Rising burden of metabolic dysfunction-associated steatotic liver disease in adolescents aged 15-19 years and projections to 2035.

BACKGROUND & AIMS: The burden of metabolic dysfunction-associated steatotic liver disease (MASLD) in adolescents is growing, but updated global data are limited. We estimated the global and regional temporal trends in the burden of MASLD among adolescents across 204 countries/territories from 2010 to 2021 and projected prevalence through 2035.

METHODS

Utilizing the methodology framework of the Global Burden of Disease Study 2021, we analyzed prevalence, incident cases, and disability-adjusted life-years among adolescents aged 15-19 years. Autoregressive integrated moving average modeling was employed for prevalence projections.

RESULTS

In 2021, the global prevalence of MASLD among adolescents was 5.31 % (95 % uncertainty interval [UI] 4.06--6.78), with marked geographic disparities. From 2010 to 2021, the global prevalence of MASLD increased substantially, with a relative increase of 6.77 %. The prevalence of MASLD among adolescents ranged from 4.53 % (3.47-5.80) in Southeast Asia to 8.80 % (6.79-11.04) in the Eastern Mediterranean region. High-middle sociodemographic index countries experienced the steepest relative increase in prevalence (+11.22 %). Sex-stratified analyses revealed higher baseline prevalence in males (5.94 % [4.53-7.56] vs. 4.64 % [3.55-5.91] in females), yet females greater increase in prevalence (+8.72 % vs. + 5.31 % increase from 2010 to 2021), with projections indicating widening disparities (10.3 % vs. 6.4 % rise by 2035). High body mass index correlated with MASLD prevalence (p < 0.001).

CONCLUSIONS

The prevalence of MASLD among adolescents continues to rise. Multiple disparities are apparent, with a rapid rise of MASLD in adolescents in Europe and among females. These data may have important implications for shaping public health policies and clinical practice.