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
ARTICLE HIGHLIGHTS
Research background

The incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) have been rapidly increasing worldwide over the past few decades, leading to cirrhosis and other chronic liver diseases (COCLDs). Cirrhosis is the leading cause of liver-related morbidity and contributes to more than 1 million deaths annually worldwide. NAFLD has become the leading cause of COCLDs.

Research motivation

A previous study reported the burden of liver cirrhosis caused by nonalcoholic steatohepatitis. However, no studies have focused on the epidemiology of COCLDs due to NAFLD across the globe.

Research objectives

We conducted a comprehensive and comparable updated analysis of the global, regional, and national levels of prevalence, death, and disability-adjusted life-years (DALYs) of COCLDs due to NAFLD in regards to age-standardized rates and numbers from 1990 to 2019, stratified by sex, age, and sociodemographic index.

Research 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 DALYs were estimated through a systematic analysis of modeled data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Estimated annual percentage change was used to determine the burden trend.

Research results

We found that the global age-standardized prevalence rate of COCLDs due to NAFLD was 15022.90 per 100000 population in 2019, with an estimated annual percentage change of 0.78. The age-standardized death rate and age-standardized DALYs rate per 100000 population were 1.66 and 43.69 in 2019, respectively. The highest prevalence rate was observed in North Africa and the Middle East. The numbers of prevalent cases, deaths, and DALYs cases of COCLDs due to NAFLD were higher in males than in females across all age groups before the age of 65-69 years. There was a negative correlation between sociodemographic index and age-standardized DALYs rate.

Research conclusions

COCLDs due to NAFLD have emerged as a large and growing public health burden worldwide. Globally, the ASPR has increased during the past three decades, whereas the ASDR and age-standardized DALY rate have decreased. There is geographical variation in the burden of COCLDs due to NAFLD. It is strongly recommended to improve the quality of COCLDs due to NAFLD health data across all countries and regions to facilitate better monitoring of the burden of COCLDs due to NAFLD.

Research perspectives

We believe that the findings of this study will provide insight into the global disease burden of COCLDs due to NAFLD and assist policymakers in formulating effective policies to mitigate modifiable risk factors.