估算 2000 年至 2021 年非酒精性脂肪性肝病的全球患病率、发病率和结局：系统评价和荟萃分析。
Estimating global prevalence, incidence, and outcomes of non-alcoholic fatty liver disease from 2000 to 2021: systematic review and meta-analysis.
机构信息
Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, China.
Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, China.
出版信息
Chin Med J (Engl). 2022 Jul 20;135(14):1682-1691. doi: 10.1097/CM9.0000000000002277.
BACKGROUND
The increasing burden of non-alcoholic fatty liver disease (NAFLD) worldwide imposes an emerging public health issue. We perform the current study to estimate the global prevalence, incidence, disease progression, and clinical outcomes of NAFLD.
METHODS
A systematic search was conducted in Medline, Embase, Web of Science, Google Scholar, and Cochrane CENTRAL that screened articles in English language published from January 2000 to December 2021. NAFLD prevalence, incidence, rate of disease progression, and outcomes were calculated with the DerSimonian-Laird random effects model with arcsine transformation.
RESULTS
Our search identified 59,156 records, of which 578 studies fulfilled our inclusion criteria. The overall prevalence of NAFLD was 29.38% (95% confidence interval [CI] 28.09-30.69) regardless of the diagnostic techniques. Looking at the group in which the diagnosis was made by ultrasound exclusively, the pooled prevalence was 30.49% (95% CI 29.55-31.43). NAFLD has become more prevalent during the year 2011-2021 (31.63%, 95% CI 30.23-33.04) compared with year 2000-2010 (27.94%, 95% CI 26.23-29.69). The pooled estimation of non-alcoholic steatohepatitis prevalence was 8.26% (95% CI 1.13-21.01), 46.49% (95% CI 35.93-57.20), and 46.72% (95% CI 37.57-55.98) in general population, NAFLD patients, and severe/morbidly obese patients, respectively. Based on a total of 110,142 newly developed NAFLD patients, the pooled incident rate was estimated as 46.24 cases per 1000 person-years (95% CI 43.21-49.30). In patients with NAFLD, the incident rate of hepatocellular carcinoma was 1.46 (95% CI 0.90-2.03) cases per 1000 person-years. The overall pooled estimate of NAFLD related mortality was 23.91 (95% CI 13.55-37.18) death per 1000 person-years.
CONCLUSIONS
The prevalence of NAFLD is increasing globally. It is contributing to poor clinical outcomes including hepatocellular carcinoma and death. Rising awareness and urgent actions are warranted to control the NAFLD pandemic across the globe.
REGISTRATION
PROSPERO, No. CRD42020171104.
背景
非酒精性脂肪性肝病（NAFLD）在全球的负担不断增加，这是一个新出现的公共卫生问题。我们进行了目前的研究，以估计 NAFLD 的全球患病率、发病率、疾病进展和临床结局。
方法
我们在 Medline、Embase、Web of Science、Google Scholar 和 Cochrane CENTRAL 中进行了系统搜索，筛选了 2000 年 1 月至 2021 年 12 月以英文发表的文章。使用 DerSimonian-Laird 随机效应模型和反正弦变换计算 NAFLD 的患病率、发病率、疾病进展率和结局。
结果
我们的搜索共确定了 59156 条记录，其中 578 项研究符合纳入标准。无论诊断技术如何，NAFLD 的总体患病率为 29.38%（95%置信区间[CI]28.09-30.69）。在仅通过超声诊断的组中，汇总患病率为 30.49%（95%CI 29.55-31.43）。与 2000-2010 年（27.94%，95%CI 26.23-29.69）相比，2011-2021 年（31.63%，95%CI 30.23-33.04）NAFLD 的患病率更高。一般人群、NAFLD 患者和严重/病态肥胖患者中非酒精性脂肪性肝炎的患病率估计分别为 8.26%（95%CI 1.13-21.01）、46.49%（95%CI 35.93-57.20）和 46.72%（95%CI 37.57-55.98）。基于总共 110142 名新发 NAFLD 患者，估计的发病率为每年每 1000 人 46.24 例（95%CI 43.21-49.30）。在 NAFLD 患者中，肝细胞癌的发病率为每年每 1000 人 1.46 例（95%CI 0.90-2.03）。NAFLD 相关死亡率的总体汇总估计为每年每 1000 人 23.91 例（95%CI 13.55-37.18）。
结论
NAFLD 的全球患病率正在上升。它导致包括肝细胞癌和死亡在内的不良临床结局。需要提高认识并采取紧急行动，以控制全球范围内的 NAFLD 流行。
登记
PROSPERO，编号 CRD42020171104。
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