The global NAFLD epidemic

• Published in: Nature reviews. Gastroenterology & hepatology Vol. 10; no. 11; pp. 686 - 690
• Main Authors: Loomba, Rohit, Sanyal, Arun J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-11-2013; Nature Publishing Group
• Subjects: 692/698/2741/288; 692/699/1503/1607/2750; 692/700/478/174; Biomedicine; Development and progression; Disease Progression; Epidemics; Fatty liver; Fatty Liver - epidemiology; Fatty Liver - genetics; Fatty Liver - physiopathology; Gastroenterology; Global Health - trends; Hepatology; Humans; Insulin Resistance - physiology; Medical geography; Medicine; Medicine & Public Health; Non-alcoholic Fatty Liver Disease; Prevalence; science-and-society
• ISSN: 1759-5045; 1759-5053
• DOI: 10.1038/nrgastro.2013.171

Global differences in the prevalence and presentation of NAFLD are presented in this Perspectives article. The authors also convey how scientific advances in our understanding and management of NAFLD now need to be translated to improve awareness at the level of society, influence global health policy and research priorities and ensure a better future for our coming generations.
NAFLD is a clinical syndrome characterized by predominant macrovesicular steatosis of the liver. The clinical and histological phenotypes of NAFLD extend from a nonalcoholic fatty liver to NASH. Although the prevalence of NAFLD is increasing globally, and it is set to become the predominant cause of chronic liver disease in many parts of the world, the epidemiology and demographic characteristics of NAFLD vary worldwide. Indeed, the condition is associated with obesity and insulin resistance in most cases in the Western world, but the disease manifests at a lower BMI in Asian countries and many patients do not seem to have insulin resistance as determined using conventional methods. The similarities and differences in the epidemiology of NAFLD in different regions of the world are discussed and the potential role of genetics and insulin resistance in disease progression is also presented.