Tang Yi, Gu Changhao
Cangnan Hospital of Traditional Chinese Medicine, Wenzhou, China.
Cangnan Branch of Zhejiang Provincial Hospital of Chinese Medicine, Wenzhou, China.
Front Nutr. 2025 Jul 15;12:1624440. doi: 10.3389/fnut.2025.1624440. eCollection 2025.
This study systematically evaluates the epidemiological transition of metabolic dysfunction-associated steatotic liver disease (MASLD)-related chronic liver diseases (CLD) and cirrhosis burden in China versus global populations (1990-2021), with emphasis on age-sex stratified disparities in incidence, prevalence, mortality, and disability-adjusted life years (DALYs). We aim to identify critical intervention windows for precision public health strategies.
Using open data from the Global Burden of Disease (GBD) database from 1990 to 2021, we conducted a comparative age-period-cohort analysis between Chinese and global populations. Joinpoint regression quantified temporal trends through average annual percentage change (AAPC) with 95% confidence intervals. Multidimensional stratification by age-sex cohorts elucidated differential burden patterns across disease progression stages.
From 1990 to 2021, China's age-standardized incidence rate (ASIR) increased from 495.16 per 100,000 population in 1990 to 621.18 per 100,000 in 2021 (AAPC = 0.74%). The age-standardized prevalence rate (ASPR) rose from 12,787.39 per 100,000 to 15,606.31 per 100,000 (AAPC = 0.63%). Globally, the ASIR increased from 475.18 per 100,000 to 592.78 per 100,000 (AAPC = 0.71%), while the ASPR increased from 12,084.69 per 100,000 to 15,017.46 per 100,000 (AAPC = 0.71%). China's age-standardized mortality rate (ASMR) declined from 0.54 per 100,000 to 0.31 per 100,000 (a decrease of 42.59%, AAPC = -1.75%), and the age-standardized DALY rate (ASDR) dropped from 13.99 per 100,000 to 7.61 per 100,000 (AAPC = -1.98%). China achieved significant reductions in mortality and age-standardized DALYs, in contrast to relatively stagnant global trends. The effects of age and gender on the disease burden varied: incidence rates remained high among younger populations, while the elderly accounted for the majority of deaths. Overall disease burden was higher in males than females; however, among individuals over 65 years old, the burden was more pronounced in females compared to males.
From 1990 to 2021, China has made progress in controlling mortality. However, the continuously rising age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) highlight an urgent need for targeted metabolic risk interventions among the youth. The observed epidemiological transition-characterized by a peak in incidence among younger populations and a concentration of deaths in older adults-calls for integrated strategies including early-life lifestyle interventions and comprehensive management frameworks for comorbidities in the elderly. Given China's large and aging population, addressing these shifting disease patterns remains a major public health challenge.
本研究系统评估了中国与全球人群（1990 - 2021年）中代谢功能障碍相关脂肪性肝病（MASLD）相关慢性肝病（CLD）的流行病学转变及肝硬化负担，重点关注发病率、患病率、死亡率和伤残调整生命年（DALYs）在年龄 - 性别分层上的差异。我们旨在确定精准公共卫生策略的关键干预窗口期。
利用1990年至2021年全球疾病负担（GBD）数据库中的公开数据，我们对中国和全球人群进行了年龄 - 时期 - 队列比较分析。Joinpoint回归通过平均年度百分比变化（AAPC）及95%置信区间对时间趋势进行了量化。按年龄 - 性别队列进行的多维分层阐明了疾病进展各阶段的不同负担模式。
1990年至2021年，中国的年龄标准化发病率（ASIR）从1990年的每10万人495.16例增至2021年的每10万人621.18例（AAPC = 0.74%）。年龄标准化患病率（ASPR）从每10万人12,787.39例升至每10万人15,606.31例（AAPC = 0.63%）。在全球范围内，ASIR从每10万人475.18例增至每10万人592.78例（AAPC = 0.71%），而ASPR从每10万人12,084.69例增至每10万人15,017.46例（AAPC = 0.71%）。中国的年龄标准化死亡率（ASMR）从每10万人0.54例降至每10万人0.31例（下降42.59%，AAPC = -1.75%），年龄标准化DALY率（ASDR）从每10万人13.99例降至每10万人7.61例（AAPC = -1.98%）。与全球相对停滞的趋势相比，中国在死亡率和年龄标准化DALYs方面实现了显著降低。年龄和性别对疾病负担的影响各不相同：发病率在较年轻人群中仍然较高，而老年人占死亡人数的大多数。总体疾病负担男性高于女性；然而，在65岁以上人群中，女性的负担比男性更为明显。
1990年至2
