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Published on: July 19, 2024
Epidemiology of Metabolic Dysfunction-Associated Steatotic Liver Disease in South Asian Ethnicities: A Systematic
Michael James1, Melanie Smuk2, Naheeda Rahman1
1Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, UK.
Background And Aims:
People of South Asian ethnicities are at increased risk of metabolic syndrome, but the epidemiology of metabolic dysfunction-associated steatotic liver disease (MASLD) in this population remains poorly understood. This systematic review and meta-analysis assesses the prevalence, cross-sectional severity, and clinically relevant endpoints of MASLD in this group.
Methods:
Studies from January 2002 to November 2023 across PubMed, Embase, Ovid, and Cochrane databases, meeting inclusion criteria, were included. We performed a random effects meta-analysis to calculate pooled prevalence and proportions.
Results:
Sixty-two articles met inclusion criteria (n = 40 745). Fifty-three were based in India, 4 in Sri Lanka, 3 in Pakistan, and 2 in Bangladesh. The pooled prevalence of MASLD in studies that did not select for T2DM status was 34.7% (95% CI 29.0%-40.5%, I2 = 99.5%) and higher in studies with only T2DM patients, 60.0% (95% CI 48.9%-71.1%, I2 = 99.0%). The pooled prevalence was higher in urban (47.1%; 95% CI 36.1%-58.1%, I2 = 99.7%) compared with rural (18.5%; 95% CI 13.7%-23.3%, I2 = 96.2%) settings. The pooled average proportion of participants with advanced fibrosis (≥ F3) was 14.0% (95% CI 9.2%-18.7%, I2 = 91.5%). Four studies reported on clinical outcomes of interest; however, all had different endpoints, and so meta-analysis was not possible.
Conclusions:
MASLD prevalence in South Asian ethnicities is high, and the proportion of people with advanced fibrosis may be higher compared with multiethnic populations, though high-quality longitudinal studies are needed to better understand the epidemiology of this cohort.
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