Non-alcoholic fatty liver disease associated with increased global burden

A recent study presented at the Digestive Disease Week (DDW) 2021 virtual conference aimed to describe the global burden of cirrhosis as the most common complication of chronic liver disease (CLD), among adolescents and young people. adults.

Investigators, led by Zobair Younossi, MD of Inova Fairfax Medical Campus, found that the global burden of Hepatitis B virus (HBV) the incidence of cirrhosis in adolescents and young adults is decreasing, while non-alcoholic fatty liver disease (NAFLD) has increased the incidence.


Researchers used the Global Burden of Disease (GBD) database to assess the incidence, deaths and disability-adjusted life years (DALYs) linked to liver cancer (LC) and cirrhosis .

Patients included early adolescents (15-19 years), late adolescents (20-24 years) and young adults (25-29 years) from 2009 to 2019.

Younossi and colleagues used estimation methods from the GBD study to assess the incidence and deaths of cirrhosis, according to 21 GBD regions.

The team also calculated the annual percentage change (APC) using a Joinpoint regression model.


Investigators found a total of 2,051,554 incidences of cirrhosis and 1,472,012 cirrhosis-related deaths worldwide. In this data set, adolescents and young adults accounted for 11.3% of the incidence of cirrhosis and 37.7% of cirrhosis deaths.

Data shows that the rates of cirrhosis per 100,000 population per year from 2009 to 2019 increased for adolescents from 7.23 to 8.12, with an annual percentage change (APC) of 1.18% (P <.001 the rate remained stable in adults from to>P = 0.651).

The team noted that trends in cirrhosis incidence rates differed across GBD regions, with all 2 of 3 regions experiencing a worsening trend (APC ≥ 0%) in rates. incidence of cirrhosis in adolescents.

However, the team found that unlike the incidence rates, the overall cirrhosis death rate per 100,000 per year declined across all age groups in the study.

Among adolescents, the rate fell from 2.02 to 1.76 (APC -1.60%, P <.001 the rate also decreased among late adolescents from to>P <.001 and in young adults from to>P <.001>

Investigators noted that improving trends in death rates was due to the decrease in the proportion of HBV-related cirrhosis deaths (P <.001 while the proportion of deaths due to hcv and nafld increased>P <.001>

Age played a role in the incidence rates, where an increase in the proportion of deaths with NAFLD increased with age (adolescent APC 0.05%, late adolescent APC 0.34%, and young adults 0.59 %, P <.001>

The data show that among the causes of death from cirrhosis, the highest demographic adjusted correlation with type 2 diabetes and high BMI was NAFLD in all age groups.


The surveys concluded that the global burden of NAFLD is increasing, while the global burden of HBV and HCV among adolescents and young adults is decreasing.

“These data should inform policy makers to address the global public health challenges of NAFLD in all age groups,” the investigators wrote.

The study, “Non-alcoholic fatty liver disease (NAFLD) leads to the global burden of chronic liver disease (CLD) in adolescents and young adultsWas posted online by DDW.

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