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肝脏疾病流行病学:全球疾病负担及预测的研究趋势

Epidemiology of liver diseases: global disease burden and forecasted research trends.

作者信息

Xiao Jia, Wang Fei, Yuan Yuan, Gao Jinhang, Xiao Lu, Yan Chao, Guo Feifei, Zhong Jiajun, Che Zhaodi, Li Wei, Lan Tian, Tacke Frank, Shah Vijay H, Li Cui, Wang Hua, Dong Erdan

机构信息

Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, 266071, China.

Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, 510630, China.

出版信息

Sci China Life Sci. 2025 Feb;68(2):541-557. doi: 10.1007/s11427-024-2722-2. Epub 2024 Oct 16.

Abstract

We assessed the global incidence, mortality, and disability-adjusted life years (DALYs) associated with various liver diseases, including alcohol-related liver disease (ALD), hepatitis B/C virus infections (HBV or HCV), liver cancer, metabolic dysfunction-associated steatotic liver disease (MASLD), and other chronic liver diseases, from the 2019 Global Burden of Disease study. Additionally, we analyzed the global trends in hepatology research and drug development. From 2000 to 2019, prevalence rates increased for ALD, MASLD and other liver diseases, while they decreased for HBV, HCV, and liver cancer. Countries with a high socio-demographic index (SDI) exhibited the lowest mortality rates and DALYs. The burden of liver diseases varied due to factors like sex and region. In nine representative countries, MASLD, along with hepatobiliary cancer, showed highest increase in funding in hepatology research. Globally, the major research categories in hepatology papers from 2000 to 2019 were cancer, pathobiology, and MASLD. The United States (U.S.) was at the forefront of hepatology research, with China gradually increasing its influence over time. Hepatologists worldwide are increasingly focusing on studying the communication between the liver and other organs, while underestimating the research on ALD. Cancer, HCV, and MASLD were the primary diseases targeted for therapeutic development in clinical trials. However, the proportion of new drugs approved for the treatment of liver diseases was relatively low among all newly approved drugs in the U.S., China, Japan, and the European Union. Notably, there were no approved drug for the treatment of ALD in the world.

摘要

我们根据2019年全球疾病负担研究评估了与各种肝脏疾病相关的全球发病率、死亡率和伤残调整生命年(DALY),这些疾病包括酒精性肝病(ALD)、乙型/丙型肝炎病毒感染(HBV或HCV)、肝癌、代谢功能障碍相关脂肪性肝病(MASLD)以及其他慢性肝病。此外,我们分析了肝病学研究和药物开发的全球趋势。2000年至2019年期间,ALD、MASLD和其他肝病的患病率上升,而HBV、HCV和肝癌的患病率下降。社会人口学指数(SDI)较高的国家死亡率和伤残调整生命年最低。由于性别和地区等因素,肝脏疾病的负担有所不同。在九个具有代表性的国家中,MASLD以及肝胆癌在肝病学研究中的资金投入增长最为显著。在全球范围内,2000年至2019年肝病学论文的主要研究类别为癌症、病理生物学和MASLD。美国在肝病学研究方面处于领先地位,中国的影响力也在随着时间的推移逐渐增强。全球肝病学家越来越关注肝脏与其他器官之间的相互作用研究,而对ALD的研究有所忽视。癌症、HCV和MASLD是临床试验中治疗开发的主要靶向疾病。然而,在美国、中国、日本和欧盟所有新批准的药物中,获批用于治疗肝病的新药比例相对较低。值得注意的是,全球尚无获批用于治疗ALD的药物。

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