Rising Global Burden of MASLD

The global burden of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as NAFLD, is rising at an alarming rate and poses a significant public health challenge. MASLD is now the most common chronic liver disease worldwide, affecting approximately 1.27 billion people in 2021, with a prevalence rate of 15,018 per 100,000 population. It is closely linked to obesity, type 2 diabetes mellitus (T2DM), and cardiovascular diseases, reflecting its intricate connection with other metabolic disorders.

Over the past two decades (2000–2021), MASLD prevalence has increased by 75%, driven by global lifestyle changes, dietary transitions, and rising obesity rates. Although its prevalence has surged, the overall disability burden (measured in disability-adjusted life years or DALYs) has remained relatively stable compared to other metabolic diseases. However, significant regional disparities exist. The Eastern Mediterranean region has the highest MASLD prevalence, while the Americas bear the greatest disability burden. Middle-income countries, particularly in low-middle socioeconomic strata, experience the highest burden due to limited healthcare access and preventive measures.

Sex-based differences reveal that males face a higher overall burden, but the rate of increase in MASLD is slightly higher in females. The pandemic has likely exacerbated this burden through sedentary lifestyles and disrupted healthcare services. MASLD is intricately linked with other metabolic diseases like T2DM and obesity, acting as both a consequence and a risk amplifier.

Urgent public health efforts, such as lifestyle interventions, early screening, and better healthcare access, are needed to address this escalating global crisis. Recognizing MASLD as a major public health threat is critical for reducing its impact.