{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:52:32Z","timestamp":1793836352414,"version":"4.6.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>NAFLD, a leading global cause of liver disease, is projected to dominate end-stage liver disease burden. Strongly linked to obesity, type 2 diabetes, and metabolic syndrome, its prevalence and incidence are rising rapidly, yet it remains unclassified by WHO as a priority non-communicable disease. This study aims to assess the global, regional, and national burden of NAFLD from 1990 to 2021 and provide evidence for future prevention and control strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using 2021 Global Burden of Disease (GBD) data, this study analyzed NAFLD prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries (1990\u20132021), stratified by sex, age, and Socio-demographic Index (SDI). Trends were assessed via age-standardized rates (ASR) and estimated annual percentage changes (EAPC), with projections to 2050.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2021, global NAFLD cases surged to 1.268 billion (124.63% increase since 1990), while ASR rose from 12,085.09 to 15,018.07 per 100,000. Middle- and high-SDI regions exhibited steepest rises in incidence and mortality. Oceania, Central and Latin America had highest prevalence; North Africa and the Middle East reported peak incidence. Projections indicate escalating global incidence through 2050, disproportionately affecting females, driven by population growth and aging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The escalating burden underscores urgent need for region-specific interventions, particularly in aging and high-growth populations. Enhanced screening and early intervention are critical to mitigate NAFLD\u2019s expanding impact. This study highlights actionable data to inform global public health strategies, emphasizing tailored prevention and control measures to address evolving epidemiological trends.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1609816","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T05:23:13Z","timestamp":1749187393000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["1990\u20132021 global, regional, and national analysis of the burden and trends of non-alcoholic fatty liver disease"],"prefix":"10.3389","volume":"12","author":[{"given":"Jun","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Xin","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Mei","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"158","DOI":"10.7524\/AJE.1673-5897.20231212001","article-title":"Research progress on non - alcoholic fatty liver induced by environmental pollutants","volume":"19","author":"Yang","year":"2024","journal-title":"Asian J Ecotoxicol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"8263","DOI":"10.3748\/wjg.v23.i47.8263","article-title":"Clinical epidemiology and disease burden of nonalcoholic fatty liver disease","volume":"23","author":"Perumpail","year":"2017","journal-title":"World J Gastroenterol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.cld.2023.01.016","article-title":"Research Priorities for Precision Medicine in NAFLD","volume":"27","author":"Iruzubieta","year":"2023","journal-title":"Clin Liver Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"4978","DOI":"10.22605\/RRH4978","article-title":"What about the health workforce distribution in rural China? An assessment based on eight-year data","volume":"19","author":"Yang","year":"2019","journal-title":"Rural Remote Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e0251","DOI":"10.1097\/HC9.0000000000000251","article-title":"The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019","volume":"7","author":"Paik","year":"2023","journal-title":"Hepatol Commun"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.jhep.2018.05.036","article-title":"Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030","volume":"69","author":"Estes","year":"2018","journal-title":"J Hepatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","year":"2020","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1186\/s12911-021-01534-6","article-title":"ICD-11: an international classification of diseases for the twenty-first century","volume":"21","author":"Harrison","year":"2021","journal-title":"BMC Med Inform Decis Mak"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1016\/S0140-6736(20)30977-6","article-title":"Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019","volume":"396","year":"2020","journal-title":"Lancet"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"11905","DOI":"10.3390\/ijms222111905","article-title":"Clinical and molecular biomarkers for diagnosis and staging of NAFLD","volume":"22","author":"Di Mauro","year":"2021","journal-title":"Int J Mol Sci"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.cmet.2023.02.003","article-title":"The global burden of metabolic disease: Data from 2000 to 2019","volume":"35","author":"Chew","year":"2023","journal-title":"Cell Metab"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1562","DOI":"10.1016\/S0140-6736(20)32226-1","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","year":"2020","journal-title":"Lancet"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"bqaa134","DOI":"10.1210\/endocr\/bqaa134","article-title":"Nafld and Nash in postmenopausal women: implications for diagnosis and treatment","volume":"161","author":"DiStefano","year":"2020","journal-title":"Endocrinology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1047129","DOI":"10.3389\/fnut.2022.1047129","article-title":"Changes in the global, regional, and national burdens of NAFLD from 1990 to 2019: A systematic analysis of the global burden of disease study 2019","volume":"9","author":"Wang","year":"2022","journal-title":"Front Nutr"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1609816\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T05:23:16Z","timestamp":1749187396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1609816\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,6]]},"references-count":15,"alternative-id":["10.3389\/fmed.2025.1609816"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1609816","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,6]]},"article-number":"1609816"}}