Global Epidemiology of NAFLD

Younossi et al. • Hepatology

Key Finding

NAFLD affects approximately 25% of adults globally with highest rates in Middle East and South America.

Original title: “Global epidemiology of nonalcoholic fatty liver disease”

Plain English Summary

Meta-analysis of NAFLD prevalence worldwide showing it affects ~25% of global population. Highlights metabolic syndrome as primary driver.

In-Depth Analysis

Background

Younossi ZM, Koenig AB, Abdelatif D, et al. Hepatology. 2016;64(1):73-84. PMID: 26707365

This systematic review and meta-analysis from Inova Fairfax Hospital established the global burden of nonalcoholic fatty liver disease (NAFLD), documenting its emergence as the most common chronic liver disease worldwide.

Study Design

Parameter	Details
Type	Systematic review and meta-analysis
Data Sources	Studies from 1989-2015 across 22 countries
Total Subjects	>8 million individuals
Primary Outcome	Global and regional NAFLD prevalence
Secondary Outcomes	NASH prevalence, fibrosis rates, mortality

Key Findings

Region	NAFLD Prevalence
Global	25.2%
Middle East	31.8%
South America	30.5%
Asia	27.4%
North America	24.1%
Europe	23.7%
Africa	13.5%

Among NAFLD patients: NASH prevalence 59.1%, significant fibrosis 20.3%.

Mechanistic Insights

The global rise parallels obesity and type 2 diabetes epidemics. The study documents NAFLD as the hepatic manifestation of metabolic syndrome, sharing common pathophysiology of insulin resistance and lipotoxicity.

Clinical Implications

NAFLD affects 1 in 4 adults globally and is now the leading cause of chronic liver disease. Most patients remain undiagnosed. Screening strategies using non-invasive methods (FLI, FIB-4) are increasingly important.

Metabolic Health Perspective

This landmark meta-analysis establishes NAFLD screening relevance. The Fatty Liver Index (FLI) calculator helps identify individuals who may benefit from further hepatic evaluation and metabolic intervention.