{
  "abstract": "Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasing health problem in the Asia-Pacific region, contributing significantly to morbidity and healthcare burden. This study provides a comprehensive analysis of the burden of MASLD across countries and territories in the Asia-Pacific region from 1990 to 2023.Methods We used the Global Burden of Disease 2023 data set to assess the burden of MASLD in the Asia-Pacific region, calculating age-standardised prevalence, incidence, death and disability-adjusted life year (DALY) rates. Temporal trends, age-specific and sex-specific patterns, and the relationship between MASLD burden and Socio-demographic Index (SDI) were also analysed, along with regional variations driven by ageing, population growth and epidemiological changes.Results In 2023, MASLD prevalence varied across the Asia-Pacific region, with the highest rates in Oceania (15 360.55 per 100 000), Central Asia (15 201.10 per 100 000), South-East Asia (15 116.91 per 100 000) and East Asia (15 042.06 per 100 000), and lower rates in Australasia (9336.02 per 100 000) and high-income regions (8654.71 per 100 000). Over the past three decades, MASLD prevalence has increased across all regions, with the largest growth in Australasia (29%) and East Asia (27%). In addition, marked regional disparities were observed in age-standardised death and DALY rates, with Central Asia exhibiting the highest health loss across the region. Age-stratified analyses revealed that the highest incidence occurred in individuals aged 20–24 years in 2023. MASLD burden followed an inverse U-shaped pattern with SDI, increasing in regions with lower SDI and decreasing in those above 0.62. Population growth and lifestyle changes were the primary drivers of MASLD in East Asia, while ageing significantly contributed to the rising burden in South Asia.Conclusions MASLD is increasingly prevalent across the Asia-Pacific region, driven by ageing, population growth and epidemiological changes, with significant regional variations in the disease burden.",
  "authors": [
    {
      "affiliations": [
        "MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China",
        "Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China"
      ],
      "name": "Xiao-Dong Zhou"
    },
    {
      "affiliations": [
        "Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China",
        "Institute of Aging, the Center for Geriatric Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China"
      ],
      "name": "Qin-Fen Chen"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Verona, Verona, Italy",
        "Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy"
      ],
      "name": "Giovanni Targher"
    },
    {
      "affiliations": [
        "Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK"
      ],
      "name": "Christopher D Byrne"
    },
    {
      "affiliations": [
        "Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy",
        "Department of Precision Medicine, Biological Resource Center Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy"
      ],
      "name": "Luca Valenti"
    },
    {
      "affiliations": [
        "Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore",
        "Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore"
      ],
      "name": "Mark D Muthiah"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea"
      ],
      "name": "Seung Up Kim"
    },
    {
      "affiliations": [
        "Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore",
        "Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore"
      ],
      "name": "Daniel Q Huang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan"
      ],
      "name": "Masato Yoneda"
    },
    {
      "affiliations": [
        "Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK"
      ],
      "name": "Wenhao Li"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey"
      ],
      "name": "Yusuf Yilmaz"
    },
    {
      "affiliations": [
        "Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University Innsbruck, Innsbruck, Austria"
      ],
      "name": "Herbert Tilg"
    },
    {
      "affiliations": [
        "Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China",
        "State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China"
      ],
      "name": "Vincent Wai-Sun Wong"
    },
    {
      "affiliations": [
        "MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China",
        "Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China"
      ],
      "name": "Ming-Hua Zheng"
    }
  ],
  "title": "Burden of metabolic dysfunction-associated steatotic liver disease in the Asia-Pacific region from 1990 to 2023",
  "uid": "b4a60ca5-e300-5cb8-b1f8-3ccca2d3d6cc"
}