Epidemiology

The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is thought to be greater than 25%.[6] Highest prevalence is in South Asia (33%), Middle East (32%), and South America (30%), and lowest prevalence is in Africa (13%).[6][7][8]​​ Prevalence increases with age.[7] The median age at diagnosis is 53 years but the condition can occur at any age, including during childhood and adolescence.[9][10]​​ Between 1997 and 2014, cases of MASLD increased 7-fold in adults aged 18-39 years, 6-fold in adults aged 40-59 years, and 4-fold in adults aged 60 years and older.[9] Prevalence of suspected MASLD in US adolescents increased from 3.9% in 1988 to 1994 to 10.7% in 2007 to 2010.[11]

Men are more likely to be affected by MASLD than women.​[12][13]

Ethnic differences seem to play a role in the prevalence of fatty liver in the US, with Hispanic people more affected than white people.[11][13]​ There is some evidence to suggest that African-Americans are less susceptible to the progressive form of the disease.[14]

In England, the rates of premature death due to MASLD increased significantly in 2020 compared with 2019. The rate was 0.64 deaths per 100,000 population aged <75 years.[15]

The incidence and prevalence of metabolic dysfunction-associated steatohepatitis (MASH) is more difficult to ascertain because of the necessity of biopsy in order to make the diagnosis. Nearly 60% of people with MASLD who have a liver biopsy for a clinical indication have histological evidence of MASH.[7] About 41% of patients with MASH have progressive liver fibrosis.[7] Advanced (stages 3 and 4) fibrosis in MASH is associated with increased liver-related complications and death.[16]

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