Guimarães João Sérgio Fonseca, Mesquita Jordana Almeida, Kimura Thais Yuki, Oliveira Ana Luíza Matos, Leite M Fatima, Oliveira André Gustavo
Department of Physiology and Biophysics, Institute of Biological Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Lancet Reg Health Am. 2024 Apr 19;33:100731. doi: 10.1016/j.lana.2024.100731. eCollection 2024 May.
BACKGROUND: Liver disease is a major cause of mortality and morbidity worldwide and its epidemiology depends on the genetic background, exposure to risk factors, access to healthcare and other sociodemographic characteristics. Brazil is a large country with diverse multicultural and ethnic heritages and important socioeconomic inequalities. The burden of liver disease in Brazil, its regions and population is unknown. METHODS: We retrieved data from the Unified Health System regarding liver diseases and analyzed the mortality and morbidity from 1996 to 2022 by gender, race/ethnicity, age, region and overall. We calculated the age-specific risk of deaths by liver disease, age-standardization of the data, mean hospitalization and liver transplant-associated costs. FINDINGS: Malignant neoplasm of the liver and intrahepatic bile ducts, alcohol-associated liver disease, fibrosis, and cirrhosis of the liver, other diseases of the liver, hepatic failure, chronic viral hepatitis were identified as the major causes of death and morbidity in Brazil in the period analyzed. The epidemiology of these diseases was diverse, with variations according to geographic regions, gender and race/ethnicity. The major economic burden of liver disease is related to liver transplants, a common outcome of the progression of these diseases. INTERPRETATION: Liver disease in Brazil is a serious issue for the public health system due to the high number of deaths and increasing mortality rate. Our study contributes as a necessary prerequisite for the development of tailored public health policies aimed at mitigating the increasing burden of liver diseases in specific populations and regions. FUNDING: CNPq, INCT, CAPES, FAPEMIG.
背景:肝脏疾病是全球死亡和发病的主要原因,其流行病学取决于遗传背景、风险因素暴露、医疗保健可及性以及其他社会人口学特征。巴西是一个大国,拥有多元的文化和种族遗产以及严重的社会经济不平等。巴西及其各地区和人口中肝脏疾病的负担尚不清楚。 方法:我们从统一卫生系统中检索了有关肝脏疾病的数据,并按性别、种族/民族、年龄、地区和总体情况分析了1996年至2022年的死亡率和发病率。我们计算了肝脏疾病的年龄特异性死亡风险、数据的年龄标准化、平均住院时间以及与肝移植相关的费用。 研究结果:在分析期内,肝和肝内胆管恶性肿瘤、酒精性肝病、肝纤维化和肝硬化、其他肝脏疾病、肝衰竭、慢性病毒性肝炎被确定为巴西死亡和发病的主要原因。这些疾病的流行病学各不相同,因地理区域、性别和种族/民族而异。肝脏疾病的主要经济负担与肝移植有关,这是这些疾病进展的常见结果。 解读:由于死亡人数众多和死亡率不断上升,巴西的肝脏疾病对公共卫生系统来说是一个严重问题。我们的研究为制定针对性的公共卫生政策做出了贡献,这些政策旨在减轻特定人群和地区日益增加的肝脏疾病负担。 资金来源:巴西国家科学技术发展委员会、国家科技创新研究所、巴西高等教育人员素质提升协调办公室、米纳斯吉拉斯州研究资助基金会。
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