancer
KW - metabolic syndrome
KW - trends
U2 - 10.1016/j.jhep.2021.05.022
DO - 10.1016/j.jhep.2021.05.022
JO - Journal of Hepatology
JF - Journal of Hepatology