Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030

  • Background & Aims: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are increasingly a cause of cirrhosis and hepatocellular carcinoma globally. This burden is expected to increase as epidemics of obesity, diabetes and metabolic syndrome continue to grow. The goal of this analysis was to use a Markov model to forecast NAFLD disease burden using currently available data. Methods: A model was used to estimate NAFLD and NASH disease progression in eight countries based on data for adult prevalence of obesity and type 2 diabetes mellitus (DM). Published estimates and expert consensus were used to build and validate the model projections. Results: If obesity and DM level off in the future, we project a modest growth in total NAFLD cases (0–30%), between 2016–2030, with the highest growth in China as a result of urbanization and the lowest growth in Japan as a result of a shrinking population. However, at the same time, NASH prevalence will increase 15–56%, while liver mortality and advanced liver disease will more than double as a result of an aging/increasing population. Conclusions: NAFLD and NASH represent a large and growing public health problem and efforts to understand this epidemic and to mitigate the disease burden are needed. If obesity and DM continue to increase at current and historical rates, both NAFLD and NASH prevalence are expected to increase. Since both are reversible, public health campaigns to increase awareness and diagnosis, and to promote diet and exercise can help manage the growth in future disease burden. Lay summary: Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis can lead to advanced liver disease. Both conditions are becoming increasingly prevalent as the epidemics of obesity and diabetes continue to increase. A mathematical model was built to understand how the disease burden associated with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis will change over time. Results suggest increasing cases of advanced liver disease and liver-related mortality in the coming years.
Author:Chris Estes, Quentin M. Anstee, María Teresa Arias-Loste, Heike Bantel, Stefano Bellentani, Joan Caballeria, Massimo Colombo, Antonio Craxi, Javier Crespo, Christopher P. Day, Yuichiro Eguchi, Andreas Geier, Loreta A. Kondili, Daniela Christina Kroy, Jeffrey V. Lazarus, Rohit Loomba, Michael P. Manns, Giulio Marchesini, Atsushi Nakajima, Francesco Negro, Salvatore Petta, Vlad Ratziu, Manuel Romero-Gomez, Arun Sanyal, Jörn Markus Schattenberg, Frank Tacke, Junko Tanaka, Christian Trautwein, Lai Wei, Stefan ZeuzemORCiDGND, Homie Razavi
Pubmed Id:
Parent Title (English):Journal of hepatology
Publisher:Elsevier Science ; Wiley-Blackwell
Place of publication:Amsterdam [u.a.] ; [s. l.]
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/06/08
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/11/20
Tag:Burden of disease; Cardiovascular disease; Cirrhosis; Diabetes mellitus; HCC; Health care resource utilization; Metabolic syndrome; NAFLD; NASH; Obesity
Page Number:10
First Page:896
Last Page:904
© 2018 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0