1990年—2021年中国因非酒精性脂肪性肝炎所致肝癌的疾病负担分析与未来趋势预测研究  

Analysis and future trend prediction of the disease burden of liver cancer attributed to nonalcoholic steatohepatitis in China from 1990 to 2021

作　　者：陈嘉慧 王海博 柯立鑫 李洁韵 王志飞[5] 王子怡 张强[7] 卢存存 CHEN Jiahui;WANG Haibo;KE Lixin;LI Jieyun;WANG Zhifei;WANG Ziyi;ZHANG Qiang;LU Cuncun(Clinical Skills Training Center,the First Hospital of Lanzhou University,Lanzhou,Gansu 730000,P.R.China;Department of Critical Care Medicine,Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou,Gansu 730000,P.R.China;Department of Pediatrics,Medical Center of University of Groningen,Groningen 9713GZ,Netherlands;School of Basic Medical Sciences,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,P.R.China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,P.R.China;Evidence-Based Social Science Research Center,School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,P.R.China;The First Affiliated Hospital of Henan University of CM,Zhengzhou,Henan 450000,P.R.China)

机构地区：[1]兰州大学第一医院临床技能培训中心,兰州730000 [2]甘肃中医药大学附属医院重症医学科,兰州730000 [3]格罗宁根大学医学中心儿科学实验室,荷兰格罗宁根9713GZ [4]上海中医药大学基础医学院,上海201203 [5]中国中医科学院中医临床基础医学研究所,北京100700 [6]兰州大学公共卫生学院循证社会科学研究中心,兰州730000 [7]河南中医药大学第一附属医院,郑州450000

出　　处：《华西医学》2025年第4期546-553,共8页West China Medical Journal

基　　金：河南省中医药科学研究专项课题(2024ZY2046)。

摘　　要：目的基于最新的全球疾病负担数据2021分析中国人群中由非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)引起的肝癌疾病负担,并与全球情况进行对比,为我国相关公共卫生政策和疾病管理方案的制定提供参考和借鉴。方法检索于2024年5月公开发布的全球疾病负担数据2021数据库,整理1990年—2021年中国与全球因NASH导致肝癌的疾病负担数据。采用Joinpoint回归模型计算各负担指标的年龄标准化率的平均年度变化百分比(average annual percentage change,AAPC),以评估疾病流行病学随时间变化的特征。同时,利用贝叶斯方法预测2022年—2045年中国与全球因NASH所致肝癌的发病数和死亡数。结果与1990年相比,2021年中国和全球总体、男性和女性人群因NASH导致的肝癌发病数、患病数、死亡数、伤残调整生命年数、年龄标准化发病率和年龄标准化患病率均有所增加;且中国男性人群在1990年和2021年的各负担指标均高于相应年份的女性人群。整体趋势分析结果显示,1990年—2021年中国总体人群因NASH导致肝癌的年龄标准化发病率[AAPC=0.44%,95%置信区间(0.35%,0.53%),P<0.001]和年龄标准化患病率[AAPC=0.92%,95%置信区间(0.73%,1.11%),P<0.001]均呈上升趋势。此外,1990年和2021年中国总体人群各负担指标的年龄标准化率均高于相应年份的全球水平。贝叶斯模型预测结果显示,2022年—2045年中国和全球总体、男性和女性人群因NASH导致肝癌的发病数和死亡数整体上将均呈上升趋势。结论中国与全球因NASH导致的肝癌疾病负担整体上呈增加趋势,为遏制不断增加的疾病负担,有必要及时制定相应的公共卫生政策和疾病管理方案。Objective To analyze the disease burden of liver cancer caused by nonalcoholic steatohepatitis(NASH)among the Chinese population by utilizing the latest global burden of disease(GBD)2021 data,and conduct a comparative analysis with the global situation,so as to provide references and lessons for the formulation of public health policies and disease management plans in China.Methods GBD 2021 database publicly released in May 2024 was searched and relevant disease burden data of liver cancer caused by NASH in China and globally from 1990 to 2021 was sorted out.Joinpoint regression model was employed to calculate the average annual percentage change(AAPC)of the age-standardized rates of various burden indicators in order to evaluate the changing characteristics of disease epidemiology over time.Meanwhile,Bayesian method was used to predict the number of incidences and deaths of liver cancer caused by NASH in China and globally from 2022 to 2045.Results Compared with 1990,in 2021,the number of incidences,prevalence,deaths,disability-adjusted life years,age-standardized incidence rate and age-standardized prevalence rate of liver cancer caused by NASH in the overall,male and female populations in China and globally all increased.Moreover,in 1990 and 2021,all the burden indicators of the Chinese male population were higher than those of the female population in the corresponding years.The overall trend analysis showed that during the 32 years from 1990 to 2021,the age-standardized incidence rate[AAPC=0.44%,95%CI(0.35%,0.53%),P<0.001]and the age-standardized prevalence rate[AAPC=0.92%,95%CI(0.73%,1.11%),P<0.001]of liver cancer caused by NASH in the overall population in China both showed a significant upward trend.In addition,in 1990 and 2021,the age-standardized rates of all the burden indicators of the overall population in China were higher than the global levels in the corresponding years.The prediction results of the Bayesian model showed that from 2022 to 2045,the number of incidences and deaths of liver cancer ca

关 键 词：疾病负担 肝癌 非酒精性脂肪性肝炎 趋势 

分 类 号：R735.7[医药卫生—肿瘤]