# The Burden of Nonmalignant Metabolic Dysfunction‐Associated Steatotic Liver Disease in the Western Pacific Region: A Systematic Analysis From 1990 to 2021

## TL;DR

This study analyzes the growing health impact of noncancerous fatty liver disease in the Western Pacific region from 1990 to 2021, showing rising cases and the need for early prevention.

## Contribution

The study provides the first comprehensive analysis of MASLD burden in the Western Pacific region using GBD data and projects future trends.

## Key findings

- Nonmalignant MASLD incidence, prevalence, and DALYs in the WPR increased significantly from 1990 to 2021.
- Younger males, especially those aged 15–19, show the highest MASLD incidence rates.
- Mongolia has the highest relative risk of MASLD-related deaths and DALYs, while Japan, Singapore, and China have lower risks.

## Abstract

The burden of metabolic dysfunction‐associated steatotic liver disease (MASLD) is increasing, yet there is little understanding in the Western Pacific Region (WPR). This study aims to report the latest MASLD burden in the WPR from 1990 to 2021. This study obtained nonmalignant and total MASLD incidence, prevalence, mortality, disability‐adjusted life years (DALYs), years of life lost (YLLs), and years of healthy life lost due to disability (YLDs) from the Global Burden of Disease (GBD) database, and calculated age‐standardized ratios (ASRs) for each indicator. Estimated annual percentage changes (EAPCs) were calculated using a log‐transformed linear regression model. The age‐period‐cohort (APC) model was used to analyze regional MASLD‐related deaths; the Bayesian age‐period‐cohort (BAPC) model was used to estimate future trends from 2022 to 2050. The incidence, prevalence, deaths, and DALYs of nonmalignant MASLD in the WPR in 2021 are 12 million, 359.2 million, 10,195 cases, and 0.24 million years, respectively. The WPR has a high incidence of MASLD in younger age groups, especially in males, with the 15–19‐year‐old male group being 1215.82 per 100,000. Mongolia has the highest relative risk of deaths and DALYs, while Japan, Singapore, and China are comparatively low. The proportion of deaths and DALYs due to nonmalignant MASLD is increasing. Nonmalignant MASLD is projected to be the dominant component of resulting deaths and DALYs by 2050 in some countries. The WPR burden of MASLD is increasing, with a high prevalence in younger individuals, indicating the need for early initiation of targeted and effective MASLD prevention.

The overall GBD descriptions of non‐malignant MASLD in the western pacific region. (A) Estimated annual percentage changes (EAPCs) in age standardized rates of incidence for non‐malignant MASLD by country, for the period 1990–2021. (B) EAPCs in age standardized rates of prevalence for non‐malignant MASLD by country, for the period 1990–2021. (C) EAPCs in age standardized rates of deaths for non‐malignant MASLD by country, for the period 1990–2021. (D) EAPCs in age standardized rates of disability adjusted life years (DALYs) for non‐malignant MASLD by country, for the period 1990–2021. (E) EAPCs in age standardized rates of years of healthy life lost due to disability (YLDs) for non‐malignant MASLD by country, for the period 1990–2021. (F) EAPCs in age standardized rates of years of life lost (YLLs) for non‐malignant MASLD by country, for the period 1990–2021.