{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:02:30Z","timestamp":1793016150609,"version":"4.5.0"},"reference-count":26,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2020,8,2]],"date-time":"2020-08-02T00:00:00Z","timestamp":1596326400000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81560487"],"award-info":[{"award-number":["81560487"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,6,14]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Non-alcoholic fatty liver disease (NAFLD) is the leading cause of end-stage liver diseases worldwide. Understanding NAFLD prevalence and trends over time at the global, regional and national levels is critical to understanding the NAFLD disease burden and creating more tailored prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was global, including 21 regions and 195 countries or territories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes measure<\/jats:title>\n                    <jats:p>The estimated annual percentage change for NAFLD prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Worldwide, cases of NAFLD have increased from 391.2\u2009million in 1990 to 882.1\u2009million in 2017, with the prevalence rate increasing from 8.2% to 10.9% during the same period. The increasing trends were consistent across sexes. Case numbers were highest in East Asia, followed by South Asia, then North Africa and the Middle East. The highest prevalence of NAFLD was observed in North Africa and the Middle East, while the greatest increase was detected in Western Europe, followed by Tropical Latin America, then high-income North America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nearly all countries or territories worldwide have experienced a significant increase in NAFLD prevalence. The greatest increase was observed in Oman. Almost all countries showed a significant increasing trend in NAFLD prevalence over the past three decades. This drastic increase is alarming and suggests that NAFLD has emerged as a new public health concern worldwide. As such, more efficient prevention strategies are urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-036663","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T01:55:13Z","timestamp":1596506113000},"page":"e036663","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":170,"title":["Prevalence trends in non-alcoholic fatty liver disease at the global, regional and national levels, 1990\u20132017: a population-based observational study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4814-448X","authenticated-orcid":false,"given":"Xiaojun","family":"Ge","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxuan","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Zunyi Medical University, Zunyi, Guizhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"2025101812162877000_10.8.e036663.1","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.1002\/hep.30251","article-title":"Global perspectives on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis","volume":"69","author":"Younossi","year":"2019","journal-title":"Hepatology"},{"key":"2025101812162877000_10.8.e036663.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2017.109"},{"key":"2025101812162877000_10.8.e036663.3","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29466"},{"key":"2025101812162877000_10.8.e036663.4","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28431"},{"key":"2025101812162877000_10.8.e036663.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00618-8"},{"key":"2025101812162877000_10.8.e036663.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60460-8"},{"key":"2025101812162877000_10.8.e036663.7","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1053\/j.gastro.2015.05.039","article-title":"High prevalence of nonalcoholic fatty liver disease in adolescents undergoing bariatric surgery","volume":"149","author":"Xanthakos","year":"2015","journal-title":"Gastroenterology"},{"key":"2025101812162877000_10.8.e036663.8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jhep.2019.08.027","article-title":"A cross-sectional study of the public health response to non-alcoholic fatty liver disease in Europe","volume":"72","author":"Lazarus","year":"2020","journal-title":"J Hepatol"},{"key":"2025101812162877000_10.8.e036663.9","unstructured":"Global Burden of Disease Collaborative Network . 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