The Rising Global Burden of MASLD and Other Metabolic Diseases (2000-2021)

Pojsakorn Danpanichkul; Kanokphong Suparan; Luis Antonio Diaz; Michael B Fallon; Vincent L Chen; Kornnatthanai Namsathimaphorn; Krittameth Rakwong; Torlap Inkongngam; Chuthathip Kaeosri; Markos Kalligeros; Phuuwadith Wattanachayakul; Cheng Han Ng; Hirokazu Takahashi; Daniel Q Huang; Mark D Muthiah; Juan Pablo Arab; Donghee Kim; Trenton M White; Mazen Noureddin; Elisabetta Bugianesi; Peter Jepsen; Vincent W S Wong; Jeffrey V Lazarus; Karn Wijarnpreecha

doi:10.1002/ueg2.70072

The Rising Global Burden of MASLD and Other Metabolic Diseases (2000-2021)

United European Gastroenterol J. 2025 Jul 3. doi: 10.1002/ueg2.70072. Online ahead of print.

Authors

Pojsakorn Danpanichkul¹, Kanokphong Suparan², Luis Antonio Diaz^{3

4

5}, Michael B Fallon^{6

7}, Vincent L Chen⁸, Kornnatthanai Namsathimaphorn⁹, Krittameth Rakwong⁹, Torlap Inkongngam⁹, Chuthathip Kaeosri⁹, Markos Kalligeros¹⁰, Phuuwadith Wattanachayakul¹¹, Cheng Han Ng¹², Hirokazu Takahashi¹³, Daniel Q Huang¹⁴, Mark D Muthiah¹⁴, Juan Pablo Arab^{4

5

15}, Donghee Kim¹⁶, Trenton M White^{17

18}, Mazen Noureddin¹⁹, Elisabetta Bugianesi²⁰, Peter Jepsen^{21

22}, Vincent W S Wong^{23

24}, Jeffrey V Lazarus^{17

18

25}, Karn Wijarnpreecha^{6

7

26}

Affiliations

¹ Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
² Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
³ MASLD Research Center, Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, California, USA.
⁴ Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
⁵ Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile.
⁶ Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA.
⁷ Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA.
⁸ Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
⁹ Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
¹⁰ Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
¹¹ Department of Medicine, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA.
¹² Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
¹³ Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan.
¹⁴ Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore.
¹⁵ Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
¹⁶ Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
¹⁷ Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
¹⁸ City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA.
¹⁹ Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA.
²⁰ Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Turin, Turin, Italy.
²¹ Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
²² Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
²³ Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
²⁴ State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
²⁵ Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
²⁶ BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA.

PMID: 40605557
DOI: 10.1002/ueg2.70072

Abstract

Background: Metabolic diseases are a public health threat to diverse populations worldwide. This study aims to update the epidemiological trends of metabolic diseases across regions and sociodemographic stratifications using the Global Burden of Diseases Study 2021.

Methods: This study focused on metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) along with obesity, hypertension, and dyslipidemia. The prevalence and disability-adjusted life years (DALYs) with their age-standardised prevalence rate and DALYs (ASPR and ASDALYs) and uncertainty intervals (UIs) were estimated and stratified by sex, geography, and the Sociodemographic Index (SDI). Epidemiological trends were analysed using the Joinpoint Regression method, which calculated the annual percent change (APC) and confidence intervals (CIs) of age-standardised rates (ASRs) from 2000 to 2021.

Results: In 2021, MASLD had a prevalence of 1.27 billion people (ASPR: 15,018.07, 95% UI: 13,756.47 to 16,361.44; ASDALYs: 42.40, 95% UI: 33.60 to 53.31), while T2DM had a prevalence of 0.51 billion people (ASPR: 5885.40, 95% UI: 5467.62 to 6334.18; ASDALYs: 871.78, 95% UI: 735.05 to 1044.78) worldwide. ASPRs of MASLD and T2DM increased over the 2 decades. ASDALYs decreased over time for dyslipidemia (APC: -1.43%, 95% CI: -1.58 to -1.27%) and hypertension (APC: -1.32%, 95% CI: -1.43 to -1.21%) but increased for T2DM (APC: 1.09%, 95% CI: 1.04 to 1.14%) and obesity (APC: 0.70%, 95% CI: 0.63 to 0.78%), while it remained stable for MASLD. The global burden of metabolic diseases was generally higher in males compared to females. The highest ASDALYs for all these metabolic diseases were observed in low-middle SDI countries.

Conclusion: The global burden of MASLD and other metabolic diseases is substantial. National and global policies must better address metabolic diseases including the MASLD public health threat.

Keywords: MASH; MASLD; dyslipidemia; epidemiology; global health; hypertension; liver disease; non‐alcoholic fatty liver disease (NAFLD); obesity; type 2 diabetes.

Abstract

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