Fatty liver disease MASLD to affect 16% of teens, young adults by 2050
Rising disease prevalence driven by physical inactivity, poor dietary habits
The total number of adolescents and young adults with metabolic dysfunction-associated steatotic liver disease (MASLD), a form of fatty liver disease, has been steadily increasing over the last three decades. If that trend continues, more than 16,000 out of every 100,000 young people are expected to have MASLD in 2050, a study shows.
“The rising prevalence of [MASLD] among adolescents and young adults is driven by unhealthy lifestyle factors, including physical inactivity, poor dietary habits, and the consumption of high-fat, high-sugar foods,” wrote the study’s researchers, who called for more efforts to combat the disease, including public health initiatives to prevent and manage it, and the development of better treatments.
The study, “Global burden trends and forecasts for MAFLD in adolescents and young adults from 1990 to 2021,” was published in Scientific Reports.
In MASLD, formerly nonalcoholic fatty liver disease, fat builds up in the liver of people who typically have risk factors such as diabetes, high blood pressure, and/or obesity. This buildup can lead to inflammation and scarring, setting the stage for liver cancer or liver failure.
Increases in MASLD
Here, scientists analyzed global MASLD epidemiological data, such as the occurrence, distribution, and patterns, from 1990 to 2021 to assess trends among adolescents and young adults, ages 15-39. The analysis was based on the latest data from the 2021 Global Burden of Disease database.
Over about three decades, MASLD global prevalence, or the total number of cases, among young people increased by 75.31%, from about 241 million in 1990 up to 423 million in 2021. Correspondingly, in 1990 about 11,000 out of every 100,000 young people had MASLD and by 2021, this increased to more than 14,200 out of every 100,000 young people.
The incidence of MASLD — that is, the number of new cases within a given time — likewise increased by 70.54%, from 17 million in 1990 to 29 million in 2021.
MASLD prevalence and incidence “among global youth and young adults showed a steady increase” over the years, and the disease burden in this population “is expected to rise steadily in the coming years,” the researchers wrote. Analyses showed that, if trends continue as they have been, 16,101 out of every 100,000 young people will have MASLD by 2050, with about 1,170 new cases per 100,000 people. This works out to about 521 million young adults and adolescents with the disease by 2050, based on projected global population changes.
Also, the number of disability-adjusted life years (DALYs), a measure of overall disease burden where a DALY represents the loss of the equivalent of one year of full health, increased from 225 million in 1990 to 377 million in 2021.
Effects of dietary changes, urbanization
The increase in MASLD rates over the past three decades has been particularly dramatic in certain parts of the world, particularly North Africa, East Asia, and the Middle East, the researchers said.
“North Africa, the Middle East, and East Asia are identified as hotspots for [MASLD] prevalence, likely due to rising obesity rates and lifestyle changes,” they wrote. “Urbanization and dietary shifts towards high-calorie, high-sugar, and high-fat foods contribute to the increasing prevalence of [MASLD] in these regions.”
Regions with a higher degree of development, including Western Europe, high-income Asia Pacific, and East Asia, showed a reduction in DALYs over time.
Rates of MASLD also varied by age and biological sex. Across the three decades studies, the disease was consistently more common in men than women, “with prevalence increasing with age and peaking in the 35–39 age group,” wrote the researchers, who noted “an alarming trend of increased incidence … in younger [groups] (under 30 years), highlighting the need for focused interventions in this age group.”
Tobacco use and having high levels of blood sugar were also identified as main behavioral and metabolic risk factors of MASLD.
“Targeted interventions, improved public health measures, and enhanced data accuracy are essential to address this growing issue effectively,” the scientists wrote.
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