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2017 年,1990 年以来儿童、青少年和年轻人中 NAFLD/NASH 的流行率不断上升:一项基于人群的观察性研究。

Increasing prevalence of NAFLD/NASH among children, adolescents and young adults from 1990 to 2017: a population-based observational study.

机构信息

Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.

State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.

出版信息

BMJ Open. 2021 May 4;11(5):e042843. doi: 10.1136/bmjopen-2020-042843.

Abstract

OBJECTIVE

To describe the prevalence and variations of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH) among children and adolescents (CADs) and young adults (YADs).

DESIGN

A population-based observational study.

SETTING

Annual cases and prevalence of NAFLD/NASH from 1990 to 2017, by sex, region and country were collected from the Global Burden of Disease database.

MAIN OUTCOME MEASURES

The estimated annual percentage change, which was calculated by a regression line, was used to quantify the temporal trends in NAFLD/NASH burden among young people at the global, regional and national levels.

RESULTS

Globally, NAFLD/NASH incidence increased from 19.34 million in 1990 to 29.49 million in 2017 among CADs, with an annual increase of 1.35%. Additionally, in YADs, the number of cases and NAFLD/NASH prevalence significantly increased during this period, independent of sex and region. The greatest NAFLD/NASH increase was in North Africa and the Middle East. Almost all countries showed an increasing trend from 1990 to 2017, with the most pronounced increase observed in the developed regions.

CONCLUSIONS

The epidemiology of NAFLD/NASH in young people has changed considerably over the last three decades. Both the prevalence and number of cases have increased irrespective of sex, age and region. This phenomenon can result in a predictable increase in chronic liver disease burden in the near future. Understanding the prevalence of NAFLD/NASH and its variations is of paramount importance to develop strategies to implement public health policy.

摘要

目的

描述儿童和青少年(CAD)和青年成年人(YAD)中非酒精性脂肪性肝病/非酒精性脂肪性肝炎(NAFLD/NASH)的流行率和变化。

设计

基于人群的观察性研究。

设置

从全球疾病负担数据库中收集了 1990 年至 2017 年按性别、地区和国家划分的 NAFLD/NASH 年度病例和流行率。

主要观察指标

通过回归线计算的估计年百分变化率用于量化全球、区域和国家层面年轻人中 NAFLD/NASH 负担的时间趋势。

结果

全球范围内,CAD 中 NAFLD/NASH 的发病率从 1990 年的 1934 万例增加到 2017 年的 2949 万例,年增长率为 1.35%。此外,在 YAD 中,无论性别和地区如何,这一期间病例数和 NAFLD/NASH 的流行率均显著增加。NAFLD/NASH 增加最多的是北非和中东地区。几乎所有国家在 1990 年至 2017 年间均呈上升趋势,其中发达地区的增幅最为明显。

结论

近三十年来,年轻人中 NAFLD/NASH 的流行病学发生了重大变化。无论性别、年龄和地区如何,患病率和病例数都有所增加。这一现象可能导致未来慢性肝病负担的预测性增加。了解 NAFLD/NASH 的流行率及其变化对于制定实施公共卫生政策的策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d4/8098935/dcee27ea52de/bmjopen-2020-042843f01.jpg

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