Nonalcoholic Fatty Liver Disease Burden - Saudi Arabia and United Arab Emirates, 2017-2030

Overview

Journal Saudi J Gastroenterol

Specialty Gastroenterology

Date 2018 Jun 30

PMID 29956688

Citations 58

Authors

Khalid Alswat

Abdulrahman A Aljumah

Faisal M Sanai

Faisal Abaalkhail

Mohamed Alghamdi

Waleed K Al Hamoudi

Abdullah Al Khathlan

Huda Al Quraishi

Ahmed Al Rifai

Mohamed Al Zaabi

Mohamed A Babatin

Chris Estes

Almoutaz Hashim

Homie Razavi

Affiliations

Soon will be listed here.

Abstract

Background/aim: Due to epidemic levels of obesity and type 2 diabetes mellitus (DM), nonalcoholic fatty liver disease (NAFLD) and resulting nonalcoholic steatohepatitis (NASH) will be driving factors in liver disease burden in the coming years in Saudi Arabia and United Arab Emirates (UAE).

Materials And Methods: Models were used to estimate NAFLD and NASH disease progression, primarily based on changes in adult prevalence rates of adult obesity and DM. The published estimates and expert interviews were used to build and validate the model projections.

Results: In both countries, the prevalence of NAFLD increased through 2030 parallel to projected increases in the prevalence of obesity and DM. By 2030, there were an estimated 12,534,000 NAFLD cases in Saudi Arabia and 372,000 cases in UAE. Increases in NASH cases were relatively greater than the NAFLD cases due to aging of the population and disease progression. Likewise, prevalent cases of compensated cirrhosis and advanced liver disease are projected to at least double by 2030, while annual incident liver deaths increase in both countries to 4800 deaths in Saudi Arabia and 140 deaths in UAE.

Conclusions: Continued high rates of adult obesity and DM, in combination with aging populations, suggest that advanced liver disease and mortality attributable to NAFLD/NASH will increase across both countries. Reducing the growth of the NAFLD population, along with potential therapeutic options, will be needed to reduce liver disease burden.

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References

Al Dawish M, Robert A, Braham R, Al Hayek A, Al Saeed A, Ahmed R . Diabetes Mellitus in Saudi Arabia: A Review of the Recent Literature. Curr Diabetes Rev. 2015; 12(4):359-368. DOI: 10.2174/1573399811666150724095130. View

Alkhouri N, Hanouneh I, Zein N, Lopez R, Kelly D, Eghtesad B . Liver transplantation for nonalcoholic steatohepatitis in young patients. Transpl Int. 2015; 29(4):418-24. DOI: 10.1111/tri.12694. View

Lazo M, Hernaez R, Eberhardt M, Bonekamp S, Kamel I, Guallar E . Prevalence of nonalcoholic fatty liver disease in the United States: the Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol. 2013; 178(1):38-45. PMC: 3698993. DOI: 10.1093/aje/kws448. View

Younossi Z, Henry L . Economic and Quality-of-Life Implications of Non-Alcoholic Fatty Liver Disease. Pharmacoeconomics. 2015; 33(12):1245-53. DOI: 10.1007/s40273-015-0316-5. View

Estes C, Razavi H, Loomba R, Younossi Z, Sanyal A . Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2017; 67(1):123-133. PMC: 5767767. DOI: 10.1002/hep.29466. View

White D, Kanwal F, El-Serag H . Association between nonalcoholic fatty liver disease and risk for hepatocellular cancer, based on systematic review. Clin Gastroenterol Hepatol. 2012; 10(12):1342-1359.e2. PMC: 3501546. DOI: 10.1016/j.cgh.2012.10.001. View

Shaikh M, Al Sharaf F, Shehzad K, Shoukat F, Naeem Z, Al Harbi S . Prevalence and trends of overweight and obesity amongst Saudi school children, a study done by using three noninvasive methods. Int J Health Sci (Qassim). 2016; 10(3):381-7. PMC: 5003581. View

Wong R, Aguilar M, Cheung R, Perumpail R, Harrison S, Younossi Z . Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology. 2014; 148(3):547-55. DOI: 10.1053/j.gastro.2014.11.039. View

Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M . Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care. 2004; 27(7):1798-811. DOI: 10.2337/diacare.27.7.1798. View

10.

El-Hassan A, Ibrahim E, Al-Mulhim F, Nabhan A, Chammas M . Fatty infiltration of the liver: analysis of prevalence, radiological and clinical features and influence on patient management. Br J Radiol. 1992; 65(777):774-8. DOI: 10.1259/0007-1285-65-777-774. View

11.

Al-Hamoudi W, Abaalkhail F, Bendahmash A, Allam N, Hegab B, Elsheikh Y . The impact of metabolic syndrome and prevalent liver disease on living donor liver transplantation: a pressing need to expand the pool. Hepatol Int. 2015; 10(2):347-54. DOI: 10.1007/s12072-015-9664-7. View

12.

Dulai P, Singh S, Patel J, Soni M, Prokop L, Younossi Z . Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta-analysis. Hepatology. 2017; 65(5):1557-1565. PMC: 5397356. DOI: 10.1002/hep.29085. View

13.

Targher G, Byrne C, Lonardo A, Zoppini G, Barbui C . Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis. J Hepatol. 2016; 65(3):589-600. DOI: 10.1016/j.jhep.2016.05.013. View

14.

Grant L, Lisker-Melman M . Nonalcoholic fatty liver disease. Ann Hepatol. 2004; 3(3):93-9. View

15.

Fan J, Farrell G . Epidemiology of non-alcoholic fatty liver disease in China. J Hepatol. 2008; 50(1):204-10. DOI: 10.1016/j.jhep.2008.10.010. View

16.

Sanyal A, Poklepovic A, Moyneur E, Barghout V . Population-based risk factors and resource utilization for HCC: US perspective. Curr Med Res Opin. 2010; 26(9):2183-91. DOI: 10.1185/03007995.2010.506375. View

17.

Angulo P, Hui J, Marchesini G, Bugianesi E, George J, Farrell G . The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007; 45(4):846-54. DOI: 10.1002/hep.21496. View

18.

Younossi Z, Zheng L, Stepanova M, Henry L, Venkatesan C, Mishra A . Trends in outpatient resource utilizations and outcomes for Medicare beneficiaries with nonalcoholic fatty liver disease. J Clin Gastroenterol. 2014; 49(3):222-7. DOI: 10.1097/MCG.0000000000000071. View

19.

Yoneda M, Mawatari H, Fujita K, Endo H, Iida H, Nozaki Y . Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). Dig Liver Dis. 2007; 40(5):371-8. DOI: 10.1016/j.dld.2007.10.019. View

20.

Cheng Y, Imperatore G, Geiss L, Wang J, Saydah S, Cowie C . Secular changes in the age-specific prevalence of diabetes among U.S. adults: 1988-2010. Diabetes Care. 2013; 36(9):2690-6. PMC: 3747941. DOI: 10.2337/dc12-2074. View