MASLD prevalence, incidence and global aspects

Over the last decade it has become clear that obesity and type 2 diabetes are key to the aetiology, pathogenesis and outcomes of metabolic dysfunction-associated steatotic liver disease (MASLD). The considerable current and potential burden of MASLD on patients and healthcare systems is therefore inextricably linked with today's global epidemics of obesity and type 2 diabetes. In this review, we discuss estimates of the global MASLD burden in terms of prevalence, incidence, disability from complications and reduced life expectancy associated with the condition. We also highlight the variability in MASLD prevalence estimates among different populations, with a particular focus on the sub-Saharan Africa and Asia Pacific regions, where population increases and the epidemiological transition (a sustained shift in population mortality and disease patterns from infectious diseases towards non-communicable diseases) are occurring most rapidly. Additionally, we consider the impact of social determinants of health, including socioeconomic conditions, structural inequities, care access, food environments and systemic discrimination. We also identify opportunities to advance equity in MASLD prevention, diagnosis and treatment worldwide.