1990—2019年中国非酒精性脂肪肝炎导致肝癌死亡负担的年龄-时期-队列效应分析  

Effect of age-period-cohort on liver cancer death burden caused by non-alcoholic steatohepatitis in China from 1990 to 2019

作　　者：赵倩雯 彭丹莉 刘姗姗 佘欣 国昊楠 ZHAO Qianwen;PENG Danli;LIU Shanshan;SHE Xin;GUO Haonan(Department of Clinical Laboratory,the Affiliated Hospital of Guilin Medical University,Guilin,Guangxi 541001,China)

机构地区：[1]桂林医学院附属医院检验科,广西桂林541001

出　　处：《肝胆胰外科杂志》2024年第11期667-672,共6页Journal of Hepatopancreatobiliary Surgery

基　　金：广西科技厅中央引导地方科技发展资金项目(桂科ZY21195024);广西肝脏损伤与修复分子医学重点实验室课题(GXLIRMMKL-K202302)。

摘　　要：目的分析1990—2019年中国非酒精性脂肪肝炎(non-alcoholic steatohepatitis,NASH)导致的肝癌死亡负担的长期趋势,为中国肝癌防控提供科学建议。方法从全球疾病负担研究2019(GBD 2019)获取1990—2019年中国NASH导致的肝癌死亡负担数据,运用年龄-时期-队列模型评估年龄、时期和队列效应。结果1990—2019年中国NASH导致的肝癌标化死亡率整体呈下降趋势,死亡总人口降幅为54.43%,男性降幅为60.72%,女性降幅46.16%。年龄-时期-队列模型显示,死亡率随年龄增加呈现先上升后下降趋势,整体呈上升趋势,死亡总人口从0.16/10万增至3.54/10万,男性从0.10/10万增至2.50/10万,女性从0.26/10万增至1.32/10万;随着时期的推移死亡风险先减小后增加,整体呈下降趋势,总人口死亡风险从1990年的1.64降至2019年的0.63,男性死亡风险从1.52降至0.69,女性死亡风险从1.78降至0.57。越晚出生的队列其死亡风险越小,死亡总人口RR值从5.24降至0.06,男性RR值从4.49降至0.08,女性RR值从5.57降至0.08。预计2020—2034年,中国NASH导致的肝癌死亡人数降至73897例,死亡率降至0.52/10万。结论1990—2019年中国NASH导致的肝癌标化死亡率呈下降趋势,须重点加强老年人群NASH的防控和体检筛查。Objective To analyze the long-term trend of liver cancer death burden caused by non-alcoholic steatohepatitis(NASH)in China from 1990 to 2019,and to provide insights for the prevention and control of liver cancer in China.Methods Data on the burden of liver cancer death caused by NASH in China from 1990 to 2019 were obtained from Global Burden of Disease Study(GBD 2019),and the age-period-cohort(APC)model was used to evaluate the age,period and cohort effects liver cancer death caused by NASH.Results From 1990 to 2019,the age-standardized mortality of liver cancer death burden caused by NASH showed an overall downward trend,with 54.43%reduction in the total patients,60.72%reduction in male patients,and 46.16%reduction in female patients.The APC model indicated that,mortality initially increased first and then decreased as patients got older,showing an overall upward trend,from 0.16/105 to 3.54/105 in the total patients,from 0.10/105 to 2.50/105 in male patients,and from 0.26/105 to 1.32/105 in female patients.Additionally,the risk of death fluctuated over time,decreased first and then increased,with an overall downward trend,from 1.64 in year 1990 to 0.6 in year 2019,from 1.52 to 0.69 in male patients,and from 1.78 to 0.57 in female patients.The later the cohort population was born,the lower the risk of death,with the RR value of the total patients decreased from 5.24 to 0.06,from 4.49 to 0.08 in male patients,and from 5.57 to 0.08 in female patients.Projections for 2020 to 2034 estimated a decrease in the number of deaths to 73897 and a mortality rate of 0.52/105.Conclusion In China,the age-standardized mortality of NASH-induced liver cancer exhibited a decresing trend from 1990 to 2019.It is imperative to enhance the prevention and control and physical examination screening for NASH in the elderly population.

关 键 词：非酒精性脂肪肝炎 肝癌 年龄-时期-队列模型 死亡率 疾病负担 

分 类 号：R735.7[医药卫生—肿瘤]