Trends in Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Nationwide Survey in Korea

The global burden of metabolic dysfunction-associated steatotic liver disease (MASLD), which is associated with higher risks of obesity, type 2 diabetes mellitus, cardiovascular disease, chronic kidney disease, and extrahepatic cancer, is increasing. This study aimed to examine the temporal trends in MASLD prevalence among Korean adults, with a focus on age-stratified patterns and related health conditions.

This secondary analysis of Korea National Health and Nutrition Examination Survey data included data of 90,912 adults aged ≥19 years from 2007 to 2023. MASLD was defined as having the presence of at least one cardiometabolic risk factor and no heavy alcohol consumption. Temporal trends in MASLD prevalence and associated cardiometabolic risk factors were examined across age groups using weighted prevalence estimates and log-linear regression models.

The overall prevalence of MASLD increased from 25.0% in 2007-2009 to 31.0% in 2022-2023 (annual percent change [APC], 1.36%). The most substantial increase was observed in young adults aged 19-44 years (22.3% to 30.5%; APC=2.09%), particularly among men. Middle-aged (45-64 years) and older (≥65 years) adults showed relatively stable or modest increases over time. Among young adults with MASLD, chronic kidney disease prevalence increased from 2.1% to 5.7%.

This nationwide study revealed a significant and continuous increase in MASLD prevalence among Korean adults, particularly in younger age groups. The disproportionate burden in these populations, along with high rates of metabolic comorbidities, underscores an emerging public health concern that may place considerable strain on future healthcare systems.