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Epidemiology and burden

TL;DR — Roughly 30% of the world's adults have steatotic liver disease of metabolic type, but the pooled point estimates published between 2019 and 2024 span 29.8% to 38%, and the spread is driven by diagnostic modality, study period and case definition rather than by real disagreement about the disease. Meta-analyses of NAFLD-defined populations give 30.05% (95% CI 27.88–32.32) across 92 studies and 9.36 million people (Younossi 2023, PMID 36626630), 32.4% (29.9–34.9) across 72 studies (Riazi 2022, PMID 35798021), 29.8% (28.6–31.1) across 245 studies and 5.4 million people (Le 2022, PMID 34890795), and 30.2% (28.7–31.7) across 479 studies and 78 million people (Amini-Salehi 2024, PMID 39094335). US elastography-based estimates of MASLD specifically are higher — 31.3% (29.2–33.4) in NHANES 2017–March 2020 (Lee 2024, PMID 37732946) and 31.9% (30.4–33.4) in NHANES 2017–2023 (Kim 2025, PMID 39610192) — because controlled attenuation parameter detects steatosis that ultrasound misses. Prevalence is rising: +50.4% between 1990–2006 and 2016–2019 by meta-regression (PMID 36626630), and MASLD age-standardised prevalence rose 11.2% between 2010 and 2021 in GBD while hepatitis B fell 20.4% (Feng 2025, PMID 40062742). The number that matters for health systems is not prevalence but the small fraction with advanced fibrosis: global advanced fibrosis prevalence in the general population is 3.3% (2.4–4.2) and cirrhosis 1.3% (0.9–1.7) (Zamani 2025, PMID 39209202), and a US model projects liver-related deaths rising from 30,500 in 2020 to 95,300 in 2050 (Le 2025, PMID 39821400).

Global prevalence: the estimates and why they differ

Estimate Population/definition Method Years covered Source
30.05% (27.88–32.32) NAFLD, population-based 92 studies, N=9,361,716; random effects 1990–2019 Younossi 2023, PMID 36626630
32.4% (29.9–34.9) NAFLD, imaging-diagnosed, general adult 72 studies, N=1,030,160, 17 countries to May 2021 Riazi 2022, PMID 35798021
29.8% (28.6–31.1) NAFLD 245 studies, N=5,399,254 to Mar 2020 Le 2022, PMID 34890795
30.2% (28.7–31.7) NAFLD 479 studies, N=78,001,755, 38 countries to May 2023 Amini-Salehi 2024, PMID 39094335
~38% NAFLD, narrative synthesis review to 2023 Wong 2023, PMID 37169151
31.3% (29.2–33.4) MASLD, CAP-defined NHANES 2017–Mar 2020, n=7,367 2017–2020 Lee 2024, PMID 37732946
31.9% (30.4–33.4) MASLD, CAP ≥285 dB/m, age-adjusted NHANES 2017–2023, n=12,199 2017–2023 Kim 2025, PMID 39610192
30–40% MASLD, narrative review to 2025 Tilg 2026, PMID 41212550

Three sources of divergence account for nearly all of the spread, and none of them is a defect in any one study:

  • Modality. Ultrasound-defined NAFLD pools at 30.69% (28.4–33.09) (PMID 36626630); vibration-controlled transient elastography with CAP detects lower-grade steatosis and yields higher SLD estimates (35.0%, 33.4–36.7, for all SLD in NHANES 2017–2023, PMID 39610192). Sensitivity of ultrasound falls at steatosis below ~20–30% of hepatocytes.
  • Period. Prevalence is genuinely increasing, so pooled estimates are anchored to their median study year. Meta-regression across 1991–2019 gives a +0.7% per year trend (p<0.0001), from 21.9% to 37.3% (PMID 34890795).
  • Definition. As covered in nomenclature and definitions, NAFLD, MAFLD and MASLD prevalences in the same NHANES III sample were 18.5%, 19.3% and 20.8% (Song 2024, PMID 38293788).

These estimates should not be averaged. They should be quoted with modality, period and definition attached.

Regional variation

Region NAFLD prevalence (95% CI) Source
Latin America 44.37% (30.66–59.00) Younossi 2023, PMID 36626630
Middle East & North Africa 36.53% (28.63–45.22) PMID 36626630
South Asia 33.83% (22.91–46.79) PMID 36626630
South-East Asia 33.07% (18.99–51.03) PMID 36626630
North America 31.20% (25.86–37.08) PMID 36626630
East Asia 29.71% (25.96–33.76) PMID 36626630
Asia-Pacific 28.02% (24.69–31.60) PMID 36626630
Western Europe 25.10% (20.55–30.28) PMID 36626630
South America 35.7% (34.0–37.5) Le 2022, PMID 34890795 (3 studies, n=5,716)
Asia (pooled, 237 studies) 29.62% (28.13–31.15) Li 2019, PMID 30902670
Australia 16.1% (9.0–24.8) Amini-Salehi 2024, PMID 39094335

Two regional patterns deserve emphasis. First, MASLD prevalence peaks at moderate socio-demographic index, not at the highest, unlike most chronic liver disease (Feng 2025, PMID 40062742); consistently, in the 479-study meta-analysis, higher human development index was associated with lower NAFLD prevalence (coefficient −0.523, p=0.005) (PMID 39094335). Second, Asian prevalence rose from 25.28% (22.42–28.37) in 1999–2005 to 33.90% (31.74–36.12) in 2012–2017 (p<0.0001), with a pooled annual incidence of 50.9 per 1,000 person-years (44.8–57.4) (Li 2019, PMID 30902670), and in China the increase has been fastest in younger people alongside a genetic and BMI profile that differs from US populations (Zhou 2020, PMID 32012320).

In the MENA region between 2010 and 2021, adult MASLD prevalence rose from 26.3% (117.97 million) to 27.7% (164.31 million), annual percent change 0.47% (95% CI 0.35–0.59), while MASLD cirrhosis prevalence rose from 0.22% to 0.28% (APC 2.18%, 2.05–2.31) and MASH liver-cancer incidence rose at APC 2.90% — the complications growing about five times faster than the disease itself (Younossi 2025, PMID 40919841).

Incidence

Incidence estimates are far scarcer than prevalence estimates and are dominated by East Asian cohorts.

Estimate Population Source
46.9 per 1,000 person-years (36.4–57.5) 16 studies, 381,765 people, 5 countries Riazi 2022, PMID 35798021
46.13 per 1,000 person-years (39.3–52.9) 63 studies, 1,201,807 people; 26 from China/Hong Kong, 22 South Korea, 14 Japan Le 2023, PMID 37040843
50.9 per 1,000 person-years (44.8–57.4) Asia, 237 studies Li 2019, PMID 30902670

Male sex, obesity and smoking all raise incidence substantially: 59.4 vs 36.7 per 1,000 PY for men vs women (p=0.0013); 86.7 vs 29.6 for obese vs non-obese (p<0.0001); 80.4 vs 46.9 for smokers vs non-smokers (p=0.046) (Le 2023, PMID 37040843). The geographic concentration of the incidence literature in three countries is a real limitation: there is no comparably powered incidence estimate for Africa, South Asia or Latin America.

Sex, age and body weight

  • Sex. Prevalence 39.7% (36.6–42.8) in men vs 25.6% (22.3–28.8) in women (p<0.0001) (Riazi 2022, PMID 35798021); 36.6% (34.7–38.4) vs 25.5% (23.9–27.1) in the 78-million meta-analysis (PMID 39094335); the male:female ratio is about 2 (Tilg 2026, PMID 41212550). Forecasting suggests the sex gap narrows over time: projected 2040 prevalence 60% in men vs 50% in women, but the annual rate of increase is steeper in women (2.5% vs 1.5%, p=0.025) (Le 2022, PMID 36117442).
  • Overweight and obesity. In overweight people, pooled NAFLD prevalence is 69.99% (65.40–74.21) and NASH 33.50% (28.38–39.04); in obesity, NAFLD 75.27% (70.90–79.18) and NASH 33.67% (28.45–39.31). Clinically significant fibrosis (F2–4) affects 20.27% (11.32–33.62) of overweight and 21.60% (11.47–36.92) of obese people with NAFLD; advanced fibrosis (F3–4) 6.65% (4.35–10.01) and 6.85% (3.85–11.90) respectively (Quek 2023, PMID 36400097).
  • Type 2 diabetes. Pooled NAFLD prevalence 65.04% (61.79–68.15) and NASH 31.55% (17.12–50.70) in 1,832,125 people with T2D; F2–4 fibrosis in 35.54% (19.56–55.56) and F3–4 in 14.95% (11.03–19.95) of those with both (Cho 2023, PMID 37491159). See MASLD and type 2 diabetes.
  • Children. Pooled paediatric NAFLD prevalence is 13% (9–18) in the general population and 47% (41–53) in children with obesity, with a male excess in both (15% vs 10%; 54% vs 39%) (Lee 2024, PMID 38771552). A separate meta-analysis gives 14.3% (10.3–18.8) in children and 38.0% (31.5–44.7) in children with obesity (PMID 39094335).
  • Lean phenotype. Covered separately in lean MASLD; global prevalence of non-obese/lean NAFLD and its distinct outcome profile come from Ye 2020, PMID 32413340.

The fraction that matters: advanced fibrosis

Prevalence of the disease and prevalence of the problem differ by an order of magnitude.

Metric Estimate Population Source
Advanced fibrosis, general population 3.3% (2.4–4.2) 46 studies, ~8 million people, 21 countries Zamani 2025, PMID 39209202
Cirrhosis, general population 1.3% (0.9–1.7) same PMID 39209202
Advanced fibrosis among people with SLD (US, pre-COVID) 7.4% (CAP ≥285) NHANES Kim 2025, PMID 39610192
Advanced fibrosis among people with SLD (US, COVID era) 9.8% (CAP ≥285), p=0.039 vs pre-COVID NHANES PMID 39610192
High-risk NASH (NAS ≥4 and F≥2), US adults, FAST ≥0.35 5.8% age-adjusted NHANES 2017–2018, n=4,218 Vilar-Gomez 2023, PMID 34958922
High-risk NASH, FAST ≥0.67 (90% specificity) 1.2% age-adjusted same PMID 34958922
High-risk NASH in people with T2D 8.7%–22.5% depending on FAST cut-off same PMID 34958922

The high-risk NASH figures translate to at least 2 million US adults at the specific cut-off, and demonstrate the compression: about 30% of adults have the disease, roughly 6% have a high-risk phenotype, ~3% have advanced fibrosis, ~1% have cirrhosis. Prevalence trends in advanced fibrosis rose after 2016 for both advanced fibrosis (p=0.004) and cirrhosis (p=0.034) (PMID 39209202).

The COVID-era signal in NHANES is worth flagging as an unresolved observation rather than an established effect: overall SLD and MASLD prevalence did not change significantly, but advanced fibrosis within SLD rose, and the proportion of advanced fibrosis and cirrhosis among people with ALD was about twice that in MASLD and MetALD (PMID 39610192).

Projections

Projection Horizon Result Source
Markov model, US 2015→2030 Prevalent NAFLD 83.1 M → 100.9 M (+21%); NASH 16.52 M → 27.00 M (+63%); decompensated cirrhosis incidence +168% to 105,430/yr; HCC +137% to 12,240/yr; liver deaths +178% to 78,300/yr; ~800,000 excess liver deaths over the period Estes 2018, PMID 28802062
Markov model, 8 countries 2016→2030 Total NAFLD cases +0–30%; NASH prevalence +15–56%; liver mortality and advanced liver disease more than double Estes 2018, PMID 29886156
Agent-based state-transition model, US adults 2020→2050 MASLD prevalence 33.7% (86.3 M) → 41.4% (121.9 M); MASH 14.9 M → 23.2 M; MASH with F≥2 6.7 M → 11.7 M; HCC 11,483 → 22,440 new cases/yr; liver transplant 1,717 → 6,720/yr; liver-related deaths 30,500 (1.0% of adult deaths) → 95,300 (2.4%) Le 2025, PMID 39821400
Hierarchical Bayesian forecast, global →2040 NAFLD prevalence 55.7%, from 38.9% in 2020; average annual increase 2.16% Le 2022, PMID 36117442
ARIMA forecast, Asia →~2041 MASLD incidence +34% vs 1990 baseline; nine CKM-related conditions including MASLD accounted for 50.9% of Asian disease prevalence and 34.4% of deaths in 2021 Duo 2026, PMID 41643809

All of these are models whose inputs are obesity and diabetes trajectories; the 2040 figure of 55.7% is a forecast, not a measurement, and its largest projected increases are in groups where the current prevalence is lowest (women, smokers, and — counterintuitively — people without metabolic syndrome, whose increase rate was 3.8% vs 0.84% per year, p=0.003) (PMID 36117442).

Place among liver diseases

Liver disease accounts for about 2 million deaths annually, 4% of all deaths worldwide, roughly two-thirds of them in men; the leading causes of cirrhosis globally are viral hepatitis, alcohol, and NAFLD (Devarbhavi 2023, PMID 36990226). Steatotic liver disease has become the leading cause of cirrhosis in the EU and USA, and cirrhosis is globally the 11th leading cause of death (Israelsen 2024, PMID 39488409).

The direction of travel is legible in GBD age-standardised prevalence per 100,000 for 2021: hepatitis B 3,583.6 (95% UI 3,293.6–3,887.7), hepatitis C 1,717.8 (1,385.5–2,075.3), MASLD 15,018.1 (13,756.5–16,361.4), cirrhosis and other chronic liver disease 20,302.6 (18,845.2–21,791.9). Between 2010 and 2021, age-standardised prevalence changed −20.4% for hepatitis B, −5.1% for hepatitis C, +11.2% for MASLD and +2.6% for cirrhosis (Feng 2025, PMID 40062742).

Prevalence is enormous; measured disability is not

The most striking number in the burden literature is a mismatch. Ranking the five common metabolic diseases by disability-adjusted life years in GBD 2021 (Zhang 2024, PMID 39151887):

Condition 2021 DALYs (95% UI) Annual percentage change, 1990–2021
Hypertension 226 million (190–259) −0.30% (−0.34 to −0.25) — slowing
Type 2 diabetes 75 million (63–90) +0.42% (0.34–0.51) — accelerating
Obesity — +0.26% (0.17–0.34) — accelerating
Hypercholesterolaemia — −0.33% (−0.37 to −0.30) — slowing
MASLD 3.67 million (2.90–4.61) +0.05% (−0.06 to 0.17) — no significant change

MASLD carries roughly 1/20th the DALY burden of type 2 diabetes and 1/60th that of hypertension, despite affecting ~30% of adults, and its age-standardised burden has not significantly changed in three decades — even as GBD's own age-standardised prevalence estimate for MASLD rose 11.2% between 2010 and 2021 (PMID 40062742). The absolute burden concentrates in India, China and the United States; the highest relative burden is in Oceania island states. One plausible reconciliation is attribution: GBD may assign much of the later burden to cirrhosis and cardiovascular disease rather than to MASLD itself. The cited analysis reports the disparity but does not test that explanation, so it remains a hypothesis. The small DALY estimate also sits uneasily beside interview evidence that patients report fatigue, pain and cognitive symptoms before cirrhosis.

An earlier GBD analysis covering 2000–2019 found prevalence rising for all metabolic diseases with the steepest rise in high socio-demographic-index countries, while mortality rates fell over time for NAFLD, hyperlipidaemia and hypertension but not for type 2 diabetes or obesity, with the highest mortality in the WHO Eastern Mediterranean region and in low and low-middle SDI countries (Chew 2023, PMID 36889281). Improving cardiovascular care is one possible explanation for falling NAFLD mortality alongside rising prevalence; the analysis did not distinguish that from coding or attribution changes.

India: a large national synthesis

The regional table above under-represents South Asia. Pooling 62 datasets from 50 Indian studies (23,581 adults, 2,903 children), NAFLD prevalence was 38.6% (32.0–45.5) in adults and 35.4% (18.2–54.7) in children (Shalimar 2022, PMID 35677499):

Subgroup Pooled prevalence
Adults, average-risk (community, controls, unselected, athletes, aviation crew, army personnel) 28.1% (20.8–36.0)
Adults, high-risk (obesity/overweight, diabetes, coronary artery disease) 52.8% (46.5–59.1)
Hospital-based data 40.8% (32.6–49.3)
Community-based data 28.2% (16.9–41.0)
Children, non-obese 12.4% (4.4–23.5)
Children, obese 63.4% (59.4–67.3)

The hospital-versus-community gap of 12.6 percentage points within one country shows how strongly sampling setting can affect a national estimate; it should not be interpreted as a direct measure of how much between-country variation is caused by setting.

Mortality and cause of death

Pooled mortality rates per 1,000 person-years in NAFLD cohorts diagnosed without biopsy: all-cause 12.60 (6.68–23.67), cardiac-specific 4.20 (1.34–7.05), extrahepatic-cancer-specific 2.83 (0.78–4.88), and liver-specific 0.92 (0.00–2.21) (Younossi 2023, PMID 36626630). Cardiac deaths therefore outnumber liver deaths roughly 4.5:1 in unselected populations — the single most consequential epidemiological fact about this condition, and the subject of cardiovascular and extrahepatic outcomes. The ordering inverts in advanced fibrosis; see natural history and fibrosis progression.

Open questions

  • Why is MASLD's measured disability burden so small relative to its prevalence? 3.67 million DALYs against 75 million for type 2 diabetes and 226 million for hypertension, with no significant change in three decades (PMID 39151887), while prevalence rose 11.2% over 2010–2021 (PMID 40062742). If this is an attribution artefact — burden shifted to "cirrhosis" and to cardiovascular disease — then GBD systematically understates the case for MASLD policy, and no study has re-attributed the burden under alternative rules.
  • Is falling NAFLD mortality alongside rising prevalence a real success or a coding shift? GBD 2000–2019 shows exactly that pattern (PMID 36889281). Improving cardiovascular care in a population dying mostly of cardiovascular disease would produce it; so would reassignment of deaths to cirrhosis or HCC. The two have not been separated.
  • What is the incidence of MASLD outside East Asia? The PubMed abstract reports 63 studies overall but lists 26 from China/Hong Kong, 22 from South Korea, 14 from Japan and two elsewhere (Sri Lanka and Israel), counts that sum to 64. That source-internal inconsistency prevents a valid “62 of 63” calculation, but still shows overwhelming East Asian concentration (PMID 37040843). No comparably powered incidence estimate was identified for Africa, South Asia or Latin America in the 2026-09-02 re-run (1,081 records).
  • Is the post-2016 rise in advanced-fibrosis prevalence real or a measurement artefact? Both the general-population meta-analysis (PMID 39209202) and NHANES (PMID 39610192) show it, but elastography deployment expanded over the same interval, so ascertainment and incidence are confounded.
  • Why does MASLD prevalence peak at moderate SDI? The inverse HDI association (PMID 39094335) and the SDI peak (PMID 40062742) are consistent with each other and inconsistent with a simple affluence model of metabolic disease; no mechanistic study has tested nutrition-transition versus surveillance-intensity explanations.
  • Do the model projections survive the arrival of effective therapy? Every projection above was built assuming no disease-modifying treatment, and the largest (PMID 39821400) says so explicitly. None has been re-run incorporating resmetirom or incretin uptake.

References

  1. Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335-1347. PMID 36626630
  2. Riazi K, Azhari H, Charette JH, et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022;7(9):851-861. PMID 35798021
  3. Le MH, Yeo YH, Li X, et al. 2019 Global NAFLD Prevalence: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2022;20(12):2809-2817.e28. PMID 34890795
  4. Amini-Salehi E, Letafatkar N, Norouzi N, et al. Global Prevalence of Nonalcoholic Fatty Liver Disease: An Updated Review Meta-Analysis comprising a Population of 78 million from 38 Countries. Arch Med Res. 2024;55(6):103043. PMID 39094335
  5. Le MH, Le DM, Baez TC, et al. Global incidence of non-alcoholic fatty liver disease: A systematic review and meta-analysis of 63 studies and 1,201,807 persons. J Hepatol. 2023;79(2):287-295. PMID 37040843
  6. Li J, Zou B, Yeo YH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2019;4(5):389-398. PMID 30902670
  7. Quek J, Chan KE, Wong ZY, et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023;8(1):20-30. PMID 36400097
  8. En Li Cho E, Ang CZ, Quek J, et al. Global prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus: an updated systematic review and meta-analysis. Gut. 2023;72(11):2138-2148. PMID 37491159
  9. Lee EJ, Choi M, Ahn SB, et al. Prevalence of nonalcoholic fatty liver disease in pediatrics and adolescents: a systematic review and meta-analysis. World J Pediatr. 2024;20(6):569-580. PMID 38771552
  10. Ye Q, Zou B, Yeo YH, et al. Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(8):739-752. PMID 32413340
  11. Zamani M, Alizadeh-Tabari S, Ajmera V, et al. Global Prevalence of Advanced Liver Fibrosis and Cirrhosis in the General Population: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2025;23(7):1123-1134. PMID 39209202
  12. Vilar-Gomez E, Vuppalanchi R, Mladenovic A, et al. Prevalence of High-risk Nonalcoholic Steatohepatitis (NASH) in the United States: Results From NHANES 2017-2018. Clin Gastroenterol Hepatol. 2023;21(1):115-124.e7. PMID 34958922
  13. Lee BP, Dodge JL, Terrault NA. National prevalence estimates for steatotic liver disease and subclassifications using consensus nomenclature. Hepatology. 2024;79(3):666-673. PMID 37732946
  14. Kim D, Danpanichkul P, Wijarnpreecha K, et al. Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023. Clin Mol Hepatol. 2025;31(2):382-393. PMID 39610192
  15. Song R, Li Z, Zhang Y, et al. Comparison of NAFLD, MAFLD and MASLD characteristics and mortality outcomes in United States adults. Liver Int. 2024;44(4):1051-1060. PMID 38293788
  16. Zhou J, Zhou F, Wang W, et al. Epidemiological Features of NAFLD From 1999 to 2018 in China. Hepatology. 2020;71(5):1851-1864. PMID 32012320
  17. Wong VW, Ekstedt M, Wong GL, et al. Changing epidemiology, global trends and implications for outcomes of NAFLD. J Hepatol. 2023;79(3):842-852. PMID 37169151
  18. Younossi ZM, Paik JM, Yilmaz Y, et al. Two-Decade Trends in MASLD and Its Complications in the Middle East and North Africa (2010-2021). Liver Int. 2025;45(10):e70342. PMID 40919841
  19. Feng G, Yilmaz Y, Valenti L, et al. Global Burden of Major Chronic Liver Diseases in 2021. Liver Int. 2025;45(4):e70058. PMID 40062742
  20. Devarbhavi H, Asrani SK, Arab JP, et al. Global burden of liver disease: 2023 update. J Hepatol. 2023;79(2):516-537. PMID 36990226
  21. 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. PMID 28802062
  22. Estes C, Anstee QM, Arias-Loste MT, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030. J Hepatol. 2018;69(4):896-904. PMID 29886156
  23. Le P, Tatar M, Dasarathy S, et al. Estimated Burden of Metabolic Dysfunction-Associated Steatotic Liver Disease in US Adults, 2020 to 2050. JAMA Netw Open. 2025;8(1):e2454707. PMID 39821400
  24. Le MH, Yeo YH, Zou B, et al. Forecasted 2040 global prevalence of nonalcoholic fatty liver disease using hierarchical bayesian approach. Clin Mol Hepatol. 2022;28(4):841-850. PMID 36117442
  25. Duo T, Wen Y, Bian Y, et al. Rising burden of MASLD and CKM syndrome in Asia: A decade of trends and future projections. Metabolism. 2026;178:156549. PMID 41643809
  26. Israelsen M, Francque S, Tsochatzis EA, et al. Steatotic liver disease. Lancet. 2024;404(10464):1761-1778. PMID 39488409
  27. Tilg H, Petta S, Stefan N, et al. Metabolic Dysfunction-Associated Steatotic Liver Disease in Adults: A Review. JAMA. 2026;335(2):163-174. PMID 41212550
  28. Zhang H, Zhou XD, Shapiro MD, et al. Global burden of metabolic diseases, 1990-2021. Metabolism. 2024;160:155999. PMID 39151887
  29. Chew NWS, Ng CH, Tan DJH, et al. The global burden of metabolic disease: Data from 2000 to 2019. Cell Metab. 2023;35(3):414-428.e3. PMID 36889281
  30. Shalimar, Elhence A, Bansal B, et al. Prevalence of Non-alcoholic Fatty Liver Disease in India: A Systematic Review and Meta-analysis. J Clin Exp Hepatol. 2022;12(3):818-829. PMID 35677499