Zamani Mohammad, Alizadeh-Tabari Shaghayegh, Ajmera Veeral, Singh Siddharth, Murad Mohammad Hassan, Loomba Rohit
Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
MASLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Gastroenterology and Hepatology, University of California San Diego, La Jolla, California.
Clin Gastroenterol Hepatol. 2025 Jun;23(7):1123-1134. doi: 10.1016/j.cgh.2024.08.020. Epub 2024 Aug 30.
BACKGROUND & AIMS: Limited data exist regarding the estimate of the prevalence of advanced liver fibrosis and cirrhosis in the general population. Therefore, we conducted a systematic review and meta-analysis to evaluate the global prevalence and risk factors of advanced fibrosis and cirrhosis.
We searched Embase, PubMed, Scopus, and Web of Science from inception to April 30 2024, with no language restriction. We included cross-sectional studies reporting the prevalence of advanced liver fibrosis and/or cirrhosis in a sample of at least 100 individuals aged ≥18 years from the general population. Subjects with cirrhosis were included in the advanced fibrosis group. The pooled prevalence proportions utilizing a random-effects model and 95% confidence intervals (CIs) were estimated using global data.
A total of 46 studies fulfilled the eligibility criteria, comprising approximately 8 million participants from 21 countries. The pooled prevalence rates of advanced liver fibrosis and cirrhosis in the general population were 3.3% (95% CI, 2.4%-4.2%) and 1.3% (95% CI, 0.9%-1.7%) worldwide, respectively. A trend was observed for an increase in the prevalence of advanced fibrosis (P = .004) and cirrhosis (P = .034) after 2016. There were significant geographic variations in the advanced fibrosis and cirrhosis prevalence at continental and national levels (P < .0001). Potential risk factors for cirrhosis were viral hepatitis, diabetes, excessive alcohol intake, obesity, and male sex.
The prevalence of advanced fibrosis and cirrhosis is considerable and increasing worldwide with significant geographic variation. Further research is needed to better understand the risk factors and how to mitigate them worldwide to address the growing global burden of cirrhosis.
关于普通人群中晚期肝纤维化和肝硬化患病率估计的数据有限。因此，我们进行了一项系统评价和荟萃分析，以评估晚期纤维化和肝硬化的全球患病率及危险因素。
我们检索了从数据库建立至2024年4月30日的Embase、PubMed、Scopus和Web of Science，无语言限制。我们纳入了报告来自普通人群中至少100名年龄≥18岁个体样本中晚期肝纤维化和/或肝硬化患病率的横断面研究。肝硬化患者被纳入晚期纤维化组。利用全球数据估计采用随机效应模型的合并患病率比例及95%置信区间（CI）。
共有46项研究符合纳入标准，包括来自21个国家的约800万参与者。全球普通人群中晚期肝纤维化和肝硬化的合并患病率分别为3.3%（95%CI，2.4%-4.2%）和1.3%（95%CI，0.9%-1.7%）。2016年后观察到晚期纤维化（P = 0.004）和肝硬化（P = 0.034）患病率呈上升趋势。在大陆和国家层面，晚期纤维化和肝硬化患病率存在显著的地理差异（P < 0.0001）。肝硬化的潜在危险因素包括病毒性肝炎、糖尿病、过量饮酒、肥胖和男性。
晚期纤维化和肝硬化的患病率在全球范围内相当可观且呈上升趋势，存在显著的地理差异。需要进一步研究以更好地了解危险因素以及如何在全球范围内减轻这些因素，以应对日益增长的全球肝硬化负担。
