Non-alcoholic fatty liver disease (NAFLD) is a hepatic disorder associated with metabolic dysregulation and serves as a critical indicator of endocrine health; however, research in this area remains limited. This study evaluated the epidemiological burden of NAFLD in China and globally by analyzing incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from the Global Burden of Disease (GBD) database.

Data (incidence, prevalence, mortality, and disability-adjusted life years [DALYs]) characterizing NAFLD in China and globally were obtained from the Global Burden of Disease (GBD) database. Temporal trends were reflected by average annual percentage change (AAPC) calculated using the Joinpoint regression model, and characteristic changes were analysed comparatively in terms of different ages, genders and time periods.

The age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of NAFLD increased from 1990 to 2021, either in China (495.63/100,000 to 621.73/100,000; 12787.89/100,000 to 15606.98/100,000) or globally (475.54/100,000 to 593.28/100,000; 12085.10/100,000 to 15018.07/100,000). Both age-standardized mortality rates (ASMR) and age-standardized DALYs rates (ASDR) decreased in China (1.04/100,000 to 0.82/100,000; 27.38/100,000 to 19.83/100,000), whereas they increased globally (1.53/100,000 to 1.62/100,000; 40.20/100,000 to 42.40/100,000). The AAPC for ASIR (0.74% vs. 0.71%), ASPR (0.63% vs. 0.71%), ASMR (-0.71% vs. 0.18%), and ASDR (-0.97% vs. 0.18%) also varied between China and worldwide. Males appeared more sensitive to NAFLD than females, with age-specific features.

The global NAFLD are experiencing an increase in incidence, prevalence, mortality and DALYs. While mortality and DALYs have shown a decrease in China, the incidence and prevalence continue to rise, displaying distinct age and gender patterns. These findings hold significant implications for health policy in China and worldwide.