Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
Xiangya Nursing School, Central South University, Changsha, China.
Front Public Health. 2022 Aug 11;10:909455. doi: 10.3389/fpubh.2022.909455. eCollection 2022.
Liver cirrhosis-related death is a serious threat worldwide. The number of studies exploring the mortality trend of cirrhosis caused by specific etiologies was limited. This study aimed to demonstrate the pattern and trend based on the data of global burden of disease (GBD).
The data of cirrhosis mortality were collected from the GBD 2017. The Age standardized mortality rate (ASR) and estimated annual percentage changes (EAPC) were used to estimate the temporal trend of liver cirrhosis mortality by etiologies, regions, sociodemographic index (SDI), and sexes.
Globally, mortality cases of cirrhosis increased by 47.15%. Although the global ASR of cirrhosis mortality remained stable during this period, the temporal trend varied in etiologies. The ASR of mortality caused by hepatitis C virus (HCV), alcohol consumption, and non-alcoholic steatohepatitis (NASH) increased with an EAPC of 0.17 (95% CI, 0.14-0.20), 0.20 (95% CI, 0.16-0.24), 1.00 (95% CI, 0.97-1.04), respectively. A decreasing trend of ASR was found among the causes of hepatitis B virus (BV) and other causes. The increased pattern was heterogeneous worldwide. The most pronounced increase trend was found in middle-high SDI regions and Eastern Europe. Contrarily, the most pronounced decrease trend was found in low SDI regions and Western Sub-Saharan Africa.
Cirrhosis is still a public health problem. The growth trend of cirrhosis mortality caused by HCV was slowed by promoting direct-acting antiviral therapy. Unfortunately, we observed an unfavorable trend in etiologies for alcohol consumption and NASH, which indicated that more targeted and specific strategies should be established to limit alcohol consumption and promote healthy lifestyles in high-risk countries, especially in middle-high SDI regions and Eastern Europe.
肝硬化相关死亡是全球范围内的严重威胁。探索特定病因引起的肝硬化死亡率趋势的研究数量有限。本研究旨在根据全球疾病负担（GBD）的数据展示模式和趋势。
从 GBD 2017 中收集肝硬化死亡率数据。使用年龄标准化死亡率（ASR）和估计年度百分比变化（EAPC），按病因、地区、社会人口指数（SDI）和性别来估计肝硬化死亡率的时间趋势。
全球范围内，肝硬化死亡病例增加了 47.15%。尽管在此期间，肝硬化死亡率的全球 ASR 保持稳定，但病因的时间趋势有所不同。丙型肝炎病毒（HCV）、酒精消费和非酒精性脂肪性肝炎（NASH）引起的死亡率的 ASR 呈上升趋势，EAPC 分别为 0.17（95%CI，0.14-0.20）、0.20（95%CI，0.16-0.24）和 1.00（95%CI，0.97-1.04）。乙型肝炎病毒（BV）和其他病因引起的 ASR 呈下降趋势。这种上升模式在全球范围内存在异质性。中高 SDI 地区和东欧的上升趋势最为明显。相反，SDI 较低的地区和撒哈拉以南非洲西部的下降趋势最为明显。
肝硬化仍然是一个公共卫生问题。通过推广直接作用抗病毒治疗，HCV 引起的肝硬化死亡率增长趋势有所放缓。不幸的是，我们观察到酒精消费和 NASH 病因的不利趋势，这表明应该在高风险国家制定更有针对性和具体的策略，限制酒精消费并促进健康的生活方式，特别是在中高 SDI 地区和东欧。
