Non-alcoholic fatty liver disease epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2] Parth Vikram Singh, MBBS[3]

Overview

The estimated annual incidence of non alcoholic liver disease with steatosis in the United States is approximately 9,255 per 100,000 individuals. The prevalence of non-alcoholic liver disease in the United States is estimated to be 10,000 to 24,000 cases per 100,000 individuals annually. Non-alcoholic fatty liver disease may occur at any age, but is diagnosed most commonly in patients aged 50 to 60 years. Hepatic steatosis is more prevalent in the hispanics.

One estimate of prevalence is 30% from a systematic review[1]. A similar estimate comes from the Global Burden of Disease (GBD) 2019 study[2].

Epidemiology

Incidence

  • The estimated annual incidence of non alcoholic liver disease with steatosis in the United States is approximately 9,255 per 100,000 individuals.
  • The estimated annual incidence of non alcoholic liver disease with steatohepatitis in the United States is approximately 265 per 100,000 individuals .
  • About 1/3 of america population is expected to have non alcoholic fatty liver disease.[3][4][5][6][7]

Prevalance

  • MASLD is the most common chronic liver disease worldwide. Approximately 30% to 40% of adults worldwide have MASLD. The prevalence is substantially higher among individuals with type 2 diabetes and obesity, affecting approximately 60% to 70% of individuals with type 2 diabetes and approximately 70% to 80% of individuals with obesity.[8]
  • In a systematic review of 92 population-based studies from 1990 to 2019, the highest prevalence of ultrasound-detected MASLD was observed in Latin America and the lowest in Western Europe. By 2040, the global prevalence of MASLD among adults is projected to exceed 55%. In 2021, the global age-standardized prevalence of MASLD was 15,018 per 100,000 population, and the annual incidence was 608 per 100,000 population. The prevalence was higher in men than women and peaked at 45 to 49 years of age in men and 50 to 54 years of age in women.
  • Among individuals with type 2 diabetes, the global pooled prevalence of MASLD based on ultrasonography was 65.3%. Among individuals with type 2 diabetes who had liver biopsy data, the global histological prevalence of MASH was 66.4%, stage F2 fibrosis was present in 40.8%, and advanced fibrosis, defined as stage F3 or F4, was present in 15.5%.
  • The prevalence of non-alcoholic liver disease in the United States is estimated to be 10,000 to 24,000 cases per 100,000 individuals annually.
  • In obese children the prevalence of non-alcoholic liver disease is estimated to be 20,000 to 50,000 cases per 100,000 individuals annually.[9]
  • Prevalence of non-alcoholic fatty liver disease increases nearly five fold in obese individuals.

Demographics

Age

  • Non-alcoholic fatty liver disease may occur at any age, but is diagnosed most commonly in patients aged 50 to 60 years.

Gender

  • Men are more commonly affected by non-alcoholic liver disease than women. In global 2021 estimates, prevalence peaked at 45 to 49 years of age in men and at 50 to 54 years of age in women.
  • Among women it is more common in post-menopausal women than pre-menopausal.

Race

  • Hepatic steatosis is more prevalent in the hispanics (45%) race and followed by caucasians (42% of men, 24% of women) and african-american (24%)

References

  1. Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L (2023). "The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review". Hepatology. 77 (4): 1335–1347. doi:10.1097/HEP.0000000000000004. PMC 10026948 Check |pmc= value (help). PMID 36626630 Check |pmid= value (help).
  2. Paik JM, Henry L, Younossi Y, Ong J, Alqahtani S, Younossi ZM (2023). "The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019". Hepatol Commun. 7 (10). doi:10.1097/HC9.0000000000000251. PMC 10545420 Check |pmc= value (help). PMID 37782469 Check |pmid= value (help).
  3. Bellentani S, Scaglioni F, Marino M, Bedogni G (2010). "Epidemiology of non-alcoholic fatty liver disease". Dig Dis. 28 (1): 155–61. doi:10.1159/000282080. PMID 20460905.
  4. Masarone M, Federico A, Abenavoli L, Loguercio C, Persico M (2014). "Non alcoholic fatty liver: epidemiology and natural history". Rev Recent Clin Trials. 9 (3): 126–33. PMID 25514916.
  5. Le MH, Devaki P, Ha NB, Jun DW, Te HS, Cheung RC; et al. (2017). "Prevalence of non-alcoholic fatty liver disease and risk factors for advanced fibrosis and mortality in the United States". PLoS One. 12 (3): e0173499. doi:10.1371/journal.pone.0173499. PMC 5367688. PMID 28346543.
  6. Fan JG, Farrell GC (2009). "Epidemiology of non-alcoholic fatty liver disease in China". J Hepatol. 50 (1): 204–10. doi:10.1016/j.jhep.2008.10.010. PMID 19014878.
  7. Vizuete J, Camero A, Malakouti M, Garapati K, Gutierrez J (2017). "Perspectives on Nonalcoholic Fatty Liver Disease: An Overview of Present and Future Therapies". J Clin Transl Hepatol. 5 (1): 67–75. doi:10.14218/JCTH.2016.00061. PMC 5411359. PMID 28507929.
  8. Tilg H, Petta S, Stefan N, Targher G (January 2026). "Metabolic Dysfunction-Associated Steatotic Liver Disease in Adults: A Review". JAMA. 335 (2): 163–174. doi:10.1001/jama.2025.19615. PMID 41212550 Check |pmid= value (help).
  9. Vizuete J, Camero A, Malakouti M, Garapati K, Gutierrez J (2017). "Perspectives on Nonalcoholic Fatty Liver Disease: An Overview of Present and Future Therapies". J Clin Transl Hepatol. 5 (1): 67–75. doi:10.14218/JCTH.2016.00061. PMC 5411359. PMID 28507929.

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