{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:59:00Z","timestamp":1787889540452,"version":"build-2784847793"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Currently, there is a lack of global or even country\/regional level data on adolescent non-alcoholic fatty liver disease (NAFLD) prevalence. However, an evidenced dose-dependent relationship exists between body mass index (BMI) and the risk of NAFLD. We aim to estimate the global and regional prevalence of adolescent NAFLD and related non-alcoholic steatohepatitis (NASH) based on BMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sigmoidal fitting curves were generated between BMI and the risk of NAFLD\/NASH using the data extracted from the NHANES database. With global and regional BMI data from the NCD-RisC database, adolescent NAFLD\/NASH prevalence was estimated at the international, regional, and country levels from 1975 to 2016. The prevalence of adolescent NAFLD\/NASH from 2017 to 2030 was also forecasted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean NAFLD prevalence was 15.31, and 12.68%, while the mean NASH prevalence was 2.50, and 2.47%, in boys, and girls aged 12\u201318, respectively. For both boys and girls, NAFLD\/NASH prevalence increased with increasing BMI, and age. The global prevalence of adolescent NAFLD\/NASH has gradually increased in the period from 1975 to 2016 and will maintain a similar trend between 2017 and 2030. High-income Western Countries had higher adolescent NAFLD\/NASH whereas South Asia and Sub-Saharan Africa exhibited relatively lower adolescent NAFLD\/NASH prevalence. The estimated annual percentage change (EAPC) of NAFLD prevalence in boys ranged from 0.72% (age 18) to 1.16% (age 12) while that in girls ranged from 0.69% (age 18) to 0.92% (age 12). EAPC of NASH prevalence in boys ranged from 1.65% (age 18) to 1.77% (age 12), and in girls from 1.48% (age 18) to 1.68% (age 12).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The adolescent NAFLD\/NASH prevalence increases year by year, and its burden varies significantly among different countries and regions. BMI is a precise predictor of NAFLD\/NASH prevalence.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1437432","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T13:59:41Z","timestamp":1729864781000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["A significant and persistent rise in the global burden of adolescent NAFLD and NASH estimated by BMI"],"prefix":"10.3389","volume":"12","author":[{"given":"Xiao-Yun","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Mao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Yi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Yan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Zhu","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangeng","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Shui","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2672","DOI":"10.1002\/hep.30251","article-title":"Global 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rates","volume":"11","author":"Hankey","year":"2000","journal-title":"Cancer Causes Control"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/S2468-1253(21)00296-X","article-title":"Health-care provision and policy for non-alcoholic fatty liver disease in sub-Saharan Africa","volume":"6","author":"Spearman","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1152\/jappl.1998.84.1.389","article-title":"A comprehensive equation for the pulmonary pressure-volume curve","volume":"84","author":"Venegas","year":"1985","journal-title":"J Appl Physiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.cgh.2020.06.048","article-title":"Prevalence of Liver Steatosis and Fibrosis Detected by Transient Elastography in Adolescents in the 2017-2018 National Health and Nutrition Examination 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