The Epidemiology of Nonalcoholic Fatty Liver Disease: A Global Perspective

Mariana Lazo, M.D., M.Sc.; Jeanne M. Clark, M.D., M.P.H.


Semin Liver Dis. 2008;28(4):339-350. 

In This Article


NAFLD is a highly prevalent condition in the United States and worldwide. Estimates in the U.S. population suggest that up to 30% of adults may have NAFLD (defined as 5% or more of liver fat). The prevalence estimates from several other countries are quite variable, but depict a highly prevalent condition with ~20% of the adult population with US-defined NAFLD (30% or more liver fat). Cross-sectional and prospective data indicate that insulin resistance and obesity are two major modifiable risk factors of NAFLD. The epidemiological data on advanced stages of NAFLD is considerably sparser and largely limited to high-risk populations.

Despite the limitations in the methods used to estimate the burden of NAFLD, this disease now represents the most common liver disease in the United States and worldwide. This could lead to an increase in the number of long-term complications, including cirrhosis and hepatocellular carcinoma. The high prevalence of NAFLD could also contribute, to some extent, to the burden of cardiovascular disease.

Although the use of operational definitions of NAFLD was necessary to advance our understanding of the epidemiology of the disease, newer and more accurate tools are needed to better characterize the disease.


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