Global burden of metabolic dysfunction-associated steatotic liver disease attributable to tobacco, 1990–2023, and projected trends to 2038

Mao Y, Du J, Li B, et al. Global burden of NASLD 1990–2021 and projections to 2035: results from the Global Burden of Disease study 2021. PLoS ONE. 2025;20(8):e0330504. https://doi.org/10.1371/journal.pone.0330504.

Article  PubMed  PubMed Central  CAS  Google Scholar 

He L, Zheng W, Qiu K, Kong W, Zeng T. Changing from NAFLD to MASLD: the new definition can more accurately identify individuals at higher risk for diabetes. J Hepatol. 2024;80(2):e85–7. https://doi.org/10.1016/j.jhep.2023.09.035.

Article  PubMed  Google Scholar 

Cotter TG, Rinella M. Nonalcoholic Fatty Liver Disease 2020: the State of the Disease. Gastroenterology. 2020;158(7):1851–64. https://doi.org/10.1053/j.gastro.2020.01.052.

Article  PubMed  CAS  Google Scholar 

Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797–835. https://doi.org/10.1097/HEP.0000000000000323.

Article  PubMed  PubMed Central  Google Scholar 

Rinella ME, Systematic Review. JAMA. 2015;313(22):2263. https://doi.org/10.1001/jama.2015.5370.

Article  PubMed  CAS  Google Scholar 

Wang J, Du J, Wang M, et al. Global, regional, and national burden of MASLD in youths and young adults aged 15–39 years, 1990–2021, its attributable risk factors, and projections to 2035. Front Nutr. 2025;12:1509232. https://doi.org/10.3389/fnut.2025.1509232.

Article  PubMed  PubMed Central  Google Scholar 

Premkumar M, Anand AC. Tobacco, Cigarettes, and the Liver: The Smoking Gun. J Clin Exp Hepatol. 2021;11(6):700–12. https://doi.org/10.1016/j.jceh.2021.07.016.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Tommasi S, Yoon JI, Besaratinia A. Secondhand Smoke Induces Liver Steatosis through Deregulation of Genes Involved in Hepatic Lipid Metabolism. Int J Mol Sci. 2020;21(4):1296. https://doi.org/10.3390/ijms21041296.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Chen B, Sun L, Zeng G, et al. Gut bacteria alleviate smoking-related NASH by degrading gut nicotine. Nature. 2022;610(7932):562–8. https://doi.org/10.1038/s41586-022-05299-4.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Wu F, Pahkala K, Juonala M, et al. Childhood and Adulthood Passive Smoking and Nonalcoholic Fatty Liver in Midlife: A 31-year Cohort Study. Am J Gastroenterol. 2021;116(6):1256–63. https://doi.org/10.14309/ajg.0000000000001141.

Article  PubMed  CAS  Google Scholar 

Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2023. (GBD 2023) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME); 2024. Accessed January 25, 2026. https://vizhub.healthdata.org/gbd-results/

Ferrari AJ, Santomauro DF, Aali A, et al. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2133–61. https://doi.org/10.1016/S0140-6736(24)00757-8.

Article  Google Scholar 

Das Gupta P. A general method of decomposing a difference between two rates into several components. Demography. 1978;15(1):99–112. PMID: 631402.

Article  PubMed  CAS  Google Scholar 

Riebler A, Held L. Projecting the future burden of cancer: Bayesian age-period-cohort analysis with integrated nested Laplace approximations. Biom J. 2017;59(3):531–49. https://doi.org/10.1002/bimj.201500263.

Article  PubMed  Google Scholar 

Cao F, He YS, Wang Y, et al. Global burden and cross-country inequalities in autoimmune diseases from 1990 to 2019. Autoimmun Rev. 2023;22(6):103326. https://doi.org/10.1016/j.autrev.2023.103326.

Article  PubMed  Google Scholar 

Schlotheuber A, Hosseinpoor A. Summary Measures of Health Inequality: a Review of Existing Measures and Their Application. Int J Environ Res Public Health. 2022;19(6):3697. https://doi.org/10.3390/ijerph19063697.

Article  PubMed  PubMed Central  Google Scholar 

Jiang B, Lin K, Buys N, Zhang B, Qi Y, Sun J. Trend and Burden of Suboptimal Breastfeeding in Children Under Five Years of Age in 1990–2021: a Systematic Analysis for the Global Burden of Disease Study 2021. Nutrients. 2025;17(7):1134. https://doi.org/10.3390/nu17071134.

Article  PubMed  PubMed Central  Google Scholar 

Hoffman SJ, Poirier MJP, Van Rogers S, Baral P, Sritharan L. Impact of the WHO Framework Convention on Tobacco Control on global cigarette consumption: quasi-experimental evaluations using interrupted time series analysis and in-sample forecast event modelling. BMJ. 2019;365:l2287. https://doi.org/10.1136/bmj.l2287.

Article  PubMed  PubMed Central  Google Scholar 

Levy DT, Huang AT, Currie LM, Clancy L. The benefits from complying with the framework convention on tobacco control: a SimSmoke analysis of 15 European nations. Health Policy Plan. 2014;29(8):1031–42. https://doi.org/10.1093/heapol/czt085.

Article  PubMed  Google Scholar 

Okamoto M, Miyake T, Kitai K, et al. Cigarette smoking is a risk factor for the onset of fatty liver disease in nondrinkers: a longitudinal cohort study. PLoS ONE. 2018;13(4):e0195147. https://doi.org/10.1371/journal.pone.0195147.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Zein CO, Unalp A, Colvin R, Liu YC, McCullough AJ. Smoking and severity of hepatic fibrosis in nonalcoholic fatty liver disease. J Hepatol. 2011;54(4):753–9. https://doi.org/10.1016/j.jhep.2010.07.040.

Article  PubMed  CAS  Google Scholar 

Mauvais-Jarvis F, Bairey Merz N, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. Lancet. 2020;396(10250):565–82. https://doi.org/10.1016/S0140-6736(20)31561-0.

Article  PubMed  PubMed Central  Google Scholar 

Lonardo A, Nascimbeni F, Ballestri S, et al. Sex Differences in Nonalcoholic Fatty Liver Disease: State of the Art and Identification of Research Gaps. Hepatology. 2019;70(4):1457–69. https://doi.org/10.1002/hep.30626.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Wong RJ, Cheung R, Ahmed A. Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma. U S Hepatol. 2014;59(6):2188–95. https://doi.org/10.1002/hep.26986.

Article  Google Scholar 

Berzigotti A, Tsochatzis E, Boursier J, et al. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis – 2021 update. J Hepatol. 2021;75(3):659–89. https://doi.org/10.1016/j.jhep.2021.05.025.

Article  Google Scholar 

Pan Q, Xu QY, Zhang LH, He YF. What is the role of nonalcoholic fatty liver disease in pulmonary carcinoma development? World J Gastroenterol. 2025;31(5):97500. https://doi.org/10.3748/wjg.v31.i5.97500.

Article  PubMed  PubMed Central  Google Scholar 

Zhu CY, Qu JC, Cao HX, Chen GY, Shi YH, Fan JG. Obesity and nonalcoholic fatty liver disease associated with adenocarcinoma in patients with lung cancer. Med (Baltim). 2019;98(37):e17098. https://doi.org/10.1097/MD.0000000000017098.

Article  CAS  Google Scholar 

Reitsma MB, Kendrick PJ, Ababneh E, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021;397(10292):2337–60. https://doi.org/10.1016/S0140-6736(21)01169-7.

Article  Google Scholar 

Marshall HM, Gartner CE, Fong KM. The tobacco endgame for the Asia Pacific. Respirology. 2023;28(4):309–12. https://doi.org/10.1111/resp.14465.

Article  PubMed  PubMed Central  Google Scholar 

Lin Z, Zhang R, Ren S, et al. Global burden of metabolic dysfunction-associated steatotic liver disease from 1990 to 2021 and the prediction for the next 10 years. Prev Med Rep. 2025;59:103248.

Comments (0)

No login
gif