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Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is one of the most prevalent liver diseases globally, contributing to both economic and health-related challenges. We aimed to evaluate the global, regional, and national burden of MASLD from 1990 to 2023, quantify the contribution of identified modifiable risk factors, and project future prevalence up to the year 2050. Methods: Estimates of MASLD prevalence and disability-adjusted life-years (DALYs) were produced by age, sex, region, Socio-demographic Index (SDI), and Healthcare Access and Quality (HAQ) index across 204 countries and territories from 1990 to 2023 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. The MASLD burden attributable to three risk factors (smoking, high BMI, and high fasting plasma glucose) was assessed as part of the GBD comparative risk assessment. As a secondary analysis, we used these estimates to forecast MASLD prevalence up to 2050 using fasting plasma glucose and mean BMI as predictors. Furthermore, to examine the relative contributions of population ageing, population growth, and changes in MASLD prevalence rate to the forecasted changes in case counts from 2023 to 2050, we conducted a decomposition analysis. Findings: In 2023, approximately 1·3 billion (95% uncertainty interval [UI] 1·2 to 1·4) individuals were estimated to be living with MASLD (ie, 16·1% of the global population), with an age-standardised prevalence rate of 14 429·3 (95% UI 13 268·3 to 15 990·6) per 100 000 population, representing a percentage increase of 142·7% (95% UI 139·2 to 146·7) in crude numbers from 1990 (0·5 billion [0·5 to 0·6]) and of 28·6% (27·8 to 29·5) in the rate (11 217·2 [10 276·8 to 12 467·0] per 100 000 in 1990). An estimated 3·6 million (2·8 to 4·5) total DALYs were attributable to MASLD worldwide in 2023, corresponding to an age-standardised DALY rate of 39·6 (31·2 to 49·9) per 100 000 population. Despite a 116·3% (93·3 to 139·4) increase in crude DALYs (from 1·7 million [1·3 to 2·1] in 1990), its age-standardised estimate remained consistent (1·8% [–8·6 to 12·8]) from 1990 (38·9 [30·1 to 49·8] per 100 000) to 2023. There was substantial variation in age-standardised estimates across regions. North Africa and the Middle East had the highest prevalence rate (29 246·1 [26 848·3 to 32 048·7] per 100 000) and Andean Latin America showed the highest DALY rate (152·3 [114·1 to 194·7] per 100 000). By contrast, the high-income Asia Pacific region had the lowest prevalence rate (8653·5 [7923·7 to 9592·8] per 100 000) and east Asia had the lowest DALY rate (16·3 [13·5 to 19·9] per 100 000) among all GBD regions. North Africa and the Middle East showed disproportionately higher prevalence rates relative to other regions with similar SDIs. Lower SDIs and HAQs were associated with higher age-standardised DALY rates. The age-standardised prevalence rate was consistently higher in males (15 616·4 [14 349·2 to 17 263·3] per 100 000 people in 2023) than in females (13 245·2 [12 132·0 to 14 692·6] per 100 000 people), and peaked at age 80–84 years in both sexes. The number of MASLD prevalent cases was the highest in younger adults, peaking at age 35–39 years for males and age 55–59 years for females. Among the risk factors for MASLD, high fasting plasma glucose presented the largest contribution to the age-standardised DALY rate of total MASLD in 2023 (2·2 [95% UI 1·6 to 3·1] per 100 000 people), followed by high BMI (1·4 [0·6 to 2·4] per 100 000 people) and smoking (1·0 [0·3 to 1·8] per 100 000 people). Our forecasting model estimates that 1·8 billion (95% UI 1·6 to 2·0) individuals are likely to have MASLD by 2050, representing a 42·0% increase from 2023. The age-standardised prevalence rate is expected to increase to 15 774·9 (95% UI 14 613·9 to 17 336·2) per 100 000 people in 2050, representing an average annual percentage change of 0·3% (95% UI 0·3–0·3). According to our decomposition analysis, this change will be primarily due to population growth, particularly in sub-Saharan Africa and North Africa and Middle East, and less by population ageing or epidemiological change. Interpretation: With a global prevalence of 16·1% and approximately 1·3 billion people already living with MASLD in 2023, the condition has and will continue to have substantial health and economic impacts worldwide. An inverse association between the HAQ Index and age-standardised DALY rates suggests that countries with lower health-care access and quality might be less well positioned to manage the growing MASLD burden, underscoring the need for strengthened health-system capacity in these settings. Funding: Gates Foundation. © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Center for Digital Health, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Pediatrics, Yonsei University, Seoul, South Korea; Department of Nursing, Al Zaytoonah University of Jordan, Amman, Jordan; Centre for Regenerative Medicine and Health, Chinese Academy of Sciences, Hong Kong, China; Department of Health Information Management, University of Medical Sciences, Ondo, Ondo, Nigeria; Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana; School of Population Health, University of New South Wales, Sydney, NSW, Australia; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, United States; Department of Radiology, Harvard University, Boston, MA, United States; Department of Biochemistry and Molecular Medicine, Alfaisal University, Riyadh, Saudi Arabia; College of Graduate Health Sciences, University of Tennessee, Memphis, TN, United States; School of Medicine, University of Sydney, Sydney, NSW, Australia; Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia; Internal Medicine and Alcohol Related Disease Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Medical and Surgical Sciences, Università Cattolica di Roma (Catholic University of Rome), Rome, Italy; Department of Microbiology, Edo State University Uzairue, Iyamho, Nigeria; Apollo Institute of Medical Sciences & Research Chittoor, Apollo Hospital, Chittoor, India; Department of Pharmacy, Muhammadiyah University of Mataram, Mataram, Indonesia; Department of Life Sciences, University of Management and Technology, Lahore, Pakistan; Department of Biosciences, COMSATS Institute of Information Technology, Islamabad, Pakistan; Brody School of Medicine, East Carolina University, Greenville, NC, United States; Department of Internal Medicine, University of Patras, Patras, Greece; Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, Patras, Greece; Department of Cardiology, Fudan University, Shanghai, China; Department of Communicable Diseases, Ministry of Health, Muscat, Oman; Middle East, Eurasia, and Africa Influenza Stakeholders Network, Muscat, Oman; Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA, United States; Department of Adult Health and Critical Care, Sultan Qaboos University, Muscat, Oman; Preventive Dentistry Department, Jouf University, Sakaka, Saudi Arabia; Department of Pediatric Surgery, Hamad Medical Corporation, Doha, Qatar; College of Nursing, Qatar University, Doha, Qatar; Department of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia; Institute of Health and Wellbeing, Federation University Australia, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Liver, Digestive,and Lifestyle Health Research Section, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, United States; Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Family and Community Medicine, University of Jeddah, Jeddah, Saudi Arabia; Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan; Faculty of Health Sciences, Equator University of Science and Technology, Uganda, Masaka, Uganda; Department of Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States; Research Group in Health Economics, Universidad de Cartagena (University of Cartagena), Cartagena, Colombia; Research Group in Hospital Management and Health Policies, Universidad de la Costa (University of the Coast), Barranquilla, Colombia; Fakeeh College for Medical Sciences, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia; College of Medical Sciences, Azal University for Human Development, Sana'a, Yemen; Department of Biomedical Engineering, German Jordanian University, Amman, Jordan; Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana; Center for Biomedical Image Computing & Analytics, University of Pennsylvania, Philadelphia, PA, United States; University of Bologna, Bologna, Italy; Centre for Sensorimotor Performance, The University of Queensland, Brisbane, QLD, Australia; Neurology Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, VA, United States; Gastroenterology Department, Pontifical Catholic University of Chile, Santiago, Chile; Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Applied Mathematics, University of Washington, Seattle, WA, United States; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States; College of Art and Science, Ottawa University, Surprise, AZ, United States; School of Life Sciences, Arizona State University, Tempe, AZ, United States; Institute for Biomedical Problems, Russian Academy of Sciences, Moscow, Russian Federation; School of Veterinary Medicine, Bahir Dar University, Bahir Dar, Ethiopia; Pioneer Journal of Biostatistics and Medical Research (PJBMR), Lahore, Pakistan; Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran; Faculty of Nursing, Philadelphia University, Amman, Jordan; Gastroenterology Department, University of Liège, Liège, Belgium; Institute of Biotechnology and Genetic Engineering, The University of Agriculture, Peshawar, Pakistan; Department of Forensic Science, Government Institute of Forensic Science Nagpur, Nagpur, India; Rashtrasant Tukadoji Maharaj Nagpur University, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, India; Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India; Miller School of Medicine, University of Miami, Miami, FL, United States; Department of Public and Environmental Health, University of The Gambia, Banjul, Gambia; Department of Epidemiology, University of Florida, Gainesville, FL, United States; University Institute of Food Science and Technology, The University of Lahore, Lahore, Pakistan; Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation; Transplant and Hepatobiliary Surgery Service, Hospital Universitario Fundación Santa Fe de Bogotá (University Hospital Santa Fe Foundation of Bogotá), Bogota, Colombia; Subdirectorate of Clinical Studies and Clinical Epidemiology, Hospital Universitario Fundación Santa Fe de Bogotá (University Hospital Santa Fe Foundation of Bogotá), Bogotá, Colombia; School of Public Health, Johns Hopkins University, Baltimore, MD, United States; School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia; Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India; Community Health Department, University of South Wales, South Wales, United Kingdom; Institute of Applied Health Research, University of Nottingham, Nottingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom; National Institute for Implementation Research on Non Communicable Diseases, Indian Council of Medical Research, Jodhpur, India; Department of General Medicine, Manipal Academy of Higher Education, Mangalore, India; Laboratory of Translational Medicine and Nanotherapeutics, Central University of Punjab, Bathinda, India; Department of Pharmacology, All India Institute of Medical Sciences, Nagpur, India; Basic and Clinical Pharmacology, All India Institute of Medical Sciences, New Delhi, India; Department of Internal Medicine, Manipal Academy of Higher Education, Mangalore, India; School of Medicine and Health, Technical University of Munich, Munich, Germany; Department of Radiology, University of Cambridge, Cambridge, United Kingdom; School of Pharmacy, The University of Jordan, Amman, Jordan; Department of Basic Biomedical Sciences, University of Sharjah, Sharjah, United Arab Emirates; School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan; Department of Internal and Geriatric Medicine, Hospital Italiano de Buenos Aires (Italian Hospital of Buenos Aires), Buenos Aires, Argentina; Board of Directors, Argentine Society of Medicine, Buenos Aires, Argentina; Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico; Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal; Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal; Non-communicable Diseases Division, National Institute of Epidemiology, Chennai, India; State Disease Investigation Laboratory, Animal Resources Development Department, Agartala, India; Department of Epidemiology and Biostatistics, Semey Medical University (SMU), Semey, Kazakhstan; Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Sawangi, India; Department of Biology, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia; Department of Scientific Resear, Tehran University of Medical Sciences, Tehran, Iran; Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA, United States; Department of Medicine, National University of Singapore, Singapore, Singapore; Department of Paediatric Surgery, Federal Medical Centre, Umuahia, Nigeria; Department of Medicine, University of Calgary, Calgary, AB, Canada; Department of Health, Northern Territory Government, Darwin, SA, Australia; Department of Internal Medicine, Texas Tech University, Lubbock, TX, United States; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Research and Development Cell, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be University), Pune, India; Department of Gastroenterology, Pontifical Catholic University of Chile, Santiago, Chile; University of California San Diego, La Jolla, CA, United States; College of Health Sciences, VinUniversity, Hanoi, Viet Nam; Institute of Health Economics and Technology (iHEAT), Hanoi, Viet Nam; Department of Public Health, Jazan University, Jazan, Saudi Arabia; Department of Medical Laboratory Sciences, Iran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States; Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States; Department of Medicine, Bangalore Medical College and Research Institute, Bangalore, India; Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Infection and Tropical Medicine, University of Sheffield, Sheffield, United Kingdom; Department of Pediatrics, Cleveland Clinic, Cleveland, OH, United States; Advanced Nursing Department, Universitas Airlangga (Airlangga University), Surabaya, Indonesia; La Trobe University, Melbourne, VIC, Australia; Gastrointestinal and Liver Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran; Iran University of Medical Sciences, Tehran, Iran; Department of Public Health and Community Medicine, Tanta University, Tanta City, Egypt; School of Public Health, Texila American University, Guyana, Guyana; Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates; College of Medicine, Korea University, Seoul, South Korea; Houston Methodist Hospital, Houston, TX, United States; School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, United Kingdom; Department of Endemic Medicine and Hepatogastroenterology, Cairo University, Cairo, Egypt; Gastroenterology and Hepatology Department, Mayo Clinic, Rochester, MN, United States; Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria; Research Centre for Healthcare and Community, Coventry University, Coventry, United Kingdom; Department of Oral Biology, Riphah International University, Islamabad, Pakistan; Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA, United States; Department of Clinical Nutrition and Dietetics, Applied Science Private University, Amman, Jordan; University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan; Laboratory of Experimental Medicine, Kazakh National Medical University, Almaty, Kazakhstan; Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong, China; Department of Pharmacy, Wollega University, Nekemte, Ethiopia; Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy, Padova, Italy; Centre for Pharmacology, Amity Institute of Pharmacy, Noida, India; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Midwifery, Adigrat University, Adigrat, Ethiopia; Department of General, Visceral, and Oncological Surgery, Klinikum Saarbrücken, Saarbrücken, Germany; Cardiovascular Epidemiology Research Center, Rajaie Cardiovascular Institute, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran; Department if Food Science and Nutrition, University of Minnesota, Saint Paul, MN, United States; Department of Hepatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; Department of Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India; National Institutes of Health, Bethesda, MD, United States; Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico; Department of Medical Microbiology, Bahir Dar University, Bahir Dar, Ethiopia; Department of Surgery, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany; Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany; Internal Medicine Department, Cleveland Clinic, Cleveland, OH, United States; Biochemistry Department, Ain Shams University, Cairo, Egypt; Medical Research Unit, Universitas Syiah Kuala (Syiah Kuala University), Banda Aceh, Indonesia; Department of Pharmaceutical Technology, Adamas University, Kolkata, India; Department of Community Medicine, Federal University Teaching Hospital, Lafia, Nigeria; Department of Epidemiology and Community Medicine, Federal University of Lafia, Lafia, Nigeria; Department of Paediatrics, University of Colombo, Colombo, Sri Lanka; Paediatric Professorial Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka; Graduate School of Medicine, University of Tokyo, Tokyo, Japan; Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India; Department of Virology, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Virology, Tehran University of Medical Sciences, Tehran, Iran; Department of Internal Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Clinical Legal Medicine, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Faculty of Health and Science, Salahaddin University-Erbil, Erbil, Iraq; Department of Biomolecular Sciences, University of Zakho, Zakho, Iraq; Arthur Riggs Diabetes & Metabolism Research Institute, Cancer Prevention and Research Institute, Duarte, CA, United States; International Master Program for Translational Science, Taipei Medical University, Taipei, Taiwan; Department of Medicine, Western University, London, ON, Canada; Departamento de Gastroenterologia (Department of Gastroenterology), Pontifical Catholic University of Chile, Santiago, Chile; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Microbiology, University of Maiduguri, Maiduguri, Nigeria; Department of Biotechnology, Sharda University, Greater Noida, India; Department of Clinical Pharmacy & Pharmacy Practice, Asian Institute of Medicine, Science and Technology, Bedong, Malaysia; Malaysian Academy of Pharmacy, Puchong, Malaysia; Department of Nursing, Aksum University, Aksum, Ethiopia; Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India; Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States; Department of Health and Safety, Dubai Municipality, Dubai, United Arab Emirates; Department of Surgery, Iran University of Medical Sciences, Tehran, Iran; Department of Biochemistry, Government Medical College, Mysuru, India; Department of Biomedical Informatics, Korea University, Seoul, South Korea; School of Medicine, Johns Hopkins University, Baltimore, MD, United States; Rothschild Foundation Hospital, Institut Français de Myopie, Paris, France; Singapore Eye Research Institute, Singapore Eye Research Institute, Singapore, Singapore; Department of Gastroenterology and Hepatology, Stanford University, Stanford, CA, United States; Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India; Department of Family Medicine and Public Health, University of Opole, Opole, Poland; Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Pathology and Microbiology, Krishna Vishwa Vidyapeeth Deemed to be University, Karad, India; Department of Endocrinology, Bharti Hospital Karnal, Karnal, India; University Centre for Research and Development, Chandigarh University, Mohali, India; NIHR Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, United Kingdom; The Hansjörg Wyss Department of Plastic and Reconstructive Surgery, NYU Langone Health, New York University, New York, NY, United States; Artificial Intelligence in Health Research Center, Iran University of Medical Sciences, Tehran, Iran; Surgery Research Unit, University of Oulu, Oulu, Finland; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Internal Medicine, State University of New York, Syracuse, NY, United States; Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman; Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan; Center for Atmospheric Particle Studies (CAPS), Carnegie Mellon University, Pittsburgh, PA, United States; Department of Mechanical Engineering (MechE), Carnegie Mellon University, Pittsburgh, PA, United States; Department of Basic Medical Sciences, Yarmouk University, Irbid, Jordan; Department of Biochemistry, Liaquat University Of Medical and Health Sciences, Jamshoro, Pakistan; Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam; Centre for Research Impact & Outcome, Chitkara University, Rajpura, India; Department of Epidemiology and Biostatistics, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran; Department of Clinical Research, Icahn School of Medicine at Mount Sinai, New York City, NY, United States; School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia; Department of Nursing, Salale University, Fitche, Ethiopia; Department of Medicine, Harvard University, Boston, MA, United States; Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology, IQVIA, Frankfurt am Main, Germany; University Hospital Marburg, Marburg, Germany; Department of Anthropology, Panjab University, Chandigarh, India; Evidence Synthesis Unit, Partnership for Research, Opportunity, Planning, Upskilling, and Leadership (PROPUL) Evidence, Chennai, India; Department of Biochemistry, University of Hail, Hail, Saudi Arabia; Department of Research Management, Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan; Gastroenterology Department, Ahalia Hospital, Abu Dhabi, United Arab Emirates; College of Allied Health Sciences, Bahria University Medical and Dental College, Karachi, Pakistan; Department of Economics, Manipal University Jaipur, Jaipur, India; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Division of Evidence Synthesis, Foundation for People-centric Health Systems, New Delhi, India; Division of Lifestyle Medicine, Centre for Health: The Specialty Practice, New Delhi, India; Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam; Department of Cardiovascular Research, Methodist Hospital, Merrillville, IN, United States; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Pattern Recognition and Machine Learning Lab, Gachon University, Seongnam, South Korea; Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan; Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China; School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia; Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States; Department of Quantitative Health Science, Case Western Reserve University, Cleveland, OH, United States; Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Jena, Germany; Department of Population Health Sciences, Duke University, Durham, NC, United States; Department of Family Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC, United States; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Tulane University, New Orleans, LA, United States; Centre for Public Health and Wellbeing, University of the West of England, Bristol, United Kingdom; Department of Basic Medical Sciences, University of Health and Allied Sciences, Ho, Ghana; Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmology Department, Dr. Soliman Fakeeh Hospital, Riyadh, Saudi Arabia; Rama Medical College Hospital and Research Centre, Uttar Pradesh, India; Department of Nutrition and Dietetics, University of Concepción, Concepción, Chile; Centre for Healthy Living, University of Concepción, Concepción, Chile; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Medical Clinic V, Heidelberg University, Mannheim, Germany; Faculty of Humanities and Health Sciences, Curtin University, Sarawak, Malaysia; Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia; Division of Infection & Immunity, University College London, London, United Kingdom; Department of Microbiology and Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia; Digital Health and Informatics Directorate, Queensland Health, Brisbane, QLD, Australia; Clinical Research Development Center, Amir Oncology Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Biosciences and Bioengineering, Indian Institute of Technology Dharwad, Dharwad, India; Department of Medical Laboratory Sciences, Adigrat University, Adigrat, Ethiopia; Department of Pathology - Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; University Centre Varazdin, University North, Varazdin, Croatia; Department of Pharmacology, University of Kelaniya, Ragama, Sri Lanka; Clinical Medicine Department, Colombo North Teaching Hospital, Ragama, Sri Lanka; Department of Pathology, Zagazig University, Zagazig, Egypt; Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States; Nursing Department, University of Health and Allied Sciences, Ho, Ghana; College of Human Medicine, Michigan State University, Flint, MI, United States; Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy; Saveetha Dental College and Hospitals, Saveetha University, Chennai, India; Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo, Italy; Internal Medicine Programme, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan; Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan; Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates; Nursing College, Sohag University, Sohag, Egypt; Skull Base Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria; Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany; Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran; Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran; Amity Institute of Pharmacy, Amity University, Noida, India; Department of Community and Global Health, The University of Tokyo, Tokyo, Japan; Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Mexico; Postgraduate in Medical Sciences, Universidad de Colima, Colima, Mexico; Rwanda Biomedical Centre, Kigali, Rwanda; College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russian Federation; Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russian Federation; Faculty of Pharmacy, Hasanuddin University, Makassar, Indonesia; College of Health Sciences, Cihan University Sulaimaniya, Sulaimaniya, Iraq; University of Sulaimani, Sulaymaniyah, Iraq; University Institute of Public Health, The University of Lahore, Lahore, Pakistan; Division of Endocrinology and Diabetes, University of Vermont, South Burlington, VT, United States; Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Biotechnology, University of Central Punjab, Lahore, Pakistan; Amity Institute of Forensic Sciences, Amity University, Noida, India; Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam; International Islamic University Islamabad, Islamabad, Pakistan; Department of Radiology, Mayo Clinic, Rochester, MN, United States; School of Information, University of California Berkeley, Berkeley, CA, United States; Center of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria; Department of Applied Economics and Quantitative Analysis, University of Bucharest, Bucharest, Romania; Bioinformatics Department, National Institute of Research and Development for Biological Sciences, Bucharest, Romania; Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin, Nigeria; Pfizer Research & Development, Pfizer Inc., Groton, CT, United States; Department of Preventive Medicine, University of Ulsan, Seoul, South Korea; Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran; University of Sydney, Sydney, NSW, Australia; Department of Food and Nutrition, Seoul National University, Seoul, South Korea; College of Medicine, University of Ibadan, Ibadan, Nigeria; School of Pharmacy, University of the Western Cape, Cape Town, South Africa; Department of Pharmacotherapy and Pharmaceutical Care, Medical University of Warsaw, Warsaw, Poland; Department of Biological Sciences, Njala University, Freetown, Sierra Leone; Faculty of Medicine, University Ferhat Abbas of Setif, Setif, Algeria; Division of Infectious Diseases, University Hospital of Setif, Setif, Algeria; Division of Medicine, University College London, London, United Kingdom; School of Medicine, Keele University, Keele, United Kingdom; Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara University, Mysore, India; Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Mangalore, India; School of Sciences, School of Sciences, Noida International University, Greater Noida, India; Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States; School of Nursing, University of British Columbia, Vancouver, BC, Canada; Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Community Medicine, Malla Reddy Medical College for Women, Malla Reddy Vishwavidya Peeth, Hyderabad, India; Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy; Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania; Facultad de Medicina (Faculty of Medicine), Universidad Diego Portales (Diego Portales University, Santiago, Chile; Department of Internal Medicine, University of Arizona, Tucson, AZ, United States; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States; Department of GenitoUrinary Oncology, Miami Cancer Institute, Miami, FL, United States; Department of Internal Medicine, University of Novi Sad, Novi Sad, Serbia; Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of Vojvodina, Novi Sad, Serbia; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States; Department of Humanities and Social Sciences, National Institute of Technology Rourkela, Rourkela, India; Department of Clinical Research and Epidemiology, Institute of Liver and Biliary Sciences, New Delhi, India; Department of Biochemistry, JSS Academy of Higher Education and Research, Mysuru, India; Department of Maternal-Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil; Department of Medical Biology, Kocaeli University, Izmit, Turkey; College of Health Sciences, Cihan University Sulaimaniya, Sulaymaniyah, Iraq; Department of Biology, University of Sulaimani, Sulaymaniyah, Iraq; Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh; Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC, Australia; Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan; Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran; Department of Clinical Sciences, University of Sharjah, Sharjah, United Arab Emirates; Department of Cardiology, Mansoura University, Mansoura, Egypt; National Institute of Epidemiology, Indian Council of Medical Research, Chennai, India; Department of Community Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, India; Department of Radiology, Stanford University, Stanford, CA, United States; Independent Consultant, Las Vegas, NV, United States; Department of Immunology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Family Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka; Department of Primary Care and Public Health, Imperial College London, London, United Kingdom; Academic Public Health England, Public Health England, London, United Kingdom; Department of Internal Medicine, Northwest Health, Porter, Valparaiso, IN, United States; Department of Biological Sciences, King Abdulaziz University, Jeddah, Egypt; Department of Protein Research, Research and Academic Institution, Alexandria, Egypt; Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Pharmacology and Toxicology, University of Antioquia, Medellin, Colombia; Warwick Medical School, University of Warwick, Coventry, United Kingdom; Department of Clinical Research, University of Sao Paulo, Ribeirão Preto, Brazil; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon; Miyan Research Institute, International University of Business Agriculture and Technology, Dhaka, Bangladesh; College of Medicine, Ajman University, Ajman, United Arab Emirates; Department of Labour, Government of West Bengal, Kolkata, India; Cardiovascular Department, Zagazig University, Zagazig, Egypt; Pharmacy Department, Hamad Medical Corporation, Doha, Qatar; College of Pharmacy, Qatar University, Doha, Qatar; Department of Medicine, Georgetown University, Washington, DC, United States; Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Public Health and Epidemiology, Khalifa University, Abu Dhabi, United Arab Emirates; Széchenyi István University, Győr, Hungary; Operational Research Center in Healthcare, Near East University, Cyprus, Turkey; Center for Global Health Research, Saveetha University, Chennai, India; Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Symbiosis Centre for Behavioural Sciences, Symbiosis International University, Pune, India; Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India; College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; Faculty of Pharmacy, Mansoura University, Mansoura, Egypt; Department of Entomology, Ain Shams University, Cairo, Egypt; Medical Ain Shams Research Institute (MASRI), Ain Shams University, Cairo, Egypt; Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH, United States; Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States; School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia; Department of Medical Informatics, Kagawa University, Miki-cho, Japan; Department of Food Processing and Nutrition, Karnataka State Akkamahadevi Women's University, Vijayapura, India; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; Emergency Department, Manian Medical Centre, Erode, India; Department of Medicine, Swami Vivekanand Subharti University, Meerut, India; National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, MD, United States; Department of Microbiology, Rajiv Gandhi University of Health Sciences, Bangalore, India; Dongguan Key Laboratory of Computer-Aided Drug Design, Guangdong Medical University, Dongguan, China; State Key Laboratories of Chemical Resources Engineering, Beijing University Of Chemical Technology, Beijing, China; Center for Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; Independent Consultant, Karachi, Pakistan; Department of Pathology and Laboratory Medicine, Northwell Health, New York, NY, United States; Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India; Science Department, Kazakh National Medical University, Almaty, Kazakhstan; College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia; Amity Institute of Public Health and Hospital Administration, Amity University, Noida, India; Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia; Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, Netherlands; Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India; Department of Ophthalmology, Harvard University, Boston, MA, United States; Ophthalmic Research Center (ORC), Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Quantitative Department, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran; Alva's Insitute of Medical Sciences & Research Centre, Rajiv Gandhi University of Health Sciences, Moodubidire, India; Department of Veterinary Public Health and Preventive Medicine, Usmanu Danfodiyo University, Sokoto, Sokoto, Nigeria; Department of Medical-Surgical Nursing, Mazandaran University of Medical Sciences, Sari, Iran; Department of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Department of Research and Academics, Kathmandu Cancer Center, Bhaktapur, Nepal; Person-Centered Research, Monash University, Box Hill, VIC, Australia; Advanced Materials Division, Mintek, Randburg, South Africa; Department of Biotechnology, University of the Western Cape, Bellville, South Africa; Unit of Basic Medical Sciences, University of Khartoum, Khartoum, Sudan; Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands; Department of Pharmacology, Government Medical College and Hospital, Chandigarh, India; Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India; School of Medicine, Urmia University of Medical Sciences, Urmia, Iran; School of Medicine, Babol University of Medical Sciences, Babol, Iran; Department of Pathology, Manipal Academy of Higher Education, Manipal, India; Department of Analytical and Applied Economics, Utkal University, Bhubaneswar, India; Institute of Medical Sciences, The John Paul II Catholic University of Lublin, Lublin, Poland; Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, NE, United States; Department of Pathology, Alexandria University, Alexandria, Egypt; Department of Surgery, National University of Singapore, Singapore, Singapore; Pediatric Intensive Care Unit, King Saud University, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Rheumatology and Immunology Unit, Mansoura University, Mansoura, Egypt; Department of Gastroenterology, St. Luke's Hospital, Patanamthitta, India; Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India; Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam; Department of Business Analytics, University of Massachusetts Dartmouth, Dartmouth, MA, United States; Research and Advocacy Initiative, ALS Vietnam, Quang Ngai, Viet Nam; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Nutrition and Dietetics, University of Health and Allied Sciences, Ho, Ghana; Department of Internal Medicine, Wake Forest University, Winston-Salem, NC, United States; Department of Clinical Biochemistry, Isfahan University of Medical Sciences, Isfahan, Iran; UKK Institute, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Internal Medicine, Texas Tech University, Odessa, TX, United States; NUST School of Health Sciences, National University of Science and Technology (NUST), Islamabad, Pakistan; Széchenyi István University, Gyor, Hungary; Faculty of Sciences, The University of Lahore, Lahore, Pakistan; Department of Community Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka; Department of Internal Medicine, University of Arizona, Phoenix, AZ, United States; Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States; Division of Gastroenterology, Huazhong University of Science and Technology, Wuhan, China; Western Institute of Digital-Intelligent Medicine, Chongqing Medical University, Chongqing, China; Department of Endocrinology, University of Science and Technology of China, Hefei, China; School of Medicine, University of Rochester, Rochester, NY, United States; Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran; Department of Microbiology and Immunology, Zagazig University, Zagazig, Egypt; Department of Cells and Tissues, Molecular Biology Institute of Barcelona, Barcelona, Spain; Department of Medicine, Thomas Jefferson University, Philadelphia, PA, United States; Department of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; The George Institute for Global Health, Imperial College London, London, United Kingdom; Department of Biostatistics, University of Toyama, Toyama, Japan; Department of Public Health, Juntendo University, Tokyo, Japan; Faculty of Medicine and Health Sciences, Hodeidah University, Hodeidah, Yemen; Research and Development Department, Sina Medical Biochemistry Technologies, Shiraz, Iran; Department of Bioengineering and Therapeutical Sciences, University of California San Francisco, San Francisco, CA, United States; Department of Administration, PGxAI, San Francisco, CA, United States; Department of Clinical Practice, Northern Border University, Rafha, Saudi Arabia; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany; Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China; Department of Hepatology, Wenzhou Medical University, Wenzhou, China; Department of Cardiovascular Medicine, Wenzhou Medical University, Wenzhou, China; Department of Biochemistry and Pharmacogenomics, Medical University of Warsaw, Warsaw, Poland; Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, United States; Massachusetts General Hospital, Boston, MA, United States; Department of Pediatrics, Kyung Hee University, Seoul, South Korea; Department of Family Medicine, University of Washington, Seattle, WA, United States
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