{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T13:59:51Z","timestamp":1788011991381,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Middle East and North Africa (MENA) region is undergoing demographic shifts potentially increasing metabolic dysfunction\u2010associated steatotic liver disease (MASLD) and its complications. We assessed MASLD prevalence and liver disease burden from 2010 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from Global Burden of Disease (GBD), United Nations Population Division and NCD Risk Factor Collaboration covering 21 MENA countries were used for annual percent change (APC) trends per Joinpoint regression. Regression modelling determined MASLD cirrhosis prevalence (compensated [CC]\/decompensated cirrhosis [DCC]). Prevalence and mortality estimates were age\u2010standardised (children and adults).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MENA region's population: progressively aged, increased (518\u2013623\u2009million), and experienced prevalence increases in adult diabetes (7.4%\u201312.1%), obesity (25.4%\u201331.3%) and MASLD (26.3% [117.97\u2009million] to 27.7% [164.31\u2009million]; APC\u2009=\u20090.47%; 95% CI, 0.35\u20130.59); steeper increase in adults \u2265\u200920\u2009years (37.1%\u201341.0%; APC\u2009=\u20090.90%; 0.79\u20131.01). MASLD cirrhosis (0.22% [1.13\u2009million] to 0.28% [1.73\u2009million]; APC\u2009=\u20092.18%; 2.05\u20132.31), CC (0.20%\u20130.25%; APC\u2009=\u20092.24%) and DCC (0.020%\u20130.025%; APC\u2009=\u20092.23%) increased. Algeria, Iraq, Morocco and Turkey had the highest increases (APCs &gt;\u20092.8% for both CC and DCC). MASH cirrhosis mortality (APC\u2009=\u20090.60%), and DALYs (APC\u2009=\u20090.47%) increased. MASH liver cancer prevalence (APC\u2009=\u20092.90%), incidence (APC\u2009=\u20092.90%), mortality (0.50\u20130.69 per 100\u2009000; APC\u2009=\u20092.87%) and DALYs (APC\u2009=\u20092.51%) increased. Iran had the most rapid increases (APC &gt;\u20096%) for all liver cancer outcomes; Egypt accounted for \u2265\u200950% liver cancer DALYs in 2021. Kuwait, West\u2010Bank\/Gaza and United Arab Emirates showed stable\/declining trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of MASLD and associated complications (cirrhosis and liver cancer) increased substantially across the MENA region from 2010 to 2021, with variation across countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70342","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T12:20:19Z","timestamp":1757334019000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Two\u2010Decade Trends in\n                    <scp>MASLD<\/scp>\n                    and Its Complications in the Middle East and North Africa (2010\u20132021)"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9313-577X","authenticated-orcid":false,"given":"Zobair M.","family":"Younossi","sequence":"first","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Beatty Liver and Obesity Research Program Inova Health System  Falls Church Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Paik","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Beatty Liver and Obesity Research Program Inova Health System  Falls Church Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4518-5283","authenticated-orcid":false,"given":"Yusuf","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Gastroenterology School of Medicine, Recep Tayyip Erdo\u011fan University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Kanat","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Medicine, DIMER Diabetes Research Center Istanbul Medeniyet University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3396-6894","authenticated-orcid":false,"given":"Mohamed","family":"El\u2010Kassas","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Endemic Medicine Department, Faculty of Medicine Helwan University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2741-0440","authenticated-orcid":false,"given":"Said A.","family":"Al\u2010Busafi","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Gastroenterology and Hepatology Unit, Department of Medicine, College of Medicine and Health Sciences Sultan Qaboos University  Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2892-266X","authenticated-orcid":false,"given":"Khalid M.","family":"Al\u2010Naamani","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Division of Gastroenterology and Hepatology, Department of Medicine The Medical City for Military and Security Services  Muscat Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9132-1752","authenticated-orcid":false,"given":"Abdel\u2010Naser","family":"Elzouki","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Medicine, Hamad Medical Corporation College of Medicine\u2010Qatar University and Weill Cornell Medicine  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3521-8523","authenticated-orcid":false,"given":"Khalid","family":"Alswat","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Medicine, Liver Disease Research Centre, College of Medicine King Saud University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Cordie","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Endemic and Hepatology, Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5370-5421","authenticated-orcid":false,"given":"Ashraf Omar Abdelaziz","family":"Osman","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Endemic and Hepatology, Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabil","family":"Debzi","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Hepatology Mustapha Bacha University Hospital  Algiers Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad","family":"Khamis","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Salmaniya Medical Complex (SMC)  Manama Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Hassanein","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Dubai Hospital and Mohamed Bin Rashid University  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abu\u2010Farha","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Translational Research Dasman Diabetes Institute  Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahd","family":"Al\u2010Mulla","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Department of Translational Research Dasman Diabetes Institute  Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Aba\u2010Alkhail","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC USA"},{"name":"Gastroenterology Section, Department of Medicine King Faisal Specialist Hospital and Research Center  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-6124","authenticated-orcid":false,"given":"Linda","family":"Henry","sequence":"additional","affiliation":[{"name":"The Global NASH Council  Washington, DC 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USA"},{"name":"Liver, Digestive, and Lifestyle Health Research Section, and Organ Transplant Center of Excellence King Faisal Specialist Hospital and Research Center  Riyadh Saudi Arabia"},{"name":"Center for Outcomes Research in Liver Diseases  Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15852"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.05.022"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000004"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","unstructured":"Z. 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