Yang Xi, Yin Xiaodan, Wu Huiqi, Li Qiaomei, Shen Yang
Department of General Surgery, the Affiliated Shuyang Hospital of Xuzhou Medical University, Suqian, Jiangsu, China.
Department of Neurology, the Third Affiliated Hospital of Naval Medical University, Shanghai, China.
Clin Transl Gastroenterol. 2025 Jun 11;16(8):e00872. doi: 10.14309/ctg.0000000000000872. eCollection 2025 Aug 1.
The aim of this study was to characterize the temporal trends of liver cancer due to metabolic dysfunction-associated steatohepatitis (LCDMDS) burden in China during 1990-2021; evaluate their age, period, and cohort effects; and predict the disease burden for the next 9 years.
Data were obtained from the Global Burden of Disease 2021 study. Joinpoint regression model was used to estimate the annual percentage change (APC) and the average APC of LCDMDS incidence and death rates, and the age-period-cohort analysis was used to estimate the age, period, and cohort effects. We extended the autoregressive integrated moving average (ARIMA) model to predict the disease burden of LCDMDS in 2022-2030.
From 1990 to 2021, the number of incidence cases, incidence rates, number of deaths, and death rates of LCDMDS among the Chinese population aged 55 years and older all increased significantly. The number of incidence cases rose from 2,763 to 9,018, the incidence rate increased from 1.93 per 100,000 to 2.38 per 100,000, the number of deaths increased from 2,942 to 8,721, and the death rate rose from 2.05 per 100,000 to 2.30 per 100,000. The average APCs of the incidence rate and death rate were 0.72% ( P < 0.05) and 0.42% ( P > 0.05), respectively. Taking the average levels of age, period, and cohort as reference, the relative risks of LCDMDS incidence and death first increased and then decreased with age, increased over time, and decreased with the development of the birth cohort. The prediction results of the ARIMA model showed that the number of incidence cases and deaths among the Chinese population aged 55 years and older will continue to increase from 2022 to 2030, whereas the incidence rate and death rate will show slight changes.
This study comprehensively explored the temporal trends of LCDMDS burden among Chinese aged 55 years and older from 1990 to 2021, revealing significant increases in incidence and mortality, as well as age, period, and cohort effects. ARIMA model projections show that the LCDMDS burden will continue to rise despite minor rate changes. Thus, immediate interventions such as early detection, public-health awareness-raising, and further research are urgently needed to relieve the LCDMDS burden in China.
本研究旨在描述1990 - 2021年期间中国代谢功能障碍相关脂肪性肝炎所致肝癌（LCDMDS）负担的时间趋势；评估其年龄、时期和队列效应；并预测未来9年的疾病负担。
数据来自《2021年全球疾病负担研究》。采用Joinpoint回归模型估计LCDMDS发病率和死亡率的年度百分比变化（APC）及平均APC，并采用年龄 - 时期 - 队列分析估计年龄、时期和队列效应。我们扩展了自回归积分移动平均（ARIMA）模型来预测2022 - 2030年LCDMDS的疾病负担。
1990年至2021年，55岁及以上中国人群中LCDMDS的发病例数、发病率、死亡例数和死亡率均显著增加。发病例数从2763例增至9018例，发病率从每10万人1.93例增至每10万人2.38例，死亡例数从2942例增至8721例，死亡率从每10万人2.05例增至每10万人2.30例。发病率和死亡率的平均APC分别为0.72%（P < 0.05）和0.42%（P > 0.05）。以年龄、时期和队列的平均水平为参照，LCDMDS发病和死亡的相对风险随年龄先升高后降低，随时间推移而增加，随出生队列的发展而降低。ARIMA模型的预测结果显示，2022年至2030年，55岁及以上中国人群的发病例数和死亡例数将继续增加，而发病率和死亡率将有轻微变化。
本研究全面探讨了1990年至2021年55岁及以上中国人群中LCDMDS负担的时间趋势，揭示出发病率和死亡率显著上升以及年龄、时期和队列效应。ARIMA模型预测表明，尽管发病率变化较小，但LCDMDS负担将持续上升。因此，迫切需要立即采取诸如早期检测、提高公众健康意识和进一步研究等干预措施，以减轻中国的LCDMDS负担。
