MASLD in India and the world

MASLD

Increasing obesity, hypertension, and type 2 diabetes have led to a parallel rise in the prevalence of MASLD both globally and in India.

 

PREVALENCE OF MASLD WORLDWIDE

The overall global prevalence of MASLD is estimated to be around 25.24% according to an analysis made with a statistical approach. The highest prevalence is reported from the Middle East with 31.79%, followed by South America with 30.45% and the least prevalent rate is reported from Africa with 13.48%.

Prevalence of MASLD in association with risk factors of MASH

  • Hypertriglyceridemia (high fat levels in blood) is prevalent in 40.74% of MASLD and 83.33% of MASH patients
  • Hypertension (high blood pressure) is prevalent in 39.34% of MASLD and 67. 97% of MASH
  • Metabolic Syndrome is prevalent among 42.54% of MASLD and 70.67% of MASH patients
  • Approximately 41% of the MASH patients had progressed to fibrosis
  • More than 95% of people undergoing bariatric surgery for severe obesity will have MASLD
  • Around 1/3rd to 2/3rd of the type 2 diabetes patients have MASLD
  • It is estimated that 50% of people with dyslipidemia (abnormal cholesterol and high fats) have MASLD
  • The prevalence of MASLD in men is twice as compared to women

 

Prevalence of MASH

The prevalence of MASH in the general population is estimated to be in the range of 1.5% and 6.45%. MASH is estimated to be prevalent in 59.10% of the MASLD population.

PREVALENCE OF MASLD AND MASH IN INDIA

It is estimated that 16-32% of the general population in India (nearly 120 million) has MASLD and among them nearly 31% are diagnosed with MASH. Industrialization and change in lifestyle and diet with less physical activity and increased calorie rich food are contributing to the increased prevalence of MASLD in the Indian population.

It is also estimated that 63 million Indians are Type 2 diabetic, and among them 70% are having MASLD (44 million). And one third of the MASLD population is estimated to have MASH (13 million). It is also probable that 5% of people with MASH (650,000) may develop liver cancer.

INCREASED MASLD PREVALENCE IN URBAN INDIAN POPULATION

In India the prevalence is more in urban areas as compared to rural areas due to the presence of risk factors of MASLD like obesity, hypertension, metabolic syndrome, diabetes, insulin resistance and high fat and cholesterol levels in blood. But it is to be noted that the growing trend of obesity in rural areas is contributing to the growing incidence of MASLD in rural India.

Indian population at increased risk of MASLD

Studies are pointing out that Indians are more prone to MASLD compared to other races due to presence of higher insulin resistance and higher fat levels (triglycerides) in blood. The major risk factor of MASLD is insulin resistance and is found in almost 7 -55% of the Indian population.

Reference:

  1. Younossi, Z. M., Koenig, A. B., Abdelatif, D. , Fazel, Y. , Henry, L. and Wymer, M. (2016), Global epidemiology of nonalcoholic fatty liver disease—Meta‐analytic assessment of prevalence, incidence, and outcomes. Hepatology, 64: 73-84. doi:10.1002/hep.28431

 

  1. Chalasani, N. , Younossi, Z. , Lavine, J. E., Charlton, M. , Cusi, K. , Rinella, M. , Harrison, S. A., Brunt, E. M. and Sanyal, A. J. (2018), The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67: 328-357. doi:10.1002/hep.29367

 

  1. Singh, S., Kuftinec, G.N., & Sarkar, S. (2017). Non-alcoholic Fatty Liver Disease in South Asians: A Review of the Literature. Journal of clinical and translational hepatology,5(1):76-81. doi: 10.14218/JCTH.2016.00045

 

  1. Dusheja A et al. (2015). Non-alcoholic Fatty Liver Disease and Metabolic Syndrome-Position Paper of the Indian National Association for the Study of the Liver, Endocrine Society of India, Indian College of Cardiology and Indian Society of Gastroenterology, 5(1):51-68. doi:  10.1016/j.jceh.2015.02.006

 

Ayushman Liver