The increasing clinical burden of NAFLD in Asia

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, affecting 25% of the adult population. 1 Younossi ZM Koenig AB Abdelatif D Fazel Y Henry L Wymer M Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016; 64: 73-84 Crossref PubMed Scopus (5260) Google Scholar The disease is heterogenous and complex, with a wide spectrum of clinical phenotypes that can be affected by a variety of genetic and environmental factors. NAFLD, particularly non-alcoholic steatohepatitis (NASH), is associated with considerable clinical burden, including the development of cirrhosis, hepatocellular carcinoma, and increased morbidity and mortality. 2 Goh GB McCullough AJ Natural history of nonalcoholic fatty liver disease. Dig Dis Sci. 2016; 61: 1226-1233 Crossref PubMed Scopus (89) Google Scholar Although NAFLD epidemiology has been well characterised in western countries, NAFLD is now increasingly recognised in Asia, and NAFLD prevalence in some parts of Asia is similar to that in western countries. 3 Fan JG Kim SU Wong VW New trends on obesity and NAFLD in Asia. J Hepatol. 2017; 67: 862-873 Summary Full Text Full Text PDF PubMed Scopus (565) Google Scholar The increased prevalence of NAFLD is partly due to socioeconomic changes that have occurred in many parts of Asia in recent decades, resulting in rapid urbanisation and changing lifestyles that have caused an increase in obesity and a higher prevalence of metabolic diseases such as NAFLD. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysisNAFLD prevalence in Asia is increasing and is associated with poor outcomes including hepatocellular carcinoma and death. Targeted public health strategies must be developed in Asia to target the drivers of this rising epidemic and its associated complications, especially in high-risk groups, such as older obese men. Full-Text PDF