Acredita-se que a prevalência global da doença hepática gordurosa associada a disfunção metabólica (DHGDM) seja superior a 25%.[6]Duell PB, Welty FK, Miller M, et al; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Lifestyle and Cardiometabolic Health; and Council on Peripheral Vascular Disease. Nonalcoholic fatty liver disease and cardiovascular risk: a scientific statement from the American Heart Association. Arterioscler Thromb Vasc Biol. 2022 Jun;42(6):e168-85.
https://www.ahajournals.org/doi/full/10.1161/ATV.0000000000000153
http://www.ncbi.nlm.nih.gov/pubmed/35418240?tool=bestpractice.com
A maior prevalência está no sul da Ásia (33%), Oriente Médio (32%) e América do Sul (30%), e a menor prevalência está na África (13%).[6]Duell PB, Welty FK, Miller M, et al; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Lifestyle and Cardiometabolic Health; and Council on Peripheral Vascular Disease. Nonalcoholic fatty liver disease and cardiovascular risk: a scientific statement from the American Heart Association. Arterioscler Thromb Vasc Biol. 2022 Jun;42(6):e168-85.
https://www.ahajournals.org/doi/full/10.1161/ATV.0000000000000153
http://www.ncbi.nlm.nih.gov/pubmed/35418240?tool=bestpractice.com
[7]Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84.
https://www.doi.org/10.1002/hep.28431
http://www.ncbi.nlm.nih.gov/pubmed/26707365?tool=bestpractice.com
[8]Wong VW, Chan WK, Chitturi S, et al. Asia-Pacific working party on non-alcoholic fatty liver disease guidelines 2017 - part 1: definition, risk factors and assessment. J Gastroenterol Hepatol. 2018 Jan;33(1):70-85.
https://www.doi.org/10.1111/jgh.13857
http://www.ncbi.nlm.nih.gov/pubmed/28670712?tool=bestpractice.com
A prevalência aumenta com a idade.[7]Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84.
https://www.doi.org/10.1002/hep.28431
http://www.ncbi.nlm.nih.gov/pubmed/26707365?tool=bestpractice.com
A idade mediana ao diagnóstico é de 53 anos, mas a condição pode ocorrer em qualquer idade, inclusive durante a infância e adolescência.[9]Allen AM, Therneau TM, Larson JJ, et al. Nonalcoholic fatty liver disease incidence and impact on metabolic burden and death: a 20 year-community study. Hepatology. 2018 May;67(5):1726-36.
http://www.ncbi.nlm.nih.gov/pubmed/28941364?tool=bestpractice.com
[10]Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):319-34.
https://www.doi.org/10.1097/MPG.0000000000001482
http://www.ncbi.nlm.nih.gov/pubmed/28107283?tool=bestpractice.com
Entre 1997 e 2014, os casos de DHGDM aumentaram 7 vezes em adultos de 18 a 39 anos, 6 vezes em adultos de 40 a 59 anos e 4 vezes em adultos com 60 anos ou mais.[9]Allen AM, Therneau TM, Larson JJ, et al. Nonalcoholic fatty liver disease incidence and impact on metabolic burden and death: a 20 year-community study. Hepatology. 2018 May;67(5):1726-36.
http://www.ncbi.nlm.nih.gov/pubmed/28941364?tool=bestpractice.com
A prevalência de suspeita de DHGDM em adolescentes norte-americanos aumentou de 3.9% em 1988 a 1994 para 10.7% em 2007 a 2010.[11]Welsh JA, Karpen S, Vos MB. Increasing prevalence of nonalcoholic fatty liver disease among United States adolescents, 1988-1994 to 2007-2010. J Pediatr. 2013 Mar;162(3):496-500.e1.
http://www.ncbi.nlm.nih.gov/pubmed/23084707?tool=bestpractice.com
Os homens têm maior probabilidade de serem afetados pela DHGDM que as mulheres.[12]Balakrishnan M. Women have a lower risk of nonalcoholic fatty liver disease but higher risk of nonalcoholic fatty liver disease fibrosis than men: summary of the findings of a systematic review and meta-analysis. Clin Liver Dis (Hoboken). 2021 Nov;18(5):251-4.
https://www.doi.org/10.1002/cld.1139
http://www.ncbi.nlm.nih.gov/pubmed/34840727?tool=bestpractice.com
[13]Shaheen M, Schrode KM, Pan D, et al. Sex-specific differences in the association between race/ethnicity and NAFLD among US population. Front Med (Lausanne). 2021;8:795421.
https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.795421/full
http://www.ncbi.nlm.nih.gov/pubmed/34926533?tool=bestpractice.com
Diferenças étnicas parecem desempenhar um papel na prevalência de fígado gorduroso nos EUA, sendo as pessoas hispânicas mais afetados que as brancas.[11]Welsh JA, Karpen S, Vos MB. Increasing prevalence of nonalcoholic fatty liver disease among United States adolescents, 1988-1994 to 2007-2010. J Pediatr. 2013 Mar;162(3):496-500.e1.
http://www.ncbi.nlm.nih.gov/pubmed/23084707?tool=bestpractice.com
[13]Shaheen M, Schrode KM, Pan D, et al. Sex-specific differences in the association between race/ethnicity and NAFLD among US population. Front Med (Lausanne). 2021;8:795421.
https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.795421/full
http://www.ncbi.nlm.nih.gov/pubmed/34926533?tool=bestpractice.com
Existem algumas evidências sugerindo que os afro-americanos são menos suscetíveis à forma progressiva da doença.[14]Sherif ZA, Saeed A, Ghavimi S, et al. Global epidemiology of nonalcoholic fatty liver disease and perspectives on US minority populations. Dig Dis Sci. 2016 May;61(5):1214-25.
http://www.ncbi.nlm.nih.gov/pubmed/27038448?tool=bestpractice.com
Na Inglaterra, as taxas de morte prematura por DHGDM aumentaram significativamente em 2020 em comparação com 2019. A taxa foi de 0.64 óbitos por 100,000 habitantes com idade <75 anos.[15]Office for Health Improvement and Disparities. Liver disease profiles: November 2021 update. Nov 2021 [internet publication].
https://www.gov.uk/government/statistics/liver-disease-profiles-november-2021-update/liver-disease-profiles-november-2021-update
A incidência e a prevalência da esteatose hepática associada a disfunção metabólica (EHDM) são mais difíceis de determinar devido à necessidade de biópsia para se fazer o diagnóstico. Quase 60% das pessoas com DHGDM que fazem biópsia hepática por indicação clínica têm evidência histológica de EHDM.[7]Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84.
https://www.doi.org/10.1002/hep.28431
http://www.ncbi.nlm.nih.gov/pubmed/26707365?tool=bestpractice.com
Cerca de 41% dos pacientes com EHDM têm fibrose hepática progressiva.[7]Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84.
https://www.doi.org/10.1002/hep.28431
http://www.ncbi.nlm.nih.gov/pubmed/26707365?tool=bestpractice.com
A fibrose avançada (estágios 3 e 4) na EHDM está associada a um aumento das complicações relacionadas ao fígado e das mortes.[16]Sanyal AJ, Van Natta ML, Clark J, et al. Prospective study of outcomes in adults with nonalcoholic fatty liver disease. N Engl J Med. 2021 Oct 21;385(17):1559-69.
http://www.ncbi.nlm.nih.gov/pubmed/34670043?tool=bestpractice.com