Global and regional prevalence, burden, and risk factors for MASLD in children and adolescents aged 5 to 24 years: a systematic review, meta-analysis, and modeling study.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational prevalence and risk factor studies combined with modeling
PubMed 41845468 · doi:10.1186/s12916-026-04801-3
What was done
A systematic review, random-effects meta-regression, and modeling study searched PubMed, EMBASE, Web of Science, Cochrane, and CNKI for studies reporting the prevalence and risk factors of MASLD, MAFLD, and NAFLD in individuals aged 5 to 24 years. Data from eligible studies were combined with Global Burden of Disease, World Population Prospects, and Chinese National Survey data to estimate and project global, regional, and Chinese provincial MASLD burdens.
What was found
Across 56 included studies (37 informing prevalence, 38 informing risk factors), estimated global MASLD prevalence in individuals aged 5 to 24 was 7.0% (95% CI: 4.1 to 11.7), increasing with age and calendar year and showing higher rates in boys. Asia had 63.8 million cases (95% CI: 51.5 to 76.6) in 2000 and 160.9 million (95% CI: 134.5 to 187.6) in 2020. Projections indicate Africa will surpass Asia in total cases from 2040 onward. In China (ages 6 to 18), the highest prevalence shifted from Hebei, Shandong, and Beijing in 2000 to Tianjin, Shandong, and Heilongjiang from 2020 onward.
Why it matters
This study provides global and regional estimates of pediatric and adolescent MASLD, highlighting a shifting future burden toward developing regions like Africa.
Limits
The study synthesizes disparate diagnostic constructs (MASLD, MAFLD, NAFLD) across primary studies. Projections rely on mathematical modeling and demographic assumptions, and sparse primary observational data were available for many regions.
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