摘要
目的 分析1990—2021年全球非酒精性脂肪性肝病(non-alcoholic fatty liver,NAFLD)所致肝硬化的疾病负担变化并预测未来趋势。方法 数据源于2021全球疾病负担(the global burden of disease,GBD)数据库,采用发病数、年龄标准化发病率(age-standardized incidence rate,ASIR)、死亡数、年龄标准化死亡率(age-standardized mortality rate,ASMR)、伤残调整生命年(disability-adjusted life Years,DALYs)及年龄标准化伤残调整生命年率(age-standardized DALY rate,ASDR)等指标衡量疾病负担,通过线性回归模型估算估计年百分比变化(estimated annual percentage changes,EAPC),用R软件分析全球以及不同亚组包括性别、年龄(按每5岁一个阶段分层)、社会人口指数(socio-demographic index,SDI)、GBD区域对NAFDL引发的肝硬化疾病负担状况及其变化趋势,构建贝叶斯年龄-时期-队列模型(bayesian age-period-cohort,BAPC)预测未来发病、DALYs和ASDR,并用ARIMA和ES模型做敏感性分析。结果 全球发病数与ASIR上升、死亡数增加但ASMR平缓、DALYs上升;男性发病及ASIR高于女性且增长快,女性死亡数略多且ASMR下降;疾病负担随年龄增长加重,55~59岁男性和60~64岁女性达峰值;不同SDI分区和GBD地区疾病负担有差异,BAPC模型预测2036年全球ASIR上升、ASDR缓慢下降,ARIMA和ES模型表明2022—2050年全球DALYs上升、ASDR平稳。结论 NAFLD所致肝硬化严重威胁全球公共卫生。防控要强化一级预防,按性别、年龄和地区实施针对性策略,且需深入研究发病机制、研发新技术药物与整合资源应对。
Objective To analyze the changes in the global burden of disease for cirrhosis due to non-alcoholic fatty liver disease(NAFLD) from 1990 to 2021 and to predict future trends.Methods Data were obtained from the global burden of disease(GBD) 2021 database using the number of incidence,age-standardized incidence rate(ASIR),number of deaths,age-standardized mortality rate(ASMR),and age-standardized mortality rate(ASMR).The burden of disease was measured using the number of morbidities,age-standardized incidence rate(ASIR),number of deaths,age-standardized mortality rate(ASMR),disability-adjusted life Years(DALYs),and age-standardized DALY rate(ASDR),and estimated through linear regression models.Estimated annual percentage changes(EAPC) were estimated by linear regression modeling,and R software was used to analyze the impact of global and different subgroups,including gender,age(stratified by stages every 5 years),socio-demographic index(SDI),and GBD region,on the burden of disease caused by NAFDL and its trends.Cirrhosis disease burden status and its trends,constructed Bayesian age-period-cohort(BAPC) models to predict future incidence,DALYs and ASDR,and did sensitivity analysis with ARIMA and ES models.Results Global morbidity and ASIR increased,deaths increased but ASMR flattened,and DALYs increased;male morbidity and ASIR were higher than females and grew faster,females had slightly more deaths and ASMR declined;the burden of disease increased with age,with peaks in males aged 55-59 years and females aged 60-64 years;there were differences in the burden of disease in different SDI subregions and GBD regions,and the BAPC models predicts rising global ASIR and slowly declining ASDR in 2036,and ARIMA and ES models suggest rising global DALYs and stable ASDR from 2022-2050.Conclusion Cirrhosis due to NAFLD is a serious threat to global public health.Prevention and control should strengthen primary prevention,implement targeted strategies by gender,age and region,and require in-depth research on pathogenesis,development of new technologies and drugs,and integration of resources.
作者
李翔
熊洋
刘晨瑶
钟晓琳
王忠琼
LI Xiang;XIONG Yang;LIU Chengyao;ZHONG Xiaolin;WANG Zhongqiong(Department of Gastroenterology,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《现代消化及介入诊疗》
2024年第12期1398-1404,共7页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
国家自然科学基金资助项目(82100632)。
关键词
非酒精性脂肪性肝病
肝硬化
疾病负担
趋势预测
全球
Non-alcoholic fatty liver disease
cirrhosis
burden of disease
trend forecasting
global
