School of Medicine, University of Leeds, Leeds, UK.
Leeds Liver Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Hepatol Commun. 2023 Apr 26;7(5). doi: 10.1097/HC9.0000000000000133. eCollection 2023 May 1.
Alcohol-associated liver disease (ALD) is a common cause of morbidity and premature mortality. To date, there has been no systematic synthesis of the prevalence of ALD. This systematic review was done with the aim of reporting the prevalence of ALD across different health care settings.
PubMed and EMBASE were searched for studies reporting the prevalence of ALD in populations subjected to a universal testing process. Single-proportion meta-analysis was performed to estimate the prevalence of all ALD, alcohol-associated fatty liver, and alcohol-associated cirrhosis, in unselected populations, primary care, and among patients with alcohol-use disorder (AUD).
Thirty-five studies were included reporting on 513,278 persons, including 5968 cases of ALD, 18,844 cases of alcohol-associated fatty liver, and 502 cases of alcohol-associated cirrhosis. In unselected populations, the prevalence of ALD was 3.5% (95% CI, 2.0%-6.0%), the prevalence in primary care was 2.6% (0.5%-11.7%), and the prevalence in groups with AUD was 51.0% (11.1%-89.3%). The prevalence of alcohol-associated cirrhosis was 0.3% (0.2%-0.4%) in general populations, 1.7% (0.3%-10.2%) in primary care, and 12.9% (4.3%-33.2%) in groups with AUD.
Liver disease or cirrhosis due to alcohol is not common in general populations and primary care but very common among patients with coexisting AUD. Targeted interventions for liver disease such as case finding will be more effective in at-risk populations.
酒精相关性肝病（ALD）是发病率和早逝的常见原因。迄今为止，还没有对 ALD 患病率进行系统综合。本系统评价旨在报告不同医疗保健环境中 ALD 的患病率。
在 PubMed 和 EMBASE 上搜索报告在接受普遍检测过程的人群中 ALD 患病率的研究。采用单比例荟萃分析来估计未选择人群、初级保健人群和酒精使用障碍（AUD）患者中所有 ALD、酒精相关性脂肪肝和酒精相关性肝硬化的患病率。
共纳入 35 项研究，涉及 513278 人，包括 5968 例 ALD、18844 例酒精相关性脂肪肝和 502 例酒精相关性肝硬化。在未选择人群中，ALD 的患病率为 3.5%（95%CI，2.0%-6.0%），在初级保健中为 2.6%（0.5%-11.7%），在 AUD 患者中为 51.0%（11.1%-89.3%）。普通人群中酒精相关性肝硬化的患病率为 0.3%（0.2%-0.4%），初级保健中的患病率为 1.7%（0.3%-10.2%），AUD 患者中的患病率为 12.9%（4.3%-33.2%）。
在普通人群和初级保健中，由酒精引起的肝病或肝硬化并不常见，但在同时患有 AUD 的患者中非常常见。针对肝脏疾病的针对性干预措施，如病例发现，在高危人群中会更有效。
