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BACKGROUND

Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.

METHODS

This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-period-cohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes.

RESULTS

The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older. Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index ( < 0.001) and sociodemographic index ( = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase.

CONCLUSION

Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.

背景

肝病每年在全球导致超过200万人死亡，约占全球总死亡人数的4%。我们旨在利用世界卫生组织（WHO）死亡率数据库分析1990年至2021年期间与肝病相关的死亡率趋势，并预测到2050年全球与肝病相关的死亡率。

方法

本研究使用来自五大洲112个国家的WHO死亡率数据库数据，考察了1990年至2021年年龄标准化的与肝病相关的死亡率。随时间变化的死亡率使用局部加权散点图平滑曲线计算，权重根据每个国家的人口分配。此外，本研究使用贝叶斯年龄-时期-队列（BAPC）模型预测了到2050年与肝病相关的死亡率。另外，进行了分解分析以识别诸如人口增长、老龄化和流行病学变化等影响因素。

结果

1990年至2021年期间，112个国家的估计全球年龄标准化与肝病相关的死亡率显著上升，从1990年的每100万人中有103.4例死亡（95%置信区间[CI]，88.16，118.74）升至2021年的每100万人中有173.0例死亡（95%CI，155.15，190.95）。这种上升趋势在低收入和中等收入国家、非洲以及65岁及以上人群中尤为明显。此外，年龄标准化与肝病相关的死亡率与较低的人类发展指数（<0.001）和社会人口指数（=0.001）相关。根据BAPC模型，预测趋势表明与肝病相关的死亡率将持续大幅下降，预计从2021年的每100万人中有185.08例死亡（95%CI，179.79，190.63）降至2050年的156.29例（112.32，214.77）。从1990年至2021年，年龄标准化与肝病相关的死亡人数激增主要归因于流行病学变化，而从1990年至2050年，人口老龄化和增长的影响成为总体上升的主要促成因素。