P2949 - Non-Alcoholic Steatohepatitis (NASH): Shifting Risk Factors, Current Burdens, and Projections Through 2040

Meghana Kakarla, MD¹, Tahera Ahmadi, MD², Sawai Singh Rathore, MBBS³, Anjiya Aswani, MD⁴, Laxmi Supriya Yarrabathina, MBBS⁵, Hairya Ajaykumar Lakhani, MBBS⁶, Bijay Mukesh Jeswani, MBBS^7
1Infirmary Health, Mobile, AL; ²Herat University, Bagh Morad, Herat, Afghanistan; ³Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India; ⁴Ross University School of Medicine, Miramar, FL; ⁵Gandhi Medical College, Secunderabad, Telangana, India; ⁶SBKS Medical Institute and Research Center, Vadodara, Gujarat, India; ⁷GCS Medical College, Hospital & Research Centre, Ahmedabad, Gujarat, India

Introduction: Non-Alcoholic Steatohepatitis (NASH) is a severe liver disease characterized by inflammation and liver damage. It can progress to cirrhosis, liver failure, and hepatocellular carcinoma, posing significant global health burdens. Prior research has examined NASH prevalence and risk factors. Yet, there remains a gap in understanding the evolving nature of these risks, the shift from behavioral to metabolic drivers, and their projected impact on future disease burden. This study aims to fill this gap by analyzing current attributable risk factors, assessing the epidemiological burden, and projecting future trends in NASH-related mortality and DALYs through 2040.

Methods: Age-standardized death and DALY rates attributed to NASH were obtained from the Global Burden of Disease (GBD) Study (1990-2019). Data include demographic stratifications across sex and socioeconomic development indices (SDI). Linear regression analysis identified and quantified trends in NASH-associated death and DALY rates. Attributable risk calculations estimated the contributions of behavioral, metabolic, and environmental/occupational factors. Predictive modeling projected future NASH-related outcomes up to 2040.

Results: Trend analysis revealed a decrease in NASH-related death rates (β1 = -0.0002 per year) and DALY rates (β1 = -0.0080 per year) from 1990 to 2019. By 2040, NASH-related death rates will decrease to 0.039 per 100,000 population (95% CI: 0.035-0.043) and DALY rates to 0.697 per 100,000 population (95% CI: 0.654-0.740). Risk factor analysis revealed a substantial shift in disease burden. Behavioral risks, accounting for 70% of NASH deaths and 72.45% of DALYs in 1990, decreased to 61% and 63.02%, respectively, by 2019. Conversely, metabolic risks increased from contributing 30% of deaths and 27.55% of DALYs in 1990 to 39% and 36.98%, respectively, by 2019.

Discussion: Findings highlight a shift in the epidemiological landscape of NASH, with metabolic risks becoming increasingly prominent. This underscores the need for targeted public health interventions focusing on metabolic health to mitigate the future burden of NASH. Continued monitoring and research are essential to inform effective strategies and policy changes to reduce NASH-related mortality. NASH remains a public health challenge with evolving risk factors. Proactive measures addressing metabolic risk factors are crucial to reducing the NASH-related burden by 2040.



Disclosures:


Meghana Kakarla, MD¹, Tahera Ahmadi, MD², Sawai Singh Rathore, MBBS³, Anjiya Aswani, MD⁴, Laxmi Supriya Yarrabathina, MBBS⁵, Hairya Ajaykumar Lakhani, MBBS⁶, Bijay Mukesh Jeswani, MBBS⁷. P2949 - Non-Alcoholic Steatohepatitis (NASH): Shifting Risk Factors, Current Burdens, and Projections Through 2040, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.