S2586 Hyperglycemia and the Global Burden of NAFLD: Insights From Age, Sex, and Socio-Demographic Index Stratification (1990-2021)

Introduction: Hyperglycemia is a well-established and modifiable risk factor for non-alcoholic fatty liver disease (NAFLD), a growing global health concern. However, the burden of NAFLD attributable to hyperglycemia has not been comprehensively quantified across different age groups, sexes, and socio-demographic contexts. Understanding these stratified patterns is essential for informing targeted public health interventions and resource allocation. This study aims to assess the global, regional, and national burden of NAFLD attributable to hyperglycemia, with detailed analyses stratified by age, sex, and Socio-demographic Index (SDI). Methods: Data on NAFLD attributable to hyperglycemia were extracted from the 2021 Global Burden of Disease (GBD) Study. Age-standardized mortality, disability-adjusted life years (DALYs), and years of life lost (YLLs) from 1990 to 2021 were analyzed. Trends were quantified using average annual percent change (AAPC) and 95% confidence intervals. Results: Globally, men consistently bore a higher burden of DALYs due to hyperglycemia-related NAFLD compared to women (2.03 million vs 1.80 million), along with a slightly faster increase over time (AAPC: 3.34 vs 3.12). Men also experienced a marginally higher number of deaths (88,815 vs 87,520) and a steeper rise in mortality rates (AAPC: 3.71 vs 3.39). Similarly, men had a greater burden of YLLs (2.01 million vs 1.77 million), with a faster increase over time (AAPC: 3.34 vs 3.11). Age-stratified analysis revealed that individuals aged 70 and older experienced the fastest rise in DALYs, mortality rates, and YLLs (AAPC: 2.17, 2.34, and 2.17, respectively), followed by those aged 15–49 and 50–69 years. When stratified by SDI, low-middle SDI regions showed the most pronounced rise in DALYs (AAPC: 4.05), mortality rates (AAPC: 4.21), and YLLs (AAPC: 4.05), followed by high SDI and middle SDI regions. Conclusion: The global burden of NAFLD attributable to hyperglycemia continues to rise, with men, older adults (≥70 years), and populations in low-middle SDI regions experiencing the most pronounced increases in DALYs, mortality, and YLLs. These findings highlight the urgent need for targeted prevention and glycemic control strategies, particularly in vulnerable demographic and socio-economic groups.