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11 reviewsABSTRACTKeywords:Background: Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hyGlobal Burden of Diseasepercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global Metabolic diseaseshealth burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) Obesitydata enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, Metabolic dysfunction-associated steatotic liver highlighting regional, temporal and differences by sex.diseaseMethods: Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for Metabolic dysfunction-associated fatty liver common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD). Agediseasestandardized DALYs (mortality) per 100,000 population and annual percentage change (APC) between 1990 and 2021 were estimated for trend analyses. Estimates are reported with uncertainty intervals (UI).Results: In 2021, among five common metabolic diseases, hypertension had the greatest burden (226 million [95 % UI: 190–259] DALYs), whilst T2DM (75 million [95 % UI: 63–90] DALYs) conferred much greater disability than MASLD (3.67 million [95 % UI: 2.90–4.61]). The highest absolute burden continues to be found in the most populous countries of the world, particularly India, China, and the United States, whilst the highest relative burden was mostly concentrated in Oceania Island states. The burden of these metabolic diseases has continued to increase over the past three decades but has varied in the rate of increase (1.6-fold to 3-fold increase). The burden of T2DM (0.42 % [95 % UI: 0.34–0.51]) and obesity (0.26 % [95 % UI: 0.17–0.34]) has increased at an accelerated rate, while the rate of increase for the burden of hypertension (− 0.30 % [95 % UI: − 0.