COMMENTARY

A Global Effort to Address the Epidemic of Fatty Liver Disease

William F. Balistreri, MD

Disclosures

September 24, 2014

In This Article

NAFLD Seen Worldwide

Left unchecked, obesity will make the current generation of children the first in human history to have a life span shorter than that of their parents...

--David Satcher, MD, PhD, US Surgeon General (1998-2002)

The Global Burden of Disease Study 2013 reported that the proportion of adults with a body mass index of 25 kg/m2 or greater increased globally from 29% to 38% in men and women between 1980 and 2013; overweight and obesity were estimated to cause 3.4 million deaths worldwide in 2010.[1] The prevalence of overweight and obesity has also increased substantially (by 47.1%) in children and adolescents, to a rate of 24% in developed countries and 13% in developing countries in 2013. The report cautions that "because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Urgent global action and leadership is needed to help countries to more effectively intervene."[1]

A major consequence of the obesity epidemic is that nonalcoholic fatty liver disease (NAFLD) is now recognized worldwide, not just in Western countries. Fatty liver disease-associated mortality has been reported in populations of the Middle East, Far East, Africa, the Caribbean, and Latin America.

It has also become increasingly apparent that the clinical burden of NAFLD is not restricted to liver-related morbidity or mortality. Armstrong and colleagues[2] focused on another layer of concern: NAFLD-associated extrahepatic disease, including chronic kidney disease, colorectal cancer, endocrinopathies, and osteoporosis. In fact, most deaths in patients with NAFLD are related to cardiovascular disease and cancer.

It is therefore very timely that the World Gastroenterology Organisation (WGO), an association of expert hepatologists from around the world, has drafted global guidelines[3] to assist clinicians in combating fatty liver disease, which they view as a worldwide pandemic. They developed this report to underscore the fact that NAFLD represents a major global public health problem that "affects rich and poor countries alike."

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