TY - JOUR
T1 - Two-Decade Trends in MASLD and Its Complications in the Middle East and North Africa (2010–2021)
AU - Younossi, Zobair M.
AU - Paik, James M.
AU - Yilmaz, Yusuf
AU - Kanat, Mustafa
AU - El-Kassas, Mohamed
AU - Al-Busafi, Said A.
AU - Al-Naamani, Khalid M.
AU - Elzouki, Abdel Naser
AU - Alswat, Khalid
AU - Cordie, Ahmed
AU - Osman, Ashraf Omar Abdelaziz
AU - Debzi, Nabil
AU - Khamis, Jawad
AU - Hassanein, Mohamad
AU - Abu-Farha, Mohamed
AU - Al-Mulla, Fahd
AU - Aba-Alkhail, Faisal
AU - Henry, Linda
AU - Zelber-Sagi, Shira
AU - Alaklabi, Asrar
AU - AlQahtani, Saleh
N1 - Publisher Copyright:
© 2025 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2025/10
Y1 - 2025/10
N2 - Background: The Middle East and North Africa (MENA) region is undergoing demographic shifts potentially increasing metabolic dysfunction-associated steatotic liver disease (MASLD) and its complications. We assessed MASLD prevalence and liver disease burden from 2010 to 2021. Methods: Data from Global Burden of Disease (GBD), United Nations Population Division and NCD Risk Factor Collaboration covering 21 MENA countries were used for annual percent change (APC) trends per Joinpoint regression. Regression modelling determined MASLD cirrhosis prevalence (compensated [CC]/decompensated cirrhosis [DCC]). Prevalence and mortality estimates were age-standardised (children and adults). Results: MENA region's population: progressively aged, increased (518–623 million), and experienced prevalence increases in adult diabetes (7.4%–12.1%), obesity (25.4%–31.3%) and MASLD (26.3% [117.97 million] to 27.7% [164.31 million]; APC = 0.47%; 95% CI, 0.35–0.59); steeper increase in adults ≥ 20 years (37.1%–41.0%; APC = 0.90%; 0.79–1.01). MASLD cirrhosis (0.22% [1.13 million] to 0.28% [1.73 million]; APC = 2.18%; 2.05–2.31), CC (0.20%–0.25%; APC = 2.24%) and DCC (0.020%–0.025%; APC = 2.23%) increased. Algeria, Iraq, Morocco and Turkey had the highest increases (APCs > 2.8% for both CC and DCC). MASH cirrhosis mortality (APC = 0.60%), and DALYs (APC = 0.47%) increased. MASH liver cancer prevalence (APC = 2.90%), incidence (APC = 2.90%), mortality (0.50–0.69 per 100 000; APC = 2.87%) and DALYs (APC = 2.51%) increased. Iran had the most rapid increases (APC > 6%) for all liver cancer outcomes; Egypt accounted for ≥ 50% liver cancer DALYs in 2021. Kuwait, West-Bank/Gaza and United Arab Emirates showed stable/declining trends. Conclusions: The prevalence of MASLD and associated complications (cirrhosis and liver cancer) increased substantially across the MENA region from 2010 to 2021, with variation across countries.
AB - Background: The Middle East and North Africa (MENA) region is undergoing demographic shifts potentially increasing metabolic dysfunction-associated steatotic liver disease (MASLD) and its complications. We assessed MASLD prevalence and liver disease burden from 2010 to 2021. Methods: Data from Global Burden of Disease (GBD), United Nations Population Division and NCD Risk Factor Collaboration covering 21 MENA countries were used for annual percent change (APC) trends per Joinpoint regression. Regression modelling determined MASLD cirrhosis prevalence (compensated [CC]/decompensated cirrhosis [DCC]). Prevalence and mortality estimates were age-standardised (children and adults). Results: MENA region's population: progressively aged, increased (518–623 million), and experienced prevalence increases in adult diabetes (7.4%–12.1%), obesity (25.4%–31.3%) and MASLD (26.3% [117.97 million] to 27.7% [164.31 million]; APC = 0.47%; 95% CI, 0.35–0.59); steeper increase in adults ≥ 20 years (37.1%–41.0%; APC = 0.90%; 0.79–1.01). MASLD cirrhosis (0.22% [1.13 million] to 0.28% [1.73 million]; APC = 2.18%; 2.05–2.31), CC (0.20%–0.25%; APC = 2.24%) and DCC (0.020%–0.025%; APC = 2.23%) increased. Algeria, Iraq, Morocco and Turkey had the highest increases (APCs > 2.8% for both CC and DCC). MASH cirrhosis mortality (APC = 0.60%), and DALYs (APC = 0.47%) increased. MASH liver cancer prevalence (APC = 2.90%), incidence (APC = 2.90%), mortality (0.50–0.69 per 100 000; APC = 2.87%) and DALYs (APC = 2.51%) increased. Iran had the most rapid increases (APC > 6%) for all liver cancer outcomes; Egypt accounted for ≥ 50% liver cancer DALYs in 2021. Kuwait, West-Bank/Gaza and United Arab Emirates showed stable/declining trends. Conclusions: The prevalence of MASLD and associated complications (cirrhosis and liver cancer) increased substantially across the MENA region from 2010 to 2021, with variation across countries.
UR - https://www.scopus.com/pages/publications/105015589258
U2 - 10.1111/liv.70342
DO - 10.1111/liv.70342
M3 - Article
C2 - 40919841
AN - SCOPUS:105015589258
SN - 1478-3223
VL - 45
JO - Liver International
JF - Liver International
IS - 10
M1 - e70342
ER -
