Epidemiology of metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis and associated cardiometabolic factors in adults in China (2013-2023): A systematic review and meta-analysis

Jan 2, 2026World journal of gastroenterology

Rates of fatty liver disease linked to metabolism and heart-related health in Chinese adults (2013-2023): A review and combined analysis

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Abstract

The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in China is 30.4%.

The prevalence of metabolic dysfunction-associated steatohepatitis (MASH) is 6.7%.
The annual incidence of MASLD is estimated at 37 cases per 1000 person-years.
Individuals with dyslipidemia have a MASLD prevalence of 59.9%.
The prevalence rates of MASLD in individuals with obesity and hypertension are 53.9% and 44.3%, respectively.
Lean MASLD, defined as having a body mass index below 24 kg/m, affects 12.0% of the population with MASLD.

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BACKGROUND: Although epidemiological data on non-alcoholic fatty liver disease in China are available, data on cardiometabolic risk factors have not been addressed under the metabolic dysfunction-associated steatotic liver disease (MASLD) consensus.

AIM: To synthesize the epidemiological characteristics of MASLD/metabolic dysfunction-associated steatohepatitis (MASH), especially their associated cardiometabolic risk factors in China.

METHODS: We searched EMBASE, MEDLINE, Central Cochrane, CNKI, and Wangfan for studies from January 1, 2013 to December 31, 2023. Studies involving individuals with MASLD/MASH in China that reported epidemiological outcomes were included. Meta-analysis was performed to assess the prevalence of MASLD/MASH. Exploratory outcomes included extrahepatic comorbidities and genetic variants related to MASLD.

RESULTS: In total, 561 studies involving 6632718 participants were included in this analysis. The prevalence of MASLD and MASH and the annual incidence of MASLD were 30.4% [95% confidence interval (CI): 29.4-31.3], 6.7% (95%CI: 2.2-13.4), and 37 cases per 1000 person-years (95%CI: 28-47), respectively. In addition, the prevalence rates of MASLD in individuals with dyslipidemia, obesity, and hypertension were 59.9% (95%CI: 52.6-67.0), 53.9% (95%CI: 47.9-59.9), and 44.3% (95%CI: 41.1-47.6), respectively. The prevalence of lean MASLD (body mass index < 24 kg/m) was 12.0% (95%CI: 10.0-14.0), and 21.7% of the total MASLD population in China had lean MASLD. 2

CONCLUSION: This study provides a comprehensive overview of the epidemiology and disease burden of MASLD/MASH in China, providing additional evidence for optimizing MASLD/MASH management in China and a reference for the global understanding of MASLD/MASH epidemiology.

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Epidemiology of metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis and associated cardiometabolic factors in adults in China (2013-2023): A systematic review and meta-analysis

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