Zhu S, Chen S T, Jin Y Y, Lu S W, Zou F J, Ma W J, Zeng F F, Liang X F
School of Basic Medicine and Public Health, Jinan University, Guangzhou 510632, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Feb 10;45(2):185-191. doi: 10.3760/cma.j.cn112338-20230920-00173.
To comprehensively understand the disease burden of liver cirrhosis and other chronic liver diseases caused by alcohol use in China from 1990 to 2019, as well as to predict the trends in disease burden from 2020 to 2030. The analysis utilized data from the Global Burden of Disease study in 2019 (GBD2019). Key indicators such as incidence rate, mortality rate, disability-adjusted life years (DALY), years of life lost due to premature mortality, and years lived with disability were selected to describe the disease burden of alcohol-related liver cirrhosis and other chronic liver diseases in China from 1990 to 2019. The estimated annual percentage change (EAPC) was used to depict the temporal trends in disease burden. Furthermore, a Bayesian age-period-cohort (BAPC) model was constructed using R software to predict the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of alcohol-related liver cirrhosis and other chronic liver diseases in China from 2020 to 2030. From 1990 to 2019, the incidence of alcohol-related liver cirrhosis and other chronic liver diseases in China showed an upward trend, with an EAPC of 0.31% (95%: 0.10%-0.52%). However, the DALY declined, with an EAPC of -2.81% (95%: -2.92% - -2.70%). The ASMR showed a downward trend, with an EAPC of -2.55% (95%: -2.66% - -2.45%). The highest incidence of cirrhosis of liver caused by alcohol and other chronic liver diseases was reported in the age group of 35-49 years, while the ASMR increased gradually with age, with a significant rise after the age of 30. The age-standardized DALY rate peaked between the ages of 55 and 64. The disease burden indicators for males were consistently higher than those for females during the same period. According to the predictions of the BAPC model, from 2020 to 2030, the ASIR for cirrhosis of liver caused by alcohol and other chronic liver diseases in the entire population of China was projected to increase from 3.45/100 000 in 2020 to 3.78/100 000 in 2030, a growth of 9.57%. Conversely, the ASMR was expected to decrease from 1.45/100 000 in 2020 to 1.24/100 000 in 2030, a reduction of 14.48%. The disease burden of cirrhosis of liver caused by alcohol and other chronic liver diseases remained serious in China, especially in men and the middle-aged to elderly population. There is a pressing need to prioritize attention and resources towards these groups. Despite the projected decrease in ASMR, the ASIR continued to rise and is expected to persist in its upward trend until 2030.
为全面了解1990年至2019年中国酒精使用所致肝硬化及其他慢性肝病的疾病负担，并预测2020年至2030年疾病负担趋势。分析利用了2019年全球疾病负担研究（GBD2019）的数据。选取发病率、死亡率、伤残调整生命年（DALY）、过早死亡所致生命年损失以及带病生存年数等关键指标，来描述1990年至2019年中国酒精相关肝硬化及其他慢性肝病的疾病负担。采用估计年变化百分比（EAPC）来描述疾病负担的时间趋势。此外，使用R软件构建贝叶斯年龄-时期-队列（BAPC）模型，以预测2020年至2030年中国酒精相关肝硬化及其他慢性肝病的年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR）。1990年至2019年，中国酒精相关肝硬化及其他慢性肝病的发病率呈上升趋势，EAPC为0.31%（95%：0.10%-0.52%）。然而，DALY呈下降趋势，EAPC为-2.81%（95%：-2.92%--2.70%）。ASMR呈下降趋势，EAPC为-2.55%（95%：-2.66%--2.45%）。酒精及其他慢性肝病所致肝硬化发病率最高的年龄段为35-49岁，而ASMR随年龄逐渐上升，30岁后显著升高。年龄标准化DALY率在55至64岁之间达到峰值。同一时期男性的疾病负担指标始终高于女性。根据BAPC模型预测，2020年至2030年，中国全体人群中酒精及其他慢性肝病所致肝硬化的ASIR预计将从2020年的3.45/10万增至2030年的3.78/10万，增长9.57%。相反，ASMR预计将从2020年的1.45/10万降至2030年的1.24/10万，降幅为14.48%。中国酒精及其他慢性肝病所致肝硬化的疾病负担依然严重，尤其是在男性以及中老年人群中。迫切需要优先关注这些群体并投入资源。尽管预计ASMR会下降，但ASIR持续上升，预计到2030年仍将保持上升趋势。
