Estes Chris, Chan Henry L Y, Chien Rong N, Chuang Wan-Long, Fung James, Goh George Boon-Bee, Hu Tsung H, Huang Jee-Fu, Jang Byoung K, Jun Dae W, Kao Jia H, Lee Jin-Woo, Lin Han-Chieh, Razavi-Shearer Kathryn, Seto Wai-Kay, Wong Grace L-H, Wong Vincent W-S, Razavi Homie
Lafayette, CO, USA.
Hong Kong.
Aliment Pharmacol Ther. 2020 Apr;51(8):801-811. doi: 10.1111/apt.15673. Epub 2020 Mar 4.
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) account for an increasing proportion of liver disease in the Asia-Pacific region. Many areas in the region are experiencing epidemics of metabolic syndrome among rapidly ageing populations.
To estimate using modelling the growth in NAFLD populations, including cases with significant fibrosis that are most likely to experience advanced liver disease and related mortality.
A disease progression model was used to summarise and project fibrosis progression among the NAFLD populations of Hong Kong, Singapore, South Korea and Taiwan. For each area, changes in the adult prevalence of obesity was used to extrapolate long-term trends in NAFLD incidence.
In the areas studied, prevalent NAFLD cases were projected to increase 6%-20% during 2019-2030, while prevalent NASH cases increase 20%-35%. Incident cases of hepatocellular carcinoma are projected to increase by 65%-85%, while incident decompensated cirrhosis cases increase 65%-100% by 2030. Likewise, NAFLD-related mortality is projected to increase between 65% and 100% from 2019 to 2030. NAFLD disease burden is expected to increase alongside rising trends in metabolic syndrome and obesity among populations in the region. This leads to more cases of advanced liver disease and associated mortality.
Preventing the growth of diabetic and obese populations will be a key factor in reducing ongoing increases in NAFLD-related disease burden in the Asia-Pacific region.
非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）在亚太地区肝病中所占比例日益增加。该地区许多地方在快速老龄化的人群中正在经历代谢综合征的流行。
通过建模估计NAFLD人群的增长情况，包括最有可能发生晚期肝病及相关死亡的显著纤维化病例。
使用疾病进展模型总结并预测香港、新加坡、韩国和台湾地区NAFLD人群的纤维化进展。对于每个地区，利用成人肥胖患病率的变化来推断NAFLD发病率的长期趋势。
在所研究的地区，预计2019年至2030年期间，NAFLD现患病例将增加6% - 20%，而NASH现患病例将增加20% - 35%。预计到2030年，肝细胞癌的新发病例将增加65% - 85%，失代偿性肝硬化新发病例将增加65% - 100%。同样，预计2019年至2030年期间，NAFLD相关死亡率将增加65%至100%。随着该地区人群代谢综合征和肥胖趋势的上升，NAFLD疾病负担预计也会增加。这将导致更多晚期肝病病例及相关死亡。
预防糖尿病和肥胖人群的增长将是减轻亚太地区NAFLD相关疾病负担持续增加的关键因素。
