Disparities in metabolic dysfunction-associated steatotic liver disease and cardiometabolic conditions in low and lower middle-income countries: a systematic analysis from the global burden of disease study 2019

• Published in: Metabolism, clinical and experimental Vol. 158; p. 155958
• Main Authors: Danpanichkul, Pojsakorn, Suparan, Kanokphong, Dutta, Priyata, Kaeosri, Chuthathip, Sukphutanan, Banthoon, Pang, Yanfang, Kulthamrongsri, Narathorn, Jaisa-aad, Methasit, Ng, Cheng Han, Teng, Margaret, Nakano, Masahito, Morishita, Asahiro, Alkhouri, Naim, Yang, Ju Dong, Chen, Vincent L., Kim, Donghee, Fallon, Michael B., Diaz, Luis Antonio, Arab, Juan Pablo, Mantzoros, Christos S., Noureddin, Mazen, Lazarus, Jeffrey V., Wijarnpreecha, Karn
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2024
• Subjects: Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Developing Countries - statistics & numerical data; Disparity; Epidemiology; Fatty Liver - complications; Fatty Liver - epidemiology; Female; Global Burden of Disease; Humans; Liver disease; Male; MASLD; Metabolic Diseases - epidemiology; Metabolic syndrome; Middle Aged; NAFLD; Non-alcoholic fatty liver disease; Prevalence; T2DM; NAFLD; ASDALYs; GNI; HTN; ICD-10; IHD; AF/AFL; GBD; DLP; SLD; Metabolic syndrome; Epidemiology; CKD; ASDR; WHO; ASR; Lower MICs; Liver disease; ASPR; MASLD; LICs; PAD; APC; GHDx; DALYs; Disparity; Non-alcoholic fatty liver disease
• ISSN: 0026-0495; 1532-8600; 1532-8600
• DOI: 10.1016/j.metabol.2024.155958

Metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic conditions affect populations across economic strata. Nevertheless, there are limited epidemiological studies addressing these diseases in low (LICs) and lower-middle-income countries (lower MICs). Therefore, an analysis of the trend of MASLD and cardiometabolic conditions in these countries is necessary. From 2000 to 2019, jointpoint regression analysis was employed to calculate the prevalence, mortality, and disability-adjusted life years (DALYs) for cardiometabolic conditions including MASLD, type 2 diabetes mellitus (T2DM), dyslipidemia (DLP), hypertension (HTN), obesity, peripheral artery disease (PAD), atrial fibrillation and flutter (AF/AFL), ischemic heart disease (IHD), stroke, and chronic kidney disease from HTN and T2DM, in LICs and lower MICs (according to the World Bank Classification 2019) using the Global Burden of Disease 2019 data. Among the eleven cardiometabolic conditions, MASLD (533.65 million), T2DM (162.96 million), and IHD (76.81 million) had the highest prevalence in LICs and Lower MICs in 2019. MASLD represented the largest proportion of global prevalence in these countries (43 %). From 2000 to 2019, mortality in LICs and lower MICs increased in all cardiometabolic conditions, with obesity-related mortality having the highest increase (+134 %). During this timeframe, there were increased age-standardized death rates (ASDR) from obesity, PAD, and AF/AFL. From all conditions, the DALYs-to-prevalence ratio was higher in LICs and lower MICs than the global average. The burden of MASLD and cardiometabolic conditions is increasing worldwide, with LICs and lower MICs experiencing higher (DALYs) disability per prevalence. As these conditions are preventable, counteracting these trends requires not only the modification of ongoing actions but also the strategizing of immediate interventions. •MASLD and cardiometabolic complications are increasingly common in many countries, yet data in low and lower-middle-income countries remain limited.•From 2000 to 2019, the mortality from MASLD and cardiometabolic complications increased, with the highest increase observed in mortality from obesity (+134 %).•MASLD in low and lower-middle-income countries accounted for approximately 43 % of the global prevalence.