Nonalcoholic fatty liver disease burden – Saudi Arabia and United Arab Emirates, 2017–2030

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.

Management of nonalcoholic fatty liver disease in the Middle East

“…The lack of properly carried out community-based epidemiological studies is a particular concern, and has obvious fallouts on resource planning and allocation, and poses considerable difficulties to these countries’ healthcare systems. To some extent, regional prevalence numbers remain best guess estimates, based in part on modeling analyses or otherwise on indirect markers of NAFLD such as obesity and T2DM[ 9 ]. This stresses an immediate need for adequately sampled, large-scale, nationwide surveys for NAFLD, where the prevalence across all population sectors, age groups, and geographic distributions is properly estimated.…”

“…Also, with an increase in the risk factors of NAFLD and NASH such as obesity, metabolic syndrome (MetS), and type 2 diabetes mellitus (T2DM), the prevalence is estimated to grow further[ 6 ]. Alswat et al[ 9 ] conducted an analysis to estimate the burden of NAFLD in Saudi Arabia and United Arab Emirates (UAE) by the year 2030[ 9 ]. The analysis projected that by 2030 there will be over 12 million individuals (an increase by 48% from 2017) with NAFLD in Saudi Arabia and 372000 (an increase by 46% from 2017) in UAE[ 9 ].…”

“…Alswat et al[ 9 ] conducted an analysis to estimate the burden of NAFLD in Saudi Arabia and United Arab Emirates (UAE) by the year 2030[ 9 ]. The analysis projected that by 2030 there will be over 12 million individuals (an increase by 48% from 2017) with NAFLD in Saudi Arabia and 372000 (an increase by 46% from 2017) in UAE[ 9 ]. This projected NAFLD prevalence corresponds to predicted increase in the burden of obesity and T2DM.…”

“…NAFLD related HCC cases are projected to increase by 209% (580 to 1790) in Saudi Arabia and by 181% (18 to 51) in UAE. By 2030, annual liver-related deaths are estimated to rise by 295% in Saudi Arabia and by 270% in UAE[ 9 ].…”

Nonalcoholic fatty liver disease: One more reason to strengthen public health

“…In this issue, Alswat et al . [ 9 ] shed light on this very important aspect, using models to estimate the disease burden of NAFLD and nonalcoholic steatohepatitis in the KSA and the UAE in the period extending to the year 2030, along with the resulting complications and mortality.…”