Steatotic Liver Disease Prevalence in China: A Population‐Based Study and Meta‐Analysis of 17.4 Million Individuals

ABSTRACT Background Steatotic liver disease (SLD), including metabolic dysfunction‐associated SLD (MASLD), has emerged as a leading cause of chronic liver disease in China. Aims We aimed to provide a comprehensive and updated description of SLD prevalence in China. Methods We described the prevalence, subgroup distribution, and clinical characteristics of SLD in the Taizhou Study of Liver Diseases (T‐SOLID). Additionally, we searched for studies reporting SLD prevalence in five databases. Eligible data were analysed using a generalised linear mixed model. Linear regression was applied to estimate the annual average percentage change (AAPC). Results Of the 28,623 participants in T‐SOLID, 30.8% were diagnosed with SLD, among which 83.8% were classified as MASLD. Prevalence of SLD increased from 22.1% in 2018 to 36.7% in 2021. The meta‐analysis included 792 publications and 17,404,296 subjects. Nationwide, the pooled SLD prevalence rose from 23.8% (95% CI 21.9%–25.9%) during 2001–2010 to 27.9% (26.0%–29.8%) during 2016–2023 in the general population (AAPC = 2.56, p < 0.0001), equating to approximately 402.0 million cases. An increase in SLD prevalence was observed in subpopulations by region, sex, and age, and in high‐risk groups. Northeast China had the highest prevalence (35.0%). Males had a higher prevalence rate than females (35.0% vs. 20.6%). SLD prevalence increased with age, ranging from 8.1% in children and adolescents to 31.8% in the elderly. Meta‐regression identified calendar period, age, sex, geographical area, and residence area as significant determinants of SLD prevalence. Conclusion The ubiquitously rising prevalence of SLD in Chinese populations underscores the urgent need for targeted public health interventions.