Evolving epidemiology of non-alcoholic fatty liver disease in South Korea: incidence, prevalence, progression, and healthcare implications from 2010 to 2022
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Background/Aims: Non-alcoholic fatty liver disease (NAFLD), now the most common chronic liver worldwide, has become a significant public health concern. This study aims to analyze the evolving epidemiology of NAFLD in South Korea. Methods: We utilized claim data from the Korean National Health Insurance Service from 2010 to 2022 to analyze NAFLD’s incidence, prevalence, and progression. Results: From 2010 to 2022, the incidence and prevalence rates of NAFLD each increased from 1.87% to 4.47% and from 10.49% to 17.13%, respectively. The differences in prevalence rates between urban and rural areas were minimal in 2012 and 2022, yet both areas showed significant increases in the prevalence of NAFLD over the decade. The NAFLD group had a higher prevalence of comorbidities compared to the control group, and the most common comorbid condition was hypertension. Moreover, the ten-year incidence rates of malignancy, heart disease, and stroke in the NAFLD group were 13.42%, 15.72%, and 8.36%, respectively, which were significantly higher than those in the control group. The incidence rates of cirrhosis and hepatocellular carcinoma in NAFLD over 10 years were 2.22% and 0.77%, respectively. The total medical costs of NAFLD patients more than doubled over ten years and were all significantly higher than those of the control group. Conclusions: A significant increase in NAFLD prevalence and its impact on healthcare utilization was observed in South Korea. With NAFLD leading to serious liver diseases and increased healthcare costs, integrated care strategies that include both medical treatment and lifestyle modifications are essential.
Abstract
Background/Aims: Non-alcoholic fatty liver disease (NAFLD), now the most common chronic liver worldwide, has become a significant public health concern. This study aims to analyze the evolving epidemiology of NAFLD in South Korea. Methods: We utilized claim data from the Korean National Health Insurance Service from 2010 to 2022 to analyze NAFLD’s incidence, prevalence, and progression. Results: From 2010 to 2022, the incidence and prevalence rates of NAFLD each increased from 1.87% to 4.47% and from 10.49% to 17.13%, respectively. The differences in prevalence rates between urban and rural areas were minimal in 2012 and 2022, yet both areas showed significant increases in the prevalence of NAFLD over the decade. The NAFLD group had a higher prevalence of comorbidities compared to the control group, and the most common comorbid condition was hypertension. Moreover, the ten-year incidence rates of malignancy, heart disease, and stroke in the NAFLD group were 13.42%, 15.72%, and 8.36%, respectively, which were significantly higher than those in the control group. The incidence rates of cirrhosis and hepatocellular carcinoma in NAFLD over 10 years were 2.22% and 0.77%, respectively. The total medical costs of NAFLD patients more than doubled over ten years and were all significantly higher than those of the control group. Conclusions: A significant increase in NAFLD prevalence and its impact on healthcare utilization was observed in South Korea. With NAFLD leading to serious liver diseases and increased healthcare costs, integrated care strategies that include both medical treatment and lifestyle modifications are essential.
참고문헌 (29)
- Huang DQ, "Global epidemiology of cirrhosis-aetiology, trends and predictions", Nat Rev Gastroenterol Hepatol, 20, pp.388~398 (2023)
- Eris T, "Changes in the etiology of chronic liver disease by referral to a FibroScan center : Increasing prevalence of the nonalcoholic fatty liver disease", Hepatol Forum, 4, pp.7~13 (2023)
- Wong RJ, "Trends in liver disease etiology among adults awaiting liver transplantation in the United States, 2014-2019", JAMA Netw Open, 3, pp.e1920294~ (2020)
- Kim DY, "Changing etiology and epidemiology of hepatocellular carcinoma : Asia and worldwide", J Liver Cancer, 24, pp.62~70 (2024)
- Daher D, "Non-alcoholic fatty liver disease-related hepatocellular carcinoma", J Liver Cancer, 23, pp.127~142 (2023)
- Oh JH, "Clinical impact of five cardiometabolic risk factors in metabolic dysfunction-associated steatotic liver disease(MASLD) : insights into regional and ethnic differences", Clin Mol Hepatol, 30, pp.168~170 (2024)
- Orci LA, "Incidence of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease : a systematic review, meta-analysis, and meta-regression", Clin Gastroenterol Hepatol, 20, pp.283~292 (2022)
- Le MH, "Global incidence of adverse clinical events in non-alcoholic fatty liver disease : a systematic review and meta-analysis", Clin Mol Hepatol, 30, pp.235~246 (2024)
- Yoo SH, "Current status of ultrasonography in national cancer surveillance program for hepatocellular carcinoma in South Korea : a large-scale multicenter study", J Liver Cancer, 23, pp.189~201 (2023)
- Rinella ME, "A multisociety Delphi consensus statement on new fatty liver disease nomenclature", J Hepatol, 79, pp.1542~1556 (2023)
- Shiha G, "Redefining fatty liver disease : an international patient perspective", Lancet Gastroenterol Hepatol, 6, pp.73~79 (2021)
- Gofton C, "MAFLD : how is it different from NAFLD?", Clin Mol Hepatol, 29(Suppl), pp.S17~S31 (2023)
- Chang Y, "Metabolically healthy obesity and the development of nonalcoholic fatty liver disease", Am J Gastroenterol, 111, pp.1133~1140 (2016)
- Lee MJ, "Age-related decrease in skeletal muscle mass is an independent risk factor for incident nonalcoholic fatty liver disease : a 10-year retrospective cohort study", Gut Liver, 13, pp.67~76 (2019)
- Li J, "Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019 : a systematic review and meta-analysis", Lancet Gastroenterol Hepatol, 4, pp.389~398 (2019)
- Bae JC, "Impact of nonalcoholic fatty liver disease on insulin resistance in relation to HbA1c levels in nondiabetic subjects", Am J Gastroenterol, 105, pp.2389~2395 (2010)
- Choi SY, "The relation between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans", Am J Gastroenterol, 104, pp.1953~1960 (2009)
- Adams LA, "The natural history of nonalcoholic fatty liver disease : a population-based cohort study", Gastroenterology, 129, pp.113~121 (2005)
- Dunn W, "Suspected nonalcoholic fatty liver disease and mortality risk in a population-based cohort study", Am J Gastroenterol, 103, pp.2263~2271 (2008)
- Huang DQ, "Global epidemiology of NAFLD-related HCC : trends, predictions, risk factors and prevention", Nat Rev Gastroenterol Hepatol, 18, pp.223~238 (2021)
- Jang W, "Clinical characteristics and prognosis of Korean patients with hepatocellular carcinoma with respect to etiology", J Liver Cancer, 22, pp.158~166 (2022)
- Lonardo A, "Sex disparity in hepatocellular carcinoma owing to NAFLD and non-NAFLD etiology : epidemiological findings and pathobiological mechanisms", Hepatoma Res, 6, pp.83~ (2020)
- Pinyopornpanish K, "Hepatocellular carcinoma in nonalcoholic fatty liver disease with or without cirrhosis : a population-based study", BMC Gastroenterol, 21, pp.394~ (2021)
- Smiriglia A, "Sex difference in liver diseases : how preclinical models help to dissect the sex-related mechanisms sustaining NAFLD and hepatocellular carcinoma", iScience, 26, pp.108363~ (2023)
- Nevola R, "Gender differences in the pathogenesis and risk factors of hepatocellular carcinoma", Biology(Basel), 12, pp.984~ (2023)
- Lee HW, "Prevalence and predictors of significant fibrosis among subjects with transient elastography-defined nonalcoholic fatty liver disease", Dig Dis Sci, 62, pp.2150~2158 (2017)
- Lee JY, "Prevalence and risk factors of non-alcoholic fatty liver disease in potential living liver donors in Korea : a review of 589 consecutive liver biopsies in a single center", J Hepatol, 47, pp.239~244 (2007)
- Kang KA, "Prevalence of significant hepatic fibrosis using magnetic resonance elastography in a health check-up clinic population", Aliment Pharmacol Ther, 51, pp.388~396 (2020)
- Park SH, "Trends in the prevalence of chronic liver disease in the Korean adult population, 1998-2017", Clin Mol Hepatol, 26, pp.209~215 (2020)