Title: Global prevalence of metabolic dysfunction-associated fatty liver disease in children and adolescents with overweight and obesity: a systematic review and meta-analysis
Source: BMC Gastroenterology 2025, 25 (1): 691
Date of publication: October 2025
Publication type: Systematic review
Abstract: Background: The prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) among children and adolescents with overweight and/or obesity is rising globally, reflecting increasing obesity rates and metabolic syndrome. This study aims to provide a comprehensive global estimate of MAFLD prevalence in this population.
Methods: A systematic review and meta-analysis were conducted using data from PubMed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, up to May 10, 2024. We included studies that diagnosed MAFLD in children and adolescents aged 1 to 19 years using histological, imaging, or blood biomarker evidence. The prevalence rates were analyzed, and subgroup analyses were performed based on continent, development status, time period, sample source, diagnostic technique, and body mass index (BMI).
Results: The analysis included 176 studies with a total of 57,058 participants. The global prevalence of MAFLD among children and adolescents with overweight and/or obesity was 41.2% (95% CI 39.7-44.6). Significant geographical variations were observed, with the highest prevalence in North America (43.6%) and the lowest in Africa (31.1%). Studies conducted after 2010 reported higher prevalence rates (42.5%) compared to those before 2010 (38.2%). Hospital-based studies showed the highest prevalence (42.5%), while community-based studies reported lower rates. Liver biopsy yielded the highest prevalence (51.2%) among diagnostic methods.
Conclusion: The global prevalence of MAFLD in children and adolescents with overweight and/or obesity is alarmingly high. The study highlights significant geographical and methodological variations, underscoring the need for standardized diagnostic criteria and targeted public health interventions to address this growing epidemic.
