[Analysis of a study for the global trend burden of MAFLD-associated cirrhosis based on the 2024 update of the Global Burden of Disease Database].

Objective: This study systematically assessed the latest epidemiological model and changing trends of metabolic-associated fatty liver disease (MAFLD)-associated cirrhosis at the global and regional levels based on the updated 2021 Global Burden of Disease (GBD2021) database, with the aim to provide important reference to make decisions in patients. Methods: Global and regional data on MAFLD-associated cirrhosis were extracted from the GBD 2021 database. Prevalence, incidence rate, and total years lived with disability (YLD), as well as age-standardized rates per 100 000 population, were analyzed according to year, age, and gender. Estimated results were presented with uncertainty intervals (UIs) to ensure the robustness of the statistical findings. Results: The global age-standardized prevalence of MAFLD-associated cirrhosis was 15,017.5 (95% UI 13 755.8-16 360.8) per 100 000 population, the incidence rate was 876.5 (95% UI 862.2-890.0) per 100 000 population, and the YLD rate was 0.4 (95% UI 0.2-0.6) per 100 000 population in 2021. The highest age-standardized prevalence was observed in North Africa and the Middle East, Central Latin America, and Tropical Latin America among the regions. The lowest age-standardized prevalence was observed in high-income North America, Australia, and high-income Asia-Pacific. The highest age-standardized prevalence was observed in Kuwait, Egypt, and Qatar, while the lowest was observed in Japan, Finland, and Canada among 204 countries. Gender analysis revealed that the prevalence rate was significantly higher in males than females, with a peaked prevalence rate in the 45-49 age group for males and the 50-54 age group for females. The incidence rates peaked in the 15-19 and 20-24 age groups, respectively. Conclusion: MAFLD-associated cirrhosis is a global health problem. The highest incidence rates are found in North Africa and the Middle East, central Latin America, and southern sub-Saharan Africa, while the lowest rates are found in high-income North America, Australia, and the Asia-Pacific region. The prevalence, incidence, and YLD and their corresponding age-standardized rates were higher in males than in females between 2010 and 2021. Therefore, understanding the epidemiological characteristics and evolving trends will aid in formulating preventive and treatment strategies to reduce the global burden of MAFLD-associated cirrhosis.