Clinical and Translational Research
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Nov 27, 2023; 15(11): 1210-1225
Published online Nov 27, 2023. doi: 10.4254/wjh.v15.i11.1210
Global burden of cirrhosis and other chronic liver diseases due to nonalcoholic fatty liver disease, 1990-2019
Zhi-Peng Liu, Guo-Qing Ouyang, Guo-Zhen Huang, Jie Wei, Luo Dai, Song-Qing He, Guan-Dou Yuan
Zhi-Peng Liu, Guo-Qing Ouyang, Guo-Zhen Huang, Jie Wei, Luo Dai, Song-Qing He, Guan-Dou Yuan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Co-first authors: Zhi-Peng Liu, Guo-Qing Ouyang.
Co-corresponding authors: Song-Qing He, Guan-Dou Yuan.
Author contributions: Liu ZP, Ouyang GQ, He SQ, and Yuan GD conceived and designed the study; Liu ZP, Ouyang GQ, Huang GZ, Wei J, and Dai L were involved in collection and interpretation of the data; Liu ZP, Ouyang GQ, and Yuan GD edited the manuscript; Liu ZP, Ouyang GQ, and He SQ revised the manuscript; All authors were involved in reading and approving the final manuscript. We designated co-corresponding authors because our research was a collaborative team effort, and the designation of co-corresponding authors helped to assign responsibilities and tasks related to the paper. This helped improve the quality and reliability of the paper. Second, He SQ and Yuan GD made equally important contributions throughout the study. The selection of co-corresponding authors recognizes this equal contribution. In conclusion, we believe that the designation of He SQ and Yuan GD as co-corresponding authors is an appropriate choice for our manuscript because it accurately reflects the collaborative spirit and diversity of our team. Liu ZP and Ouyang GQ contributed equally as co-first authors to this work; He SQ and Yuan GD contributed equally as co-corresponding authors to this work.
Supported by National Key research and Development Program, No. 2022YFE0131600; National Natural Science Foundation of China, No. 82160500; Special Project of Central Government Guiding Local Science and Technology Development, No. ZY20198011; Guangxi Science and Technology Base and Talent Project, No. GuikeAA21220002; Natural Science Foundation of Guangxi, No. 2022GXNSFAA035642; The Liuzhou Science and Technology Plan Project, No. 2021CB0101.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Guangxi Medical University.
Clinical trial registration statement: This study was an analysis of the burden of cirrhosis and other chronic liver diseases due to nonalcoholic fatty liver disease. The data were extracted from the Global Burden of Diseases, Injuries, and Risk Factors database, and clinical trial registration statements were not necessary.
Informed consent statement: This study was an analysis of the burden of cirrhosis and other chronic liver diseases due to nonalcoholic fatty liver disease. The data were extracted from the Global Burden of Diseases, Injuries, and Risk Factors database, and ethics approval and consent to participate were not necessary.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Data are available from http://ghdx.healthdata.org/gbd-results-tool and can be acquired from the corresponding author at dr_hesongqing@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Song-Qing He, PhD, Chief Doctor, Doctor, Professor, Research Assistant Professor, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. dr_hesongqing@163.com
Received: July 26, 2023
Peer-review started: July 26, 2023
First decision: August 16, 2023
Revised: August 29, 2023
Accepted: October 30, 2023
Article in press: October 30, 2023
Published online: November 27, 2023
Abstract
BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) has become the leading cause of cirrhosis and other chronic liver diseases (COCLDs).

AIM

To conduct a comprehensive and comparable updated analysis of the global, regional, and national burden of COCLDs due to NAFLD in 204 countries and territories from 1990 and 2019 by age, sex, and sociodemographic index.

METHODS

Data on COCLDs due to NAFLD were collected from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Numbers and age-standardized prevalence, death, and disability-adjusted life years (DALYs) were estimated through a systematic analysis of modelled data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. The estimated annual percentage change was used to determine the burden trend.

RESULTS

In 2019, the global age-standardized prevalence rate of COCLDs due to NAFLD was 15022.90 per 100000 population [95% uncertainty interval (UI): 13493.19-16764.24], which increased by 24.51% (22.63% to 26.08%) from 1990, with an estimated annual percentage change of 0.78 (95% confidence interval: 0.74-0.82). In the same year, however, the age-standardized death rate and age-standardized DALYs per 100000 population were 1.66 (95%UI: 1.20-2.17) and 43.69 (95%UI: 31.28-58.38), respectively. North Africa and the Middle East had the highest prevalence rates of COCLDs due to NAFLD. The death rate increased with age up to the 95+ age group for both sexes. Males had higher numbers of prevalence, death rate, and DALYs than females across all age groups before the 65-69 age group. The sociodemographic index was negatively correlated with the age-standardized DALYs.

CONCLUSION

Globally, the age-standardized prevalence rate has increased during the past three decades. However, the age-standardized death rate and age-standardized DALYs decreased. There is geographical variation in the burden of COCLDs due to NAFLD. It is strongly recommended to improve the data quality of COCLDs due to NAFLD across all countries and regions to facilitate better monitoring of the burden of COCLDs due to NAFLD.

Keywords: Cirrhosis, Nonalcoholic fatty liver disease, Global burden of disease, Prevalence, Disability-adjusted life years, Death

Core Tip: Nonalcoholic fatty liver disease is the leading cause of cirrhosis and other chronic liver diseases. The global age-standardized prevalence rate of cirrhosis and other chronic liver diseases due to nonalcoholic fatty liver disease increased by 24.51% from 1990. The age-standardized death rate and age-standardized disability-adjusted life-years rate per 100000 population were 1.66 and 43.69, respectively. The highest prevalence rate was observed in North Africa and the Middle East. Males had a higher burden of prevalence, death, and disability-adjusted life-years lost than females before the 65-69 age group. Furthermore, there is a negative correlation between sociodemographic index and age-standardized death rate.