NAFLD: Global and Regional Prevalence, Incidence, and Mortality Rates

Non-alcoholic fatty liver disease (NAFLD) is a major contributor to liver-related illnesses and fatalities worldwide. Its clearly established two-way connection with obesity, a significant public health issue showing increasing prevalence rates globally and regionally, necessitates comprehensive education focused on NAFLD and the implementation of worldwide policies to address it effectively.
PUBLISHED IN: Hepatology (April 2023)


Non-alcoholic fatty liver disease (NAFLD) is a leading cause of liver-related morbidity and mortality worldwide. Its well-characterised bidirectional relationship with obesity, a significant public health concern with rising global and regional prevalence rates, warrants extensive NAFLD-centred education coupled with mobilising global policies. Despite this, only 32 countries worldwide possess NAFLD guidelines, and none have comprehensive public NAFLD health responses. 

This meta-analysis aimed to determine NAFLD’s global and regional prevalence as well as its incidence and mortality rates.

Key learnings:

The overall global prevalence of NAFLD was found to be 30.05%. Crucially, this prevalence underwent a 50.4% increase from 25.26% in 1990–2006 to an astounding 38.00% in 2016–2019. Regions most affected by NAFLD include Latin America followed by the Middle East and North Africa, characterised by a prevalence of 44.37% and 36.53%, respectively. NAFLD’s incidence experienced a 58% increase from 1994–2006 to 2010–2014. Moreover, among those diagnosed without a liver biopsy, NAFLD’s pooled mortality rate per 1000 person-years was found to be 12.60 for all-cause mortality; 4.20 for cardiac-specific mortality; 2.83 for extrahepatic cancer-specific mortality; and 0.92 for liver-specific mortality. Although the heterogeneity of the studies it considered limits its findings, this meta-analysis exposes NAFLD as a global disease requiring the World Health Organisation’s urgent attention.

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S Duarte, BSc

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