HOW PREVALENT IS NASH?

Because NASH is difficult to identify until the late stages of the disease,1,2 prevalence can only be estimated. However, the trends in these estimations of NASH and NAFLD prevalence are alarming and should not be ignored.

  • Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver condition in Western populations and is fueled by the obesity and type 2 diabetes epidemics.3-6
  • NASH prevalence is expected to increase by 63% between 2015 and 2030.7
  • NASH is expected to become the leading cause of liver transplantation in the United
    States between 2020-2025.8

PREVALENCE WORLDWIDE:

In a meta-analysis of several studies using various methodologies, worldwide prevalence of:8

  • NAFLD: 25.2%
  • NASH: 1.5–6.45%

Another study based on one of the largest databases in the United States (12,317 individuals) reported that 34% of the general adult population of the United States is affected by NAFLD, amounting to at least 43 million adults.10

PREVALENCE IN THE UNITED STATES:10, 11

  • NAFLD: 34%
  • NASH: 12%

PREVALENCE BY ETHNICITY IN THE UNITED STATES11

NAFLD:
  • Hispanics: 58.3%
  • Caucasians: 44.6%
  • Afro-Americans: 35.1%
NASH prevalence:
  • Hispanics: 19.4%
  • Caucasians: 9.8%

PEDIATRIC NAFLD AND NASH

Fueled by the growing childhood obesity epidemic, NAFLD in children has become a major health concern for the medical community. Since the first reported case in 1983, NAFLD has become a leading cause of childhood chronic liver disease.12

A growing number of studies in pediatric populations report a significant increase of NAFLD prevalence in children and adolescents over the last few decades with prevalence of NAFLD ranging from 3% to 10% and up to 70% in obese populations.13,14

WHO IS AT RISK FOR NASH?

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References

  1. Mayo Clinic. Nonalcoholic fatty liver disease. https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567?p=1. Accessed October 7, 2019.
  2. Polis S, Fernandez R. Impact of physical and psychological factors on health-related quality of life in adult patients with liver cirrhosis: a systematic review protocol. JBI Database System Rev Implement Rep. 2015;13(1)39-51.
  3. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol, 2016;64(6):1388-1402.
  4. Younossi ZM, Blissett D, Blissett R, et al. The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe. Hepatology. 2016;64(5):1577-1586.
  5. Organisation for Economic Co-operation and Development (OECD). Obesity Update 2017. https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf. Published 2017. Accessed October 8, 2019.
  6. Guariguata L, Whiting DR, Hambleton I, et al. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103:137-149.
  7. Estes C, Razavi H, Loomba R, et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018;67(1):123-133.
  8. Wong RJ, Aguilar M, Cheung R, et al. Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology. 2015;148:547-555.
  9. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease – Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84.
  10. Kim D, Kim WR, Kim HJ, et al. Association between non-invasive fibrosis markers and mortality among adults with non-alcoholic fatty liver disease in the United States. Hepatology. 2013;57(4):1357-1365.
  11. Williams CD, Stengel J, Asike MI, et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology. 2011;140(1):124- 131.
  12. Selvakumar PKC, Kabbany MN, Nobili V, Alkhouri N. Nonalcoholic fatty liver disease in children: hepatic and extrahepatic complications. Pediatr Clin North Am. 2017;64(3):659-675.
  13. Doycheva I, Watt KD, Alkhouri N. Nonalcoholic fatty liver disease in adolescents and young adults: the next frontier in the epidemic. Hepatology. 2017;65:2100-2109.
  14. Welsh JA, Karpen S, Vos MB. Increasing prevalence of nonalcoholic fatty liver disease among United States adolescents, 1988-1994 to 2007-2010. J Pediatr. 2013;162(3):496- 500.

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