Kolluri Vinutna Muvva, Bhamat Aayushi, Gohel Chinmay, Bindu Gowri, Enumula Deepthi
Medicine, All American Institute of Medical Sciences, Black River, JAM.
Internal Medicine, Godrej Memorial Hospital, Mumbai, IND.
Cureus. 2025 Aug 24;17(8):e90861. doi: 10.7759/cureus.90861. eCollection 2025 Aug.
Introduction Non-alcoholic fatty liver disease (NAFLD) is a major cause of mortality and its association with liver cirrhosis remains underexplored. Understanding this relationship is essential to identifying high-risk populations and developing targeted public health interventions. Aims and objective To analyze mortality trends and demographic disparities in NAFLD with liver cirrhosis as a contributing cause using the Centres for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) Multiple Causes of Death (MCD) database from 1999 to 2020. Methodology A retrospective cross-sectional study was conducted using the CDC MCD database to assess mortality trends in individuals aged 25 years and older in the United States from 1999 to 2020. The study included deaths where NAFLD (ICD-10: K76.0) was listed as the underlying cause and liver cirrhosis (ICD-10: K74) as a contributing cause. Data were analyzed by age, gender, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated. Results A total of 14,383 deaths were recorded. The AAMR for NAFLD with liver cirrhosis showed an increase from 1999 to 2006 with an APC of +20.66 (p<0.05), which further showed an increase between 2006 and 2009 with an APC of +27.60, and then again increased significantly from 2009 to 2020 with an APC of 15.87 (p<0.05). The highest mortality was observed in females, the white population, and metropolitan areas. Temporal trends showed an increase, with disparities noted across demographic and geographic factors. Conclusion This study highlights significant mortality trends (increasing) in NAFLD with liver cirrhosis, with disparities by gender, race, and location. The findings underscore the need for targeted prevention strategies and improved healthcare access.
引言
非酒精性脂肪性肝病（NAFLD）是导致死亡的主要原因之一，其与肝硬化的关联仍未得到充分研究。了解这种关系对于识别高危人群和制定有针对性的公共卫生干预措施至关重要。
目的
利用疾病控制与预防中心（CDC）的广泛在线流行病学研究数据（WONDER）多死因（MCD）数据库，分析1999年至2020年期间以肝硬化为促成原因的NAFLD的死亡率趋势和人口统计学差异。
方法
采用回顾性横断面研究，利用CDC的MCD数据库评估1999年至2020年美国25岁及以上人群的死亡率趋势。该研究纳入了以NAFLD（国际疾病分类第十版：K76.0）为根本死因且肝硬化（国际疾病分类第十版：K74）为促成原因的死亡病例。数据按年龄、性别、种族、地理区域和死亡地点进行分析。计算年龄调整死亡率（AAMR）和年百分比变化（APC）。
结果
共记录了14383例死亡病例。伴有肝硬化的NAFLD的AAMR在1999年至2006年呈上升趋势，APC为+20.66（p<0.05），在2006年至2009年进一步上升，APC为+27.60，然后在2009年至2020年再次显著上升，APC为15.87（p<0.05）。女性、白人和大都市地区的死亡率最高。时间趋势显示死亡率上升，在人口统计学和地理因素方面存在差异。
结论
本研究突出了伴有肝硬化的NAFLD显著的死亡率趋势（上升），在性别、种族和地点方面存在差异。研究结果强调了制定针对性预防策略和改善医疗服务可及性的必要性。
