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

  • World J Gastroenterol. 2025 Dec 14;31(46):113608. doi: 10.3748/wjg.v31.i46.113608.
Shang-Yu Chai  1 ,  Ru-Ya Zhang  1 ,  Gail Fernandes  2 ,  Yi-Man Zheng  1 ,  Lai Wei  3  4
Affiliations
  • 1. Value & Implementation Global Medical & Scientific Affairs, MSD China, Shanghai 200233, China.
  • 2. Value & Implementation Outcomes Research, MRL, Merck & Co., Inc., Rahway, NJ 19454, United States.
  • 3. Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China.
  • 4. Key Laboratory of Digital Intelligent Hepatobiliary Medicine (Tsinghua University), Ministry of Education, Beijing 102218, China. [email protected].
PMID: 41479652 DOI: 10.3748/wjg.v31.i46.113608
Abstract

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/m2) was 12.0% (95%CI: 10.0-14.0), and 21.7% of the total MASLD population in China had lean MASLD.

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.

Keywords
Disease burden; Epidemiology; Meta-analysis; Metabolic dysfunction-associated steatohepatitis; Metabolic dysfunction-associated steatotic liver disease.
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