Zhao Xinyu, Xu Dong, Ji Wei, Lu Zhengzhao, Huang Cheng, Zhao Jingjie, Xiao Tingting, Wang Dongxu, Kong Yuanyuan, Jia Jidong, You Hong
National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Clinical Epidemiology and EBM Unit, Beijing Clinical Research Institute, Beijing 100050, China.
Chin Med J (Engl). 2025 Jun 20. doi: 10.1097/CM9.0000000000003726.
Chronic liver disease (CLD), mainly non-alcoholic fatty liver disease (NAFLD), is a significant public health concern worldwide. This study aims to quantify the burden of NAFLD in CLD globally and within China, using data from the Global Burden of Disease (GBD) Study 2021, providing crucial insights for global and local health policies.
The study used comprehensive data from the GBD study 2021. It included estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Age-standardized rates and average annual percent change (AAPC) from 2011 to 2021 were reported. A meticulous decomposition analysis was conducted.
In 2021, there were 1582.5 million prevalent cases, 47.6 million incident cases, 1.4 million deaths, and 44.4 million DALYs attributable to CLD, globally. Among these, NAFLD has emerged as the predominant cause, accounting for 78.0% of all prevalent CLD cases (1234.7 million) and 87.2% of incident cases (41.5 million). Correspondingly, NAFLD had the highest age-standardized prevalence (15,017.5 per 100,000) and incidence (876.5 per 100,000) rates among CLDs. In addition, China's CLD age-standardized prevalence rate was 21,659.5 per 100,000, and the age-standardized incidence rate was 752.6 per 100,000, higher than the global average. From 2011 to 2021, the global prevalence rate of CLD increased slowly (AAPC = 0.17), consistent with the trend in China (AAPC = 0.23). Furthermore, the prevalence rate of NAFLD rose significantly in China (AAPC = 1.30) compared with the global average (AAPC = 0.91). Decomposition analysis also showed the worldwide increase in deaths and DALYs for NAFLD, which were primarily attributable to population growth and aging.
The burden of CLD and NAFLD remains substantial globally and within China in terms of high prevalence and incidence. As such, this underscores the need for targeted prevention and treatment strategies. These findings emphasize the importance of continued surveillance and research to mitigate the growing impact of liver diseases on global and Chinese health systems.
慢性肝病（CLD），主要是非酒精性脂肪性肝病（NAFLD），是全球重大的公共卫生问题。本研究旨在利用《2021年全球疾病负担（GBD）研究》的数据，量化全球及中国慢性肝病中非酒精性脂肪性肝病的负担，为全球和地方卫生政策提供关键见解。
该研究使用了《2021年全球疾病负担研究》的综合数据。包括患病率、发病率、死亡率和伤残调整生命年（DALYs）的估计值。报告了2011年至2021年的年龄标准化率和年均变化百分比（AAPC）。进行了细致的分解分析。
2021年，全球慢性肝病的患病率为15.825亿例，发病率为4760万例，死亡140万例，伤残调整生命年为4440万。其中，非酒精性脂肪性肝病已成为主要病因，占所有慢性肝病患病率的78.0%（12.347亿例）和发病率的87.2%（4150万例）。相应地，在慢性肝病中，非酒精性脂肪性肝病的年龄标准化患病率（每10万人中15017.5例）和发病率（每10万人中876.5例）最高。此外，中国慢性肝病的年龄标准化患病率为每10万人中21659.5例，年龄标准化发病率为每10万人中752.6例，高于全球平均水平。2011年至2021年，全球慢性肝病患病率缓慢上升（年均变化百分比=0.17），与中国趋势一致（年均变化百分比=0.23）。此外，与全球平均水平（年均变化百分比=0.91）相比，中国非酒精性脂肪性肝病的患病率显著上升（年均变化百分比=1.30）。分解分析还显示，全球非酒精性脂肪性肝病的死亡和伤残调整生命年增加，这主要归因于人口增长和老龄化。
就高患病率和发病率而言，全球及中国慢性肝病和非酒精性脂肪性肝病的负担仍然很大。因此，这凸显了针对性预防和治疗策略的必要性。这些发现强调了持续监测和研究的重要性，以减轻肝病对全球和中国卫生系统日益增长的影响。
