S2587 Mapping the Burden of Hyperglycemia-Associated NAFLD: A Global Burden of Disease (GBD) 2021-Based Analysis

Introduction: Hyperglycemia is a well-established metabolic risk factor for non-alcoholic fatty liver disease (NAFLD), yet its population-level burden remains underexplored across global, regional, and national levels. This study aims to quantify trends in disability-adjusted life years (DALYs), mortality, and years of life lost (YLLs) due to NAFLD attributable to hyperglycemia from 1990 to 2021 using data from the Global Burden of Disease (GBD) Study. Methods: We extracted NAFLD-related data attributable to hyperglycemia from the 2021 GBD database. Age-standardized DALYs, mortality rates, and YLLs were analyzed globally, regionally, and nationally. Annual Percentage Change (APC) and Average APC (AAPC) with 95% confidence intervals (CI) were calculated to assess trends. Results: Globally, hyperglycemia as a risk factor for NAFLD contributed to 3.83 million DALYs. The DALY rate increased from 1.01 in 1990 to 2.71 in 2021 (AAPC: 3.26). A total of 176,335 deaths were attributed to hyperglycemia-related NAFLD, with mortality rates rising from 0.04 to 0.12 per 100,000 population (AAPC: 3.55). Additionally, hyperglycemia led to 3.79 million YLLs, increasing from a rate of 1.00 in 1990 to 2.67 in 2021 (AAPC: 3.25). Nationally, the highest DALY rates were observed in Canada (7.59), followed by Australia (7.14) and Chile (7.07), while the lowest burden was reported in Mauritius (–0.42). These same countries also had the highest mortality and YLL rates: Canada (mortality 8.19; YLL 7.96), Australia (mortality 7.81; YLL 7.61), and Chile (mortality 7.66; YLL 7.45). Mauritius consistently recorded the lowest rates (mortality –0.43; YLL –0.42). Regionally, the fastest increases in DALY rates, mortality, and YLLs were observed in Australasia (AAPC: 6.69, 6.98, and 6.69, respectively), followed by Southern Latin America and High-income North America. Conclusion: The global burden of NAFLD attributable to hyperglycemia has more than doubled over the past 3 decades, with the steepest rises observed in high-income regions such as Australasia, Southern Latin America, and North America. Notably, Canada, Australia, and Chile faced the highest national burdens. These findings highlight the urgent need for integrated strategies targeting hyperglycemia to curb the growing liver disease burden, particularly in high-risk regions.