Non-alcoholic fatty liver disease (NAFLD) is currently the fastest-growing indicator for liver transplantation worldwide. Its status as a growing health concern further parallels the global rise of obesity. Recent studies suggest the existence of an association between obesity and NAFLD, with the latter possessing a clear metabolic basis. The latest guidelines from the American Association of Clinical Endocrinology themselves highlight overweight and obesity as effective risk factors for first-line NAFLD screening. Despite this, the global prevalence of NAFLD in overweight and obese individuals remains unclarified.
The aim of this study was to investigate the global prevalence of NAFLD, which encompasses both non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), in the overweight and obese population.
NAFLD’s prevalence in the overweight population was found to be 69.99%, while NAFL’s prevalence was 42.49% and that of NASH was 33.5%. Similar estimates were reported in obese populations for all three pathologies. Importantly, the prevalence of NAFLD in the overweight population was found to be the highest in the Americas. Furthermore, 20.27% and 21.6% of overweight and obese patients with NAFLD, respectively, were found to possess clinically significant fibrosis (F2-F4). Advanced fibrosis (F3-F4) affected 6.65% of overweight and 6.85% of obese NAFLD patients. These significant statistics support the inclusion of bodyweight categories for the first-line screening of individuals with NAFLD, and could be crucial to patient risk stratification at the primary care level.