Trends of metabolic dysfunction-associated steatotic liver disease in Mexico, 1990–2023: insights from the Global Burden of disease study

INTRODUCTION AND OBJECTIVES: Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a rapidly increasing global public health challenge. The objective was to analyze MASLD trends in Mexico by sex and state (1990-2023) and assess the association between the MASLD burden and the Socio-Demographic Index (SDI). MATERIALS AND METHODS: Secondary analysis of Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2023 data (NAFLD definition, interpreted under the 2023 MASLD nomenclature) conducted across Mexico's 32 states and nationally. We examined key burden indicators like mortality, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALY). We used a Joinpoint regression to identify significant trends and the Pearson correlation coefficient to estimate the relationship between DALY rates and the SDI. RESULTS: Between 1990 and 2023, the national MASLD deaths increased significantly by 229%. Male DALY rates were 2.2 times higher than female rates in 2023, and premature mortality accounted for almost all the burden (around 97%). YLD rates increased significantly, particularly among males, indicating a growing contribution of disability to the total impact of the disease. Sub-nationally, DALY rates rose significantly in 21 states, although declines occurred in Mexico City, Hidalgo, and Jalisco. Nationally, a significant positive correlation (0.71) was found between the DALY rates and the SDI. CONCLUSIONS: These results suggest that socioeconomic development in most regions is associated with the adoption of unhealthy lifestyles and dietary patterns. Future policy interventions must include targeted health campaigns, especially for adult men and women aged between 60-84 years, to mitigate the accelerating trend, alongside regulatory actions necessary to control Mexico's obesogenic environment.