[Analysis and prediction of disease burden of cirrhosis and other chronic liver diseases due to alcohol use in China from 1990 to 2030]

Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Feb 10;45(2):185-191. doi: 10.3760/cma.j.cn112338-20230920-00173.
[Article in Chinese]

Abstract

Objective: To comprehensively understand the disease burden of liver cirrhosis and other chronic liver diseases caused by alcohol use in China from 1990 to 2019, as well as to predict the trends in disease burden from 2020 to 2030. Methods: The analysis utilized data from the Global Burden of Disease study in 2019 (GBD2019). Key indicators such as incidence rate, mortality rate, disability-adjusted life years (DALY), years of life lost due to premature mortality, and years lived with disability were selected to describe the disease burden of alcohol-related liver cirrhosis and other chronic liver diseases in China from 1990 to 2019. The estimated annual percentage change (EAPC) was used to depict the temporal trends in disease burden. Furthermore, a Bayesian age-period-cohort (BAPC) model was constructed using R software to predict the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of alcohol-related liver cirrhosis and other chronic liver diseases in China from 2020 to 2030. Results: From 1990 to 2019, the incidence of alcohol-related liver cirrhosis and other chronic liver diseases in China showed an upward trend, with an EAPC of 0.31% (95%CI: 0.10%-0.52%). However, the DALY declined, with an EAPC of -2.81% (95%CI: -2.92% - -2.70%). The ASMR showed a downward trend, with an EAPC of -2.55% (95%CI: -2.66% - -2.45%). The highest incidence of cirrhosis of liver caused by alcohol and other chronic liver diseases was reported in the age group of 35-49 years, while the ASMR increased gradually with age, with a significant rise after the age of 30. The age-standardized DALY rate peaked between the ages of 55 and 64. The disease burden indicators for males were consistently higher than those for females during the same period. According to the predictions of the BAPC model, from 2020 to 2030, the ASIR for cirrhosis of liver caused by alcohol and other chronic liver diseases in the entire population of China was projected to increase from 3.45/100 000 in 2020 to 3.78/100 000 in 2030, a growth of 9.57%. Conversely, the ASMR was expected to decrease from 1.45/100 000 in 2020 to 1.24/100 000 in 2030, a reduction of 14.48%. Conclusions: The disease burden of cirrhosis of liver caused by alcohol and other chronic liver diseases remained serious in China, especially in men and the middle-aged to elderly population. There is a pressing need to prioritize attention and resources towards these groups. Despite the projected decrease in ASMR, the ASIR continued to rise and is expected to persist in its upward trend until 2030.

目的: 了解中国1990-2019年酒精导致的肝硬化和其他慢性肝病的疾病负担情况,并预测2020-2030年的疾病负担变化趋势。 方法: 利用2019全球疾病负担(GBD2019)数据,选择发病率、死亡率、伤残调整寿命年(DALY)、过早死亡损失寿命年、伤残损失寿命年等指标描述1990-2019年中国酒精导致的肝硬化和其他慢性肝病疾病负担情况,利用年估计变化百分比(EAPC)描述疾病负担的时间趋势变化。采用R软件构建贝叶斯年龄-时期-队列(BAPC)模型,预测2020-2030年中国酒精导致的肝硬化和其他慢性肝病年龄标化发病率(ASIR)和年龄标化死亡率(ASMR)。 结果: 1990-2019年,中国酒精导致的肝硬化和其他慢性肝病ASIR呈上升趋势,其EAPC为0.31%(95%CI:0.10%~0.52%);DALY呈现下降趋势,EAPC为-2.81%(95%CI:-2.92%~-2.70%);ASMR呈下降趋势,EAPC为-2.55%(95%CI:-2.66%~-2.45%)。酒精导致的肝硬化和其他慢性肝病ASIR在35~49岁年龄段中达到最高,而ASMR随着年龄升高逐渐增加,年龄30~岁开始显著升高;年龄标化DALY率在55~64岁之间达到高峰。男性居民的疾病负担指标均高于同时期的女性居民。根据BAPC模型预测结果,2020-2030年中国全人群酒精导致的肝硬化和其他慢性肝病ASIR从2020年的3.45/10万上升至2030年的3.78/10万,增长9.57%,ASMR从2020年的1.45/10万下降至2030年的1.24/10万,降低14.48%。 结论: 我国因酒精导致的肝硬化和其他慢性肝病的疾病负担仍然较重,尤其是在男性和中老年人群中,需要更加重视对这些人群的关注。2020-2030年预测结果显示ASMR呈下降趋势,ASIR仍在上升。.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Bayes Theorem
  • China / epidemiology
  • Cost of Illness
  • Ethanol
  • Female
  • Global Burden of Disease
  • Humans
  • Incidence
  • Liver Cirrhosis* / epidemiology
  • Liver Cirrhosis, Alcoholic* / epidemiology
  • Male
  • Middle Aged
  • Quality-Adjusted Life Years

Substances

  • Ethanol