Prevalence and Overlap of Overweight/Obesity Type 2 Diabetes and Metabolic Dysfunction-Associated Liver Disease in England: A Clinical Practice Research Datalink Study
Author(s)
Margherita Bortolini, MSc1, Chalini Lankage, MBBS1, Nia C. Jenkins, MSc2, Joe Hollinghurst, PhD2, Kushala W M Abeysekera, MBBS, MRCP, PhD3.
1Novo Nordisk, Gatwick, United Kingdom, 2Health Economics and Outcomes Research Ltd, Cardiff, United Kingdom, 3Bristol Medical School, Bristol, United Kingdom.
1Novo Nordisk, Gatwick, United Kingdom, 2Health Economics and Outcomes Research Ltd, Cardiff, United Kingdom, 3Bristol Medical School, Bristol, United Kingdom.
OBJECTIVES: The increasing prevalence of metabolic disorders, including obesity, type 2 diabetes (T2D), metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH), represent a major global health concern. This study explored the prevalence and multimorbidity overlap of overweight/obesity, T2D, and MASH/MASLD.
METHODS: Adults (18+ years) with at least 365-days of registration data from Clinical Practice Research Datalink (CPRD) Aurum and linked Hospital Episode Statistics datasets in England at yearly intervals between 01 January 2014 and 01 January 2020 were eligible. Prevalence of overweight/obesity (body mass index ≥ 27 kg/m2), T2D and MASH/MASLD were calculated annually from diagnostic codes, and the overlap between conditions evaluated.
RESULTS: A total of 9,373,835 to 10,782,480 people were eligible for analysis each year. Overall prevalence of registered overweight/obesity, T2D or MASH/MASLD increased annually, reaching 44.4%, 7.9% and 1.7%, respectively, in 2020. During the same period, the proportion of patients with overlapping overweight/obesity, T2D and MASH/MASLD more than doubled, from 0.15% to 0.40%. The overlap in prevalence of MASH/MASLD and overweight/obesity increased from 0.35% to 0.92%, that between MASH/MASLD and T2D increased from 0.03% to 0.08%, and the overlap between T2D and overweight/obesity increased from 4.37% to 5.15%. While prevalence of either overweight/obesity only or T2D only increased gradually (from 35.6% and 2.0% in 2014 to 37.9% and 2.3% in 2020 respectively), the proportion of patients with diagnosed MASH/MASLD but without overweight/obesity or T2D increased at a greater rate, from 0.14% in 2014 to 0.34% 2020.
CONCLUSIONS: The prevalence of overweight/obesity, T2D, and MASH/MASLD is increasing along with the concomitant overlap of these conditions. Despite increasing overlap, there remains a number of patients with MASH/MASLD without overweight/obesity or T2D. Due to under-coding, these figures likely underestimate true prevalence of overweight/obesity, T2D and MASH/MASLD, highlighting the urgent need for improved disease recognition and documentation in clinical settings.
METHODS: Adults (18+ years) with at least 365-days of registration data from Clinical Practice Research Datalink (CPRD) Aurum and linked Hospital Episode Statistics datasets in England at yearly intervals between 01 January 2014 and 01 January 2020 were eligible. Prevalence of overweight/obesity (body mass index ≥ 27 kg/m2), T2D and MASH/MASLD were calculated annually from diagnostic codes, and the overlap between conditions evaluated.
RESULTS: A total of 9,373,835 to 10,782,480 people were eligible for analysis each year. Overall prevalence of registered overweight/obesity, T2D or MASH/MASLD increased annually, reaching 44.4%, 7.9% and 1.7%, respectively, in 2020. During the same period, the proportion of patients with overlapping overweight/obesity, T2D and MASH/MASLD more than doubled, from 0.15% to 0.40%. The overlap in prevalence of MASH/MASLD and overweight/obesity increased from 0.35% to 0.92%, that between MASH/MASLD and T2D increased from 0.03% to 0.08%, and the overlap between T2D and overweight/obesity increased from 4.37% to 5.15%. While prevalence of either overweight/obesity only or T2D only increased gradually (from 35.6% and 2.0% in 2014 to 37.9% and 2.3% in 2020 respectively), the proportion of patients with diagnosed MASH/MASLD but without overweight/obesity or T2D increased at a greater rate, from 0.14% in 2014 to 0.34% 2020.
CONCLUSIONS: The prevalence of overweight/obesity, T2D, and MASH/MASLD is increasing along with the concomitant overlap of these conditions. Despite increasing overlap, there remains a number of patients with MASH/MASLD without overweight/obesity or T2D. Due to under-coding, these figures likely underestimate true prevalence of overweight/obesity, T2D and MASH/MASLD, highlighting the urgent need for improved disease recognition and documentation in clinical settings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH188
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding, Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas