The Rising Global Burden of MASLD and Other Metabolic Diseases (2000–2021)

BACKGROUND: Metabolic diseases are a public health threat to diverse populations worldwide. This study aims to update the epidemiological trends of metabolic diseases across regions and sociodemographic stratifications using the Global Burden of Diseases Study 2021. METHODS: This study focused on metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) along with obesity, hypertension, and dyslipidemia. The prevalence and disability-adjusted life years (DALYs) with their age-standardised prevalence rate and DALYs (ASPR and ASDALYs) and uncertainty intervals (UIs) were estimated and stratified by sex, geography, and the Sociodemographic Index (SDI). Epidemiological trends were analysed using the Joinpoint Regression method, which calculated the annual percent change (APC) and confidence intervals (CIs) of age-standardised rates (ASRs) from 2000 to 2021. RESULTS: In 2021, MASLD had a prevalence of 1.27 billion people (ASPR: 15,018.07, 95% UI: 13,756.47 to 16,361.44; ASDALYs: 42.40, 95% UI: 33.60 to 53.31), while T2DM had a prevalence of 0.51 billion people (ASPR: 5885.40, 95% UI: 5467.62 to 6334.18; ASDALYs: 871.78, 95% UI: 735.05 to 1044.78) worldwide. ASPRs of MASLD and T2DM increased over the 2 decades. ASDALYs decreased over time for dyslipidemia (APC: -1.43%, 95% CI: -1.58 to -1.27%) and hypertension (APC: -1.32%, 95% CI: -1.43 to -1.21%) but increased for T2DM (APC: 1.09%, 95% CI: 1.04 to 1.14%) and obesity (APC: 0.70%, 95% CI: 0.63 to 0.78%), while it remained stable for MASLD. The global burden of metabolic diseases was generally higher in males compared to females. The highest ASDALYs for all these metabolic diseases were observed in low-middle SDI countries. CONCLUSION: The global burden of MASLD and other metabolic diseases is substantial. National and global policies must better address metabolic diseases including the MASLD public health threat.