Alarming Global Rise in Adolescent Metabolic Dysfunction-Associated Steatotic Liver Disease by 2030

This study forecasts the global burden of ultrasound-diagnosed MASLD in adolescents (15-19 years) from 2020 to 2030, examining socioeconomic influences.

Using generalised additive models (GAM) and estimated annual percentage change (EAPC), age-standardised incidence (ASIR), mortality (ASDR) and disability-adjusted life years (DALYs) rates were projected. Regional analyses used the Socio-Demographic Index (SDI), with regression models quantifying associations.

Global ASIR is projected to rise significantly (EAPC: +1.46%), outpacing slower increases in DALYs (EAPC: +0.20%) and ASDR (EAPC: +0.18%). High-income North America faces the steepest ASIR surge (EAPC: +2.52%), while Central/Eastern Europe and Central Asia are stable. By 2030, low-SDI regions will have the highest median ASIR, with Turkmenistan predicted to have the world's highest (0.77 per 100 000). Striking disparities exist: higher SDI strongly correlates with elevated ASIR in Europe (R² = 0.339), indicating lifestyle risks in affluent settings. Conversely, higher SDI correlates with reduced DALYs/ASDR elsewhere. Despite some declines in low-SDI areas, high-income North America and vulnerable low-SDI regions (e.g., Turkmenistan) face escalating burdens.

Socioeconomic factors and lifestyle disparities drive divergent global adolescent MASLD trajectories. Without intervention, the burden will surge by 2030-particularly in high-income North America and low-SDI hotspots-demanding region-specific policies to address metabolic health inequities.