The prevalence of non‐alcoholic fatty liver disease (NAFLD) and its more progressive form non‐alcoholic steatohepatitis (NASH)1,2 has increased markedly, both in Australia and overseas, over the past two decades, as has the prevalence of frequently associated conditions such as type 2 diabetes mellitus3 and obesity.4 Further, as the most common condition affecting the liver, NAFLD is rapidly becoming the most frequent indication for liver transplantation and a major risk factor for liver cancer. Nevertheless, few strategies to combat NAFLD or NASH have been developed in Australia or overseas.5 Only limited local data are available regarding the risk factors for progressive liver disease in people with NAFLD and the roles that frequently associated conditions play in its progression.
- 1. Adams LA, Roberts SK, Strasser SI, et al. Nonalcoholic fatty liver disease burden: Australia, 2019–2030. J Gastroenterol Hepatol 2020; 35: 1628‐1635.
- 2. Vaz K, Kemp W, Majeed A, et al. Non‐alcoholic fatty liver disease prevalence in Australia has risen over 15 years in conjunction with increased prevalence of obesity and reduction in healthy lifestyle. J Gastroenterol Hepatol 2023; https://doi.org/10.1111/jgh.16314 [online ahead of print].
- 3. Australian Institute of Health and Welfare, Diabetes: Australian facts. Updated 30 June 2023. https://www.aihw.gov.au/reports/diabetes/diabetes/contents/summary (viewed Sept 2023).
- 4. Australian Institute of Health and Welfare. Overweight and obesity. Updated 19 May 2023. https://www.aihw.gov.au/reports/overweight‐obesity/overweight‐and‐obesity/contents/overweight‐and‐obesity (viewed Sept 2023).
- 5. Lazarus JV, Mark HE, Villota‐Rivas M, et al; NAFLD policy review collaborators. The global NAFLD policy review and preparedness index: are countries ready to address this silent public health challenge? J Hepatol 2022; 76: 771‐780.
- 6. O'Beirne J, Skoien R, Leggett BA, et al. Diabetes mellitus and the progression of non‐alcoholic fatty liver disease to decompensated cirrhosis: a retrospective cohort study. Med J Aust 2023; 219: 358‐365.
- 7. United Nations Department of Economic and Social Affairs (Population Division). World population ageing 2019: highlights (ST/ESA/SER.A/430). New York: United Nations, 2019. https://digitallibrary.un.org/record/3846855/files/WorldPopulationAgeing2019‐Highlights.pdf (viewed Sept 2023).
- 8. Lovett GC, Ha P, Roberts AT, et al. Healthcare utilisation and costing for decompensated chronic liver disease hospitalisations at a Victorian network. Intern Med J 2022; https://doi.org/10.1111/imj.15962 [online ahead of print].
- 9. Alexopoulos AS, Crowley MJ, Wang Y, et al. Glycemic control predicts severity of hepatocyte ballooning and hepatic fibrosis in nonalcoholic fatty liver disease. Hepatology 2021; 74: 1220‐1233.
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