Wu Chutian, Targher Giovanni, Byrne Christopher D, Mao Yilei, Cheung Tan To, Yilmaz Yusuf, Valenti Luca, Méndez-Sánchez Nahum, Sookoian Silvia, Chan Wah-Kheong, Treeprasertsuk Sombat, Yu Hon Ho, Kim Seung Up, George Jacob, Hu Dandan, Sebastiani Giada, Ryan John D, Oviedo Rodolfo J, Zhong Jian-Hong, Schattenberg Jörn M, Lonardo Amedeo, Ruiz-Úcar Elena, Seto Wai-Kay, Sotoudeheian Mohammadjavad, Ocama Ponsiano, Lupşor-Platon Monica, Yang Tian, Ghazinyan Hasmik, Pan Qiuwei, Hamid Saeed, Adams Leon, Chai Jin, Prasad Arun, Perera Nilanka, Alswat Khalid, Isakov Vasily, Sarin Shiv Kumar, Sharara Ala I, Sanai Faisal M, Al-Busafi Said A, Opio Christopher Kenneth, Toro-Huamanchumo Carlos Jesus, Yang Wah, Wong Yu Jun, Torzilli Guido, Fouad Yasser, Zheng Ming-Hua
Department of Gastroenterology, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Department of Medicine, University of Verona, Verona, Italy.
Am J Gastroenterol. 2025 Jan 3. doi: 10.14309/ajg.0000000000003288.
The global burden of metabolic diseases is increasing, but estimates of their impact on primary liver cancer are uncertain. We aimed to assess the global burden of primary liver cancer attributable to metabolic risk factors, including high body mass index (BMI) and high fasting plasma glucose (FPG) levels, between 1990 and 2021.
The total number and age-standardized rates of deaths and disability-adjusted life years (DALYs) from primary liver cancer attributable to each metabolic risk factor were extracted from the Global Burden of Disease Study 1990-2021. The metabolic burden trends of liver cancer across regions and countries by sociodemographic index (SDI) and sex were estimated. The annual percentage changes in age-standardized DALYs rate were also calculated.
Globally, in 2021, primary liver cancer attributable to high BMI and/or high FPG was estimated to have caused 59,970 deaths (95% uncertainty interval [UI] 20,567-104,103) and 1,540,437 DALYs (95% UI 540,922-2,677,135). The age-standardized rates of death and DALYs were 0.70 (95% UI 0.24-1.21) and 17.64 (95% UI 6.19-30.65) per 100,000 person-years. A consistent global rise in liver cancer attributable to metabolic risks was observed from 1990 to 2021, with high BMI identified as the major contributing risk factor. The highest burden of deaths and DALYs of liver cancer consistently occurred in high SDI countries, while the fastest growth trends were observed in low-middle SDI countries. The burdens of high levels of BMI and FPG were higher in men than in women.
Primary liver cancer attributable to high BMI and/or high FPG imposes an increasingly substantial clinical burden on global public health, particularly in high SDI countries. Rapid growth trends are also found in middle SDI countries.
代谢性疾病的全球负担正在增加，但其对原发性肝癌影响的估计尚不确定。我们旨在评估1990年至2021年间，包括高体重指数（BMI）和高空腹血糖（FPG）水平在内的代谢风险因素所致原发性肝癌的全球负担。
从《1990 - 2021年全球疾病负担研究》中提取每种代谢风险因素所致原发性肝癌的死亡总数、年龄标准化死亡率以及伤残调整生命年（DALY）。按社会人口指数（SDI）和性别估算各地区和国家肝癌的代谢负担趋势。还计算了年龄标准化DALY率的年度百分比变化。
全球范围内，2021年，归因于高BMI和/或高FPG的原发性肝癌估计导致59,970例死亡（95%不确定区间[UI] 20,567 - 104,103）和1,540,437个DALY（95% UI 540,922 - 2,677,135）。年龄标准化死亡率和DALY率分别为每10万人年0.70（95% UI 0.24 - 1.21）和17.64（95% UI 6.19 - 30.65）。1990年至2021年期间，观察到代谢风险所致肝癌在全球持续上升，其中高BMI被确定为主要风险因素。肝癌死亡和DALY负担最高的始终是高SDI国家，而中低SDI国家的增长趋势最快。高BMI和高FPG的负担在男性中高于女性。
归因于高BMI和/或高FPG的原发性肝癌给全球公共卫生带来了日益沉重的临床负担，尤其是在高SDI国家。在中SDI国家也发现了快速增长趋势。
