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Danpanichkul P, Pang Y, Díaz LA, White TM, Sirimangklanurak S, Auttapracha T, Suparan K, Syn N, Jatupornpakdee P, Saowapa S, Ng CH, Kaewdech A, Lui RN, Fallon MB, Yang JD, Louvet A, Noureddin M, Liangpunsakul S, Jepsen P, Lazarus JV, Arab JP, Wijarnpreecha K. Alcohol-Attributable Cancer: Update From the Global Burden of Disease 2021 Study. Aliment Pharmacol Ther 2025. [PMID: 40287931 DOI: 10.1111/apt.70163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Revised: 01/28/2025] [Accepted: 04/14/2025] [Indexed: 04/29/2025]
Abstract
BACKGROUND AND AIMS Alcohol is a major risk factor for cancer development. Our study aimed to provide the updated global, regional and national burden of alcohol-attributable cancer. APPROACH AND RESULTS We analysed the Global Burden of Disease Study 2021 to determine the death and age-standardised death rate (ASDR) from alcohol-attributable cancer and the change of these measures between 2000 and 2021 (reflected as annual percent change [APC]), classified by region, nation and country's developmental status, which is based on the sociodemographic index (SDI). RESULTS In 2021, there were 343,370 deaths globally from alcohol-attributable cancer, which was an increase from 2000 by 51%. Alcohol-attributable cancer accounted for 3.5% of all cancer deaths. Among alcohol-attributable cancer, liver cancer (27%) accounted for the highest mortality from alcohol, followed by oesophageal (24%) and colorectal cancer (16%). From 2000 to 2021, ASDR from alcohol-attributable cancer decreased (APC: -0.66%). Regionally, from 2000 to 2021, the fastest-growing ASDR was observed in South Asia. Classified by SDI, low (APC: 0.33%) and low-to-middle SDI countries (APC: 1.58%) exhibited an uptrend in ASDR from alcohol-attributable cancer. While the ASDR from all other cancers decreased, ASDR from early-onset (15-49 years) lip and oral cavity cancer increased (APC: 0.40%). CONCLUSIONS From 2000 to 2021, although the ASDR from alcohol-attributable cancer declined, the total number of deaths continued to rise. This trend was accompanied by variations across sociodemographic groups and cancer types, particularly gastrointestinal cancers. Urgent efforts are needed both globally and at regional levels to address the burden of alcohol-attributable cancers.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Yanfang Pang
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
- National Immunological Laboratory of Traditional Chinese Medicine, Guangxi, China
- Key Laboratory of Research on Clinical Molecular Diagnosis for High Incidence Diseases in Western Guangxi, Guangxi, China
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Luis Antonio Díaz
- Division of Gastroenterology and Hepatology, MASLD Research Center, University of California San Diego, San Diego, California, USA
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
- The Global NASH Council, Washington, District of Columbia, USA
| | - Trenton M White
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA
- ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | | | - Kanokphong Suparan
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicholas Syn
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Sakditad Saowapa
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Cheng Han Ng
- Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Rashid N Lui
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Michael B Fallon
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, California, Los Angeles, USA
| | - Alexandre Louvet
- Services Des Maladies de L'appareil Digestif, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington, District of Columbia, USA
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA
- ISGlobal, Hospital Clínic, University of Barcelona, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
- The Global NASH Council, Washington, District of Columbia, USA
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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Wong ZY, Ou KQ, Wong ZN, Faderani R, Kanapathy M, Mosahebi A. Disease and Economic Burden of Plastic Surgery-Related Diseases in the United Kingdom. PLASTIC AND AESTHETIC NURSING 2025; 45:108-116. [PMID: 40153730 DOI: 10.1097/psn.0000000000000589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2025]
Abstract
This study aimed to assess the burden and economic impact of disease associated with plastic and reconstructive surgery in the United Kingdom. We calculated a value per statistical life year of £60,000 per person in the United Kingdom ($75,510 in U.S. dollars). We found that in 2019, the estimated age-standardized incident rates, age-standardized death rates, and age-standardized disability-adjusted life years of plastic surgery-related conditions were 361.47 per 100,000, 19.5 per 100,000 and 551.0 per 100,000, respectively. Burn emerged as the leading contributor to the overall disease burden, accounting for 32%, followed by decubitus ulcer (21%) and breast cancer (17%). The economic burden of plastic surgery-related diseases in the United Kingdom amounted to £34.3 billion (43.2 billion in U.S. dollars) in 2019, exhibiting a steady increase from £19.6 billion (24.7 billion in U.S. dollars) in 1990. Plastic and reconstructive surgery-related diseases, primarily breast cancer, thermal burns, and malignant melanoma, impose a substantial burden on the U.K. health care system. These findings hold significant implications for national health care policy, funding allocation, and research prioritization.
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Affiliation(s)
- Zhen Yu Wong
- Zhen Yu Wong, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital National Health Service (NHS) Trust, Nottingham, England
- Kai Qi Ou, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, England
- Zhen Ning Wong is a medical student at Manipal University College Malaysia, Bukit Baru, Melaka, Malaysia
- Ryan Faderani, MBBS, BSc, MRCS, FHEA, is an academic clinical fellow in plastic surgery at University College London, London, UK
- Muholan Kanapathy, MD, MSc, MRCS, PhD, is an academic clinical lecturer in plastic surgery at University College London, London, UK
- Afshin Mosahebi, MBBS, FRCS(Plast), PhD, MBA, is a Consultant Plastic Surgeon at the Royal Free Hospital and an Honorary Professor at the Department of Surgical Biotechnology in the Division of Surgery & Interventional Science at University College London, London, UK
| | - Kai Qi Ou
- Zhen Yu Wong, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital National Health Service (NHS) Trust, Nottingham, England
- Kai Qi Ou, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, England
- Zhen Ning Wong is a medical student at Manipal University College Malaysia, Bukit Baru, Melaka, Malaysia
- Ryan Faderani, MBBS, BSc, MRCS, FHEA, is an academic clinical fellow in plastic surgery at University College London, London, UK
- Muholan Kanapathy, MD, MSc, MRCS, PhD, is an academic clinical lecturer in plastic surgery at University College London, London, UK
- Afshin Mosahebi, MBBS, FRCS(Plast), PhD, MBA, is a Consultant Plastic Surgeon at the Royal Free Hospital and an Honorary Professor at the Department of Surgical Biotechnology in the Division of Surgery & Interventional Science at University College London, London, UK
| | - Zhen Ning Wong
- Zhen Yu Wong, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital National Health Service (NHS) Trust, Nottingham, England
- Kai Qi Ou, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, England
- Zhen Ning Wong is a medical student at Manipal University College Malaysia, Bukit Baru, Melaka, Malaysia
- Ryan Faderani, MBBS, BSc, MRCS, FHEA, is an academic clinical fellow in plastic surgery at University College London, London, UK
- Muholan Kanapathy, MD, MSc, MRCS, PhD, is an academic clinical lecturer in plastic surgery at University College London, London, UK
- Afshin Mosahebi, MBBS, FRCS(Plast), PhD, MBA, is a Consultant Plastic Surgeon at the Royal Free Hospital and an Honorary Professor at the Department of Surgical Biotechnology in the Division of Surgery & Interventional Science at University College London, London, UK
| | - Ryan Faderani
- Zhen Yu Wong, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital National Health Service (NHS) Trust, Nottingham, England
- Kai Qi Ou, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, England
- Zhen Ning Wong is a medical student at Manipal University College Malaysia, Bukit Baru, Melaka, Malaysia
- Ryan Faderani, MBBS, BSc, MRCS, FHEA, is an academic clinical fellow in plastic surgery at University College London, London, UK
- Muholan Kanapathy, MD, MSc, MRCS, PhD, is an academic clinical lecturer in plastic surgery at University College London, London, UK
- Afshin Mosahebi, MBBS, FRCS(Plast), PhD, MBA, is a Consultant Plastic Surgeon at the Royal Free Hospital and an Honorary Professor at the Department of Surgical Biotechnology in the Division of Surgery & Interventional Science at University College London, London, UK
| | - Muholan Kanapathy
- Zhen Yu Wong, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital National Health Service (NHS) Trust, Nottingham, England
- Kai Qi Ou, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, England
- Zhen Ning Wong is a medical student at Manipal University College Malaysia, Bukit Baru, Melaka, Malaysia
- Ryan Faderani, MBBS, BSc, MRCS, FHEA, is an academic clinical fellow in plastic surgery at University College London, London, UK
- Muholan Kanapathy, MD, MSc, MRCS, PhD, is an academic clinical lecturer in plastic surgery at University College London, London, UK
- Afshin Mosahebi, MBBS, FRCS(Plast), PhD, MBA, is a Consultant Plastic Surgeon at the Royal Free Hospital and an Honorary Professor at the Department of Surgical Biotechnology in the Division of Surgery & Interventional Science at University College London, London, UK
| | - Afshin Mosahebi
- Zhen Yu Wong, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital National Health Service (NHS) Trust, Nottingham, England
- Kai Qi Ou, MBBS, is a doctor at Queen's Medical Centre, Nottingham University Hospital NHS Trust, Nottingham, England
- Zhen Ning Wong is a medical student at Manipal University College Malaysia, Bukit Baru, Melaka, Malaysia
- Ryan Faderani, MBBS, BSc, MRCS, FHEA, is an academic clinical fellow in plastic surgery at University College London, London, UK
- Muholan Kanapathy, MD, MSc, MRCS, PhD, is an academic clinical lecturer in plastic surgery at University College London, London, UK
- Afshin Mosahebi, MBBS, FRCS(Plast), PhD, MBA, is a Consultant Plastic Surgeon at the Royal Free Hospital and an Honorary Professor at the Department of Surgical Biotechnology in the Division of Surgery & Interventional Science at University College London, London, UK
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Danpanichkul P, Duangsonk K, Tham EKJ, Tothanarungroj P, Auttapracha T, Prasitsumrit V, Sim B, Tung D, Barba R, Wong RJ, Leggio L, Yang JD, Chen VL, Noureddin M, Díaz LA, Arab JP, Wijarnpreecha K, Liangpunsakul S. Increased mortality from alcohol use disorder, alcohol-associated liver disease, and liver cancer from alcohol among older adults in the United States: 2000 to 2021. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2025; 49:368-378. [PMID: 39701596 PMCID: PMC11828968 DOI: 10.1111/acer.15516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 12/04/2024] [Indexed: 12/21/2024]
Abstract
BACKGROUND To investigate the trends in alcohol-associated liver disease (ALD), liver cancer from alcohol, and alcohol use disorder (AUD) burden among older adults in the United States (US). METHODS We gathered the ALD, liver cancer from alcohol, and AUD prevalence, mortality, and age-standardized rates (ASRs) from the Global Burden of Disease (GBD) Study 2021 between 2010 and 2021. We estimated the annual percent change (APC) with confidence intervals (CIs) for the burden of ALD, liver cancer from alcohol, and AUD in older adults (>70 years) in the United States. The findings were contrasted with global estimates and categorized by sex and state. RESULTS In 2021, there were approximately 512,340 cases of AUD, 56,990 cases of ALD, and 4490 cases of primary liver cancer from alcohol among older adults in the United States. In contrast to declining ASRs of prevalence and mortality in the global burden, these parameters were increased in older adults in the United States. From 2000 to 2021, prevalence from AUD (APC: 0.54%, 95% CI 0.43% to 0.65%), ALD (APC + 0.54%, 95% CI 0.22% to 0.86%), and primary liver cancer from alcohol (APC 2.93%, 95% CI 2.76% to 3.11%) increased. Forty states in the United States exhibited a rise in the prevalence rates of ALD in older adults. CONCLUSION Our findings highlighted the increased prevalence and mortality of AUD, ALD, and primary liver cancer from alcohol among older adults in the United Sates, contrasting with the decline in global trends. Public health strategies on ALD, AUD, and primary liver cancer from alcohol, which targets older adults, are urgently needed.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal MedicineTexas Tech University Health Sciences CenterLubbockTexasUSA
| | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Ethan Kai Jun Tham
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | | | | | | | - Benedix Sim
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Division of Gastroenterology and Hepatology, Department of MedicineNational University Health SystemSingaporeSingapore
| | - Daniel Tung
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Division of Gastroenterology and Hepatology, Department of MedicineNational University Health SystemSingaporeSingapore
| | - Romelia Barba
- Department of Internal MedicineTexas Tech University Health Sciences CenterLubbockTexasUSA
| | - Robert J. Wong
- Gastroenterology SectionVeterans Affairs Palo Alto Healthcare SystemPalo AltoCaliforniaUSA
- Division of Gastroenterology and HepatologyStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program (NIDA IRP) and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research (NIAAA DICBR)NIHBaltimore and BethesdaMarylandUSA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Samuel Oschin Comprehensive Cancer InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Vincent L. Chen
- Division of Gastroenterology and Hepatology, Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist HospitalHoustonTexasUSA
| | - Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de MedicinaPontificia Universidad Católica de ChileSantiagoChile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales (OMEGA)SantiagoChile
- Division of Gastroenterology, MASLD Research CenterUniversity of California at San DiegoLa JollaCaliforniaUSA
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de MedicinaPontificia Universidad Católica de ChileSantiagoChile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales (OMEGA)SantiagoChile
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal MedicineVirginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of MedicineUniversity of Arizona College of MedicinePhoenixArizonaUSA
- Department of Internal MedicineBanner University Medical CenterPhoenixArizonaUSA
- BIO5 InstituteUniversity of Arizona College of Medicine‐PhoenixPhoenixArizonaUSA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of MedicineIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Biochemistry and Molecular BiologyIndiana University School of MedicineIndianapolisIndianaUSA
- Roudebush Veterans' Administration Medical CenterIndianapolisIndianaUSA
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Danpanichkul P, Suparan K, Chaiyakunapruk N, Auttapracha T, Kongarin S, Wattanachayakul P, Ramadoss V, Suenghataiphorn T, Sukphutanan B, Pang Y, Lui RN, Yang JD, Noureddin M, Díaz LA, Liangpunsakul S, Arab JP, Wijarnpreecha K. Alcohol-related liver and extrahepatic malignancies: burden of disease and socioeconomic disparities in 2019. Eur J Gastroenterol Hepatol 2025; 37:198-206. [PMID: 39589794 DOI: 10.1097/meg.0000000000002882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Abstract
BACKGROUND Alcohol is linked to various cancers. While many studies have focused on developed countries, the burden of alcohol-related cancers in developing countries remains underexplored. METHODS We analyzed data from the Global Burden of Disease Study (2000-2019) to assess mortality and disability-adjusted life years (DALYs) from alcohol-related cancers in low and low-to-middle sociodemographic index (SDI) countries. RESULTS In 2019, there were 494 730 mortality from alcohol-related cancer. Low and low-middle SDI countries contributed over 15% of global mortality of alcohol-related cancer. Among multiple types of cancer, other pharyngeal cancers in these countries accounted for over 30% of global mortality of alcohol-related cancer. Primary liver cancer exhibited the highest mortality ( n = 16 090) in low and low-middle SDI countries. While deaths and DALYs rates from alcohol-related cancers decreased globally between 2000 and 2019, the related burden increased in low and low-middle SDI countries with a rise in all types of alcohol-related cancers, except for primary liver cancer. The most rapidly growing mortality rates in low SDI were from other pharyngeal cancers (+2.25%), whereas in low-middle SDI countries, colorectal cancer evidenced the highest increase (+2.76%). CONCLUSION The burden from alcohol-related cancer has risen in countries with low and low-to-middle SDI, especially other pharyngeal cancers and colorectal cancer. Policymakers should focus on improving alcohol-related policies as well as screening availability to tackle the associated burden of cancer in resource-constrained countries. However, the difficulty in isolating the impact of alcohol due to limited data on other confounders necessitates caution in interpreting these findings.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA
| | | | | | | | - Vijay Ramadoss
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore
| | | | | | - Yanfang Pang
- Affiliated Hospital of Youjiang Medical University for Nationalities
- National Immunological Laboratory of Traditional Chinese Medicine
- Center for Medical Laboratory Science, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Rashid N Lui
- Department of Clinical Oncology, and Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Institute of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Luis Antonio Díaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine
- Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine
- Department of Internal Medicine, Banner University Medical Center
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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Hwang SY, Danpanichkul P, Agopian V, Mehta N, Parikh ND, Abou-Alfa GK, Singal AG, Yang JD. Hepatocellular carcinoma: updates on epidemiology, surveillance, diagnosis and treatment. Clin Mol Hepatol 2025; 31:S228-S254. [PMID: 39722614 PMCID: PMC11925437 DOI: 10.3350/cmh.2024.0824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Revised: 11/08/2024] [Accepted: 12/20/2024] [Indexed: 12/28/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is a major global burden, ranking as the third leading cause of cancer-related mortality. HCC due to chronic hepatitis B virus (HBV) or C virus (HCV) infection has decreased due to universal vaccination for HBV and effective antiviral therapy for both HBV and HCV, but HCC related to metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease is increasing. Biannual liver ultrasonography and serum α-fetoprotein are the primary surveillance tools for early HCC detection among high-risk patients (e.g., cirrhosis, chronic HBV). Alternative surveillance tools such as blood-based biomarker panels and abbreviated magnetic resonance imaging (MRI) are being investigated. Multiphasic computed tomography or MRI is the standard for HCC diagnosis, but histological confirmation should be considered, especially when inconclusive findings are seen on cross-sectional imaging. Staging and treatment decisions are complex and should be made in multidisciplinary settings, incorporating multiple factors including tumor burden, degree of liver dysfunction, patient performance status, available expertise, and patient preferences. Early-stage HCC is best treated with curative options such as resection, ablation, or transplantation. For intermediate-stage disease, locoregional therapies are primarily recommended although systemic therapies may be preferred for patients with large intrahepatic tumor burden. In advanced-stage disease, immune checkpoint inhibitor-based therapy is the preferred treatment regimen. In this review article, we discuss the recent global epidemiology, risk factors, and HCC care continuum encompassing surveillance, diagnosis, staging, and treatments.
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Affiliation(s)
- Soo Young Hwang
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, Baltimore, Maryland, USA
| | - Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Vatche Agopian
- Dumont-UCLA Transplant and Liver Cancer Centers, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Neil Mehta
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, California, USA
| | - Neehar D. Parikh
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ghassan K. Abou-Alfa
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
- Department of Medicine, Weill Medical College at Cornell University, New York, USA
- Trinity College Dublin, Dublin, Ireland
| | - Amit G. Singal
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Howden CW, Loomba R. A Message From the Editors. Aliment Pharmacol Ther 2025; 61:4-5. [PMID: 39665518 DOI: 10.1111/apt.18404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2024]
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Danpanichkul P, Duangsonk K, Díaz LA, Chen VL, Rangan P, Sukphutanan B, Dutta P, Wanichthanaolan O, Ramadoss V, Sim B, Tung D, Siranart N, Noritake H, Takahashi H, Noureddin M, Leggio L, Yang JD, Fallon MB, Arab JP, Winder GS, Liangpunsakul S, Mellinger JL, Wijarnpreecha K. The burden of alcohol and substance use disorders in adolescents and young adults. Drug Alcohol Depend 2025; 266:112495. [PMID: 39603063 DOI: 10.1016/j.drugalcdep.2024.112495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 09/29/2024] [Accepted: 10/29/2024] [Indexed: 11/29/2024]
Abstract
BACKGROUND Substance use disorders (SUDs) play a major role in global preventable disability and mortality. Even though they impact patients of all ages, adolescents and young adults (AYAs) are at increased risk of substance use at a later age. We aim to assess the burden of SUDs and alcohol-related harms in AYAs. METHODS This study employed the Global Burden of Disease Study 2019 data. We assessed the prevalence, incidence, years of life lost, years of living with disability, and disability-adjusted life years (DALYs) of SUDs, alcohol use disorder (AUD), and alcohol-related burden in AYAs (10-24 years). RESULTS Among multiple SUDs, AUD had the highest prevalence (13.31 million), followed by cannabis use disorder (10.69 million) and opioid use disorder (4.27 million). From 2010-2019, while many SUDs saw a decrease in prevalence and incidence rates, opioid use disorder experienced increases across prevalence and incidence rates. Geographically, Europe and the Americas recorded the highest SUD burden. Higher Socio-demographic Index (SDI) levels correlated with increased SUD burden. Females showed a lower burden from SUDs and related health issues compared to males. The distribution of DALYs relative to prevalence varied across different SUDs and SDIs. The largest mortality caused by alcohol use were road injuries, interpersonal violence, and self-harm. CONCLUSION The worldwide burden of SUDs, particularly AUD, cannabis use disorder, opioid use disorder, and alcohol-induced harms (particularly injuries) among AYAs, is significant. Addressing this issue urgently requires the implementation of effective policies targeting SUDs.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Thailand
| | - Luis Antonio Díaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Pooja Rangan
- Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | - Priyata Dutta
- Department of Internal Medicine, Trinity Health, Ann Arbor, MI, USA
| | | | - Vijay Ramadoss
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Benedix Sim
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Daniel Tung
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Noppachai Siranart
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thailand; Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA
| | - Hidenao Noritake
- Division of Hepatology Department of Internal Medicine Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, TX, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore, MD, USA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Michael B Fallon
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, London, Ontario, Canada
| | | | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA; Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA
| | - Jessica Leigh Mellinger
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA; BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
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8
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ShojaeiBaghini M, Fattahi M, Mohammadi M, Hamzavi F. Risk Factors for Non-alcoholic Fatty Liver Disease from the Perspective of Medical Professionals: A Systematic Review and Expert Opinion. Middle East J Dig Dis 2025; 17:54-59. [PMID: 40322573 PMCID: PMC12048834 DOI: 10.34172/mejdd.2025.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 12/09/2024] [Indexed: 05/08/2025] Open
Abstract
Background The incidence of non-alcoholic fatty liver disease (NAFLD) has increased with the global increase in the outbreak of obesity, type 2 diabetes, and metabolic syndrome, reaching a 25% prevalence. However, there is currently no effective treatment for this disease apart from lifestyle modification. Furthermore, NAFLD commonly presents without symptoms, hence, leading to potentially severe and irreparable consequences. Methods This study was based on a systematic review. The search used the keywords "non-alcoholic fatty liver" and "risk factor" across the PubMed, Scopus, and Web of Science databases. First, the articles were evaluated based on their abstract and then on their full text. The risk factors were extracted from the articles and entered into the Excel form, and then a dataset was provided to the expert panel. The risk factors were investigated, and those related to NAFLD were selected. Results The results led to the identification of 180 risk factors in 15 categories. First, the risk factors mentioned in fewer than five articles were removed. Then, the remaining 101 risk factors were presented to the expert panel, of which 39 risk factors related to NAFLD were selected. Conclusion In summary, this study shows that NAFLD is caused by various factors such as metabolic syndrome, certain diseases, demographic information, specific surgeries, drug consumption, different foods and beverages, occupation, physical activity status, and socioeconomic status. Recognizing these risk factors enables doctors to make earlier diagnoses, potentially preventing disease progression. Additionally, it is possible to develop treatment strategies aimed at reducing the risk factors of the disease, which could result in fewer patients suffering from NAFLD in the future.
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Affiliation(s)
- Mahdie ShojaeiBaghini
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Mohammadi
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Fateme Hamzavi
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Health Information Department, School of Management and Medical Informatics, Kerman University of Medical Science, Kerman, Iran
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9
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Danpanichkul P, Suparan K, Prasitsumrit V, Ahmed A, Wijarnpreecha K, Kim D. Long-term outcomes and risk modifiers of metabolic dysfunction-associated steatotic liver disease between lean and non-lean populations. Clin Mol Hepatol 2025; 31:74-89. [PMID: 39439408 PMCID: PMC11791619 DOI: 10.3350/cmh.2024.0631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 10/20/2024] [Accepted: 10/22/2024] [Indexed: 10/25/2024] Open
Abstract
One-third of adults across the globe exhibit metabolic dysfunction-associated steatotic liver disease (MASLD)-formerly known as nonalcoholic fatty liver disease (NAFLD). To date, MASLD is the fastest-growing etiology of chronic liver disease and hepatocellular carcinoma (HCC). Besides the population with obesity, MASLD can also be found in lean populations, accounting for 13% of the global population, especially Asians. Notably, individuals with lean MASLD face equal or higher overall mortality rates compared to their non-lean counterparts. Risk modifiers encompass advanced age, hepatic fibrosis, and type 2 diabetes mellitus (T2DM). Moreover, the population with lean MASLD is associated with an increased risk of HCC, while their non-lean counterparts are more prone to cardiovascular outcomes and T2DM. Existing evidence indicates a similar risk of liver-related events and extrahepatic cancer between the two groups. However, MASLD-related genetic variants, such as PNPLA3 and TM6SF2, did not significantly affect mortality between the two populations. Still, underreporting alcohol consumption and regional representation limits the study's comprehensiveness. Longitudinal studies and mechanistic explorations are needed to understand differences in lean versus non-lean MASLD populations. This review highlights the need for awareness and tailored interventions in managing MASLD, considering lean individuals' unique risks.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Aijaz Ahmed
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
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Hahn JW, Woo S, Park J, Lee H, Kim HJ, Ko JS, Moon JS, Rahmati M, Smith L, Kang J, Pizzol D, Tully MA, Dragioti E, Sánchez GFL, Lee K, Ha Y, Lee J, Lee H, Rhee SY, Son Y, Kim S, Yon DK. Global, Regional, and National Trends in Liver Disease-Related Mortality Across 112 Countries From 1990 to 2021, With Projections to 2050: Comprehensive Analysis of the WHO Mortality Database. J Korean Med Sci 2024; 39:e292. [PMID: 39623966 PMCID: PMC11611658 DOI: 10.3346/jkms.2024.39.e292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 08/25/2024] [Indexed: 12/06/2024] Open
Abstract
BACKGROUND Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050. METHODS This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-period-cohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes. RESULTS The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older. Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase. CONCLUSION Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.
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Affiliation(s)
- Jong Woo Hahn
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Korea
| | - Hyeri Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Korea
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Masoud Rahmati
- Assistance Publique-Hopitaux de Marseille, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jiseung Kang
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Damiano Pizzol
- Health Unit Eni, Maputo, Mozambique
- Health Unit, Eni, San Donato Milanese, Italy
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Ireland, UK
| | - Elena Dragioti
- Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Kwanjoo Lee
- Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Yeonjung Ha
- Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jinseok Lee
- Department of Biomedical Engineering, Kyung Hee University College of Electronics and Information, Yongin, Korea
| | - Hayeon Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Kyung Hee University College of Electronics and Information, Yongin, Korea
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Endocrinology and Metabolism, Kyung Hee University College of Medicine, Seoul, Korea
| | - Yejun Son
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Soeun Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Korea
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea.
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Aboona MB, Danpanichkul P, Chen VL, Rangan P, Kim D, Alkhouri N, Fallon MB, Noureddin M, Arab JP, Wijarnpreecha K. Mortality outcomes in individuals with MASLD versus MASLD and increased alcohol intake. J Gastroenterol Hepatol 2024; 39:2456-2463. [PMID: 39175201 PMCID: PMC11620910 DOI: 10.1111/jgh.16726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/03/2024] [Accepted: 08/09/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND AND AIM Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a leading cause of chronic liver disease worldwide. A new entity termed MetALD has also been described and is defined as individuals with MASLD and increased alcohol intake. However, the natural history of MetALD compared with MASLD is unknown. We aimed to compare longitudinal outcomes in patients with MASLD versus MetALD. METHODS This study was performed using data from the National Health and Nutrition Examination Survey from 2011 to 2018. MASLD patients (defined by the United States Fatty Liver Index > 30) who met cardiometabolic criteria including body mass index (BMI) > 25 (BMI > 23 in Asians), hypertension, diabetes mellitus, dyslipidemia, and hypertriglyceridemia were included. MetALD was defined as MASLD with increased alcohol intake (3-6 standard drinks per day in males; 2-5 standard drinks per day in females). A comparison of overall, cardiovascular, cancer-related, and other causes of mortality in patients with MASLD versus MetALD was performed. RESULTS A total of 2838 individuals with MASLD and 2557 individuals with MetALD were included with a median follow-up time of 56 months. MetALD patients were at increased risk of cancer-related mortality compared with patients with MASLD (hazard ratio 1.32; 95% confidence interval 1.14-1.53; P < 0.01). However, there was no significant difference in overall, cardiovascular, and other causes of mortality. CONCLUSIONS Patients with MetALD were at higher risk for cancer-related mortality than MASLD. Close attention to regular cancer surveillance and accurate classification of alcohol consumption in individuals with diagnosed MASLD is warranted to help improve patient care and outcome.
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Affiliation(s)
- Majd B. Aboona
- Division of Clinical Data Analytics and Decision Support, University of Arizona College of Medicine—Phoenix, Arizona, USA
| | - Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Pooja Rangan
- Division of Clinical Data Analytics and Decision Support, University of Arizona College of Medicine—Phoenix, Arizona, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Naim Alkhouri
- Arizona Liver Institute, Banner University Medical Center, Phoenix, Arizona, USA
| | - Michael B. Fallon
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine—Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Juan Pablo Arab
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- Departmento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine—Phoenix, Arizona, USA
- BIO5 Institution, University of Arizona College of Medicine—Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
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12
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Chen DS, Chen ZP, Zhu DZ, Guan LX, Zhu Q, Lou YC, He ZP, Chen HN, Sun HC. Burden landscape of hepatobiliary and pancreatic cancers in Chinese young adults: 30 years’ overview and forecasted trends. World J Gastrointest Oncol 2024; 16:4177-4193. [DOI: 10.4251/wjgo.v16.i10.4177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 08/18/2024] [Accepted: 08/28/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Hepatobiliary and pancreatic (HBP) cancers impose a considerable burden on young populations (aged 15 to 49 years), resulting in a substantial number of new cases and fatalities each year. In young populations, the HBP cancers shows extensive variance worldwide and the updated data in China is lacking.
AIM To investigate the current status, trends, projections, and underlying risk factors of HBP cancers among young populations in China.
METHODS The Global Burden of Disease Study 2019 provided data on the annual incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) of HBP cancers in young Chinese adults between 1990 and 2019. Temporal trends were assessed using estimated annual percentage change and hierarchical clustering. Sex-specific mortality and DALYs caused by various risks were analyzed across China and other regions, with future trends until 2035 projected using the Bayesian age-period-cohort model.
RESULTS From 1990 to 2019, incident cases, deaths, DALYs, ASIR, ASMR, and ASDR for liver cancer (LC) in young Chinese individuals decreased, classified into 'significant decrease' group. Conversely, cases of gallbladder and biliary tract cancer and pancreatic cancer rose, categorized as either 'significant increase' or 'minor increase' groups. The contribution of risk factors to mortality and DALYs for HBP tumors increased to varying degrees. Healthy lifestyle behaviors, such as tobacco control, weight management, alcohol moderation, and drug avoidance, could lower HBP cancers incidence. Moreover, except for LC in females, which is likely to initially decline slightly and then rise, the forecasting model predicted that the ASIR and ASMR for all HPB cancers subtypes by gender will increase among young adults.
CONCLUSION HBP cancers burden among young adults in China is expected to increase until 2035, necessitating lifestyle interventions and targeted treatment strategies to mitigate the public health impact of these cancers.
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Affiliation(s)
- De-Sheng Chen
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Ze-Ping Chen
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Dong-Zi Zhu
- Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lv-Xin Guan
- Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China
| | - Qi Zhu
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Yi-Chao Lou
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Ze-Ping He
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Hao-Nan Chen
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Hong-Cheng Sun
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
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Danpanichkul P, Aboona MB, Sukphutanan B, Kongarin S, Duangsonk K, Ng CH, Muthiah MD, Huang DQ, Seko Y, Díaz LA, Arab JP, Yang JD, Chen VL, Kim D, Noureddin M, Liangpunsakul S, Wijarnpreecha K. Incidence of liver cancer in young adults according to the Global Burden of Disease database 2019. Hepatology 2024; 80:828-843. [PMID: 38598364 DOI: 10.1097/hep.0000000000000872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND AIMS The worldwide burden of cancer is increasing in younger populations. However, the epidemiology of primary liver cancer remains understudied in young adults compared to other cancer forms. APPROACH AND RESULTS This study analyzed data from the Global Burden of Disease study between 2010 and 2019 to assess the age-standardized incidence, mortality, and disability-adjusted life years associated with primary liver cancer in the young (15-49 y), stratified by region, nation, sociodemographic index, and sex. The study found a global estimate of 78,299 primary liver cancer cases, 60,602 deaths, and 2.90 million disability-adjusted life years in the young population. The Western Pacific region exhibited the highest burden in 2019, showing the most significant increase compared to other regions between 2010 and 2019. More than half of the countries worldwide have undergone an increase in primary liver cancer incidence rates in young adults. Around 12.51% of deaths due to primary liver cancer occur in young individuals. Throughout the study period, there was a significant decline in primary liver cancer mortality due to most etiologies, except for metabolic dysfunction-associated steatotic liver disease-attributable primary liver cancer (annual percentage change + 0.87%, 95% CI: 0.70%-1.05%) and alcohol-attributable primary liver cancer (annual percentage change + 0.21%, 95% CI: 0.01%-0.42%). The limitations of the Global Burden of Disease database include reliance on the quality of primary data and possible underestimation of alcohol consumption. CONCLUSIONS Over the past decade, there has been a marked increase in the burden of primary liver cancer, especially that originating from steatotic liver disease. This trend calls for the development of urgent and comprehensive strategies to mitigate this rising burden globally.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Majd B Aboona
- Department of Internal Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | | | | | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Cheng Han Ng
- Department of Medicine, Division of Gastroenterology and Hepatology, National University Health System, Singapore
- Department of Medicine, Division of Gastroenterology, Kurume University School of Medicine, Kurume, Japan
| | - Mark D Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Daniel Q Huang
- Department of Medicine, Division of Gastroenterology and Hepatology, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- MASLD Research Center, Division of Gastroenterology, University of California, San Diego, La Jolla, California, USA
| | - Yuya Seko
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyou-ku, Kyoto, Japan
| | - Luis Antonio Díaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Department of Medicine, Division of Gastroenterology, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Suthat Liangpunsakul
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Karn Wijarnpreecha
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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14
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Ichikawa T, Yamashima M, Yamamichi S, Koike M, Nakano Y, Yajima H, Miyazaki O, Ikeda T, Okamura T, Nagata K, Sawa K, Niiya K, Nakao K. Serum immunoglobulin A levels: Diagnostic utility in alcoholic liver disease and association with liver fibrosis in steatotic liver disease. Biomed Rep 2024; 21:142. [PMID: 39161940 PMCID: PMC11332156 DOI: 10.3892/br.2024.1830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/09/2024] [Indexed: 08/21/2024] Open
Abstract
The relationship between immunoglobulin A (IgA) levels and chronic liver disease remains poorly understood. The present study evaluated the clinical significance of IgA in 478 new patients who visited the Outpatient Clinic of Nagasaki Harbor Medical Center (Nagasaki, Japan). Serum IgA levels in comparison to liver stiffness (LS), as measured using a FibroScan® device, were evaluated in 358 patients. Furthermore, in 270 patients, the associations between serum IgA levels and body composition were analyzed using computed tomography. The IgA levels of patients in the groups with Child-Pugh classification B and C (CPGBC), alcoholic liver disease (ALD), steatotic liver disease (SLD) or diabetes were higher than the IgA levels of patients in the groups with CPGA, non-ALD, non-SLD or no diabetes, respectively. Logistic regression analysis showed that CPGBC, ALD, high IgG (>1,700 mg/dl), high macrophage galactose-specific lectin-2 binding protein glycosylation isomer (M2BPGi) (>1 cut-off index) and diabetes were contributing factors for high serum IgA level (>410 mg/dl). The ratio of IgA level divided by IgG level was highest in patients with ALD, followed by those with metabolic dysfunction-associated SLD (MASLD) and non-SLD. In SLD, IgA level was associated more with LS than M2BPGi and fibrosis-4 (FIB-4) in multiple regression analysis. In the receiver operating characteristic analysis, IgA level, M2BPG, and FIB-4 had similar area under the curve values for discriminating high LS (>8 kPa) from low LS (≤8 kPa) in SLD. IgA levels were also associated with visceral fat, and this association was only found in women. In conclusion, elevated IgA is an indicator of liver fibrosis that also reflects the presence of diabetes and an increased visceral fat level. Therefore, IgA is considered a useful marker of liver disease severity in the current era of increased SLD.
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Affiliation(s)
- Tatsuki Ichikawa
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
- Department of Comprehensive Community Care Systems, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan
- Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Mio Yamashima
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Shinobu Yamamichi
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Makiko Koike
- Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Yusuke Nakano
- Innovation and Translational Research Center, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Hiroyuki Yajima
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Osamu Miyazaki
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Tomonari Ikeda
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Takuma Okamura
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
- Department of Comprehensive Community Care Systems, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan
| | - Kazuyoshi Nagata
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Kenichi Sawa
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Kazutaka Niiya
- Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 850-8555, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan
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15
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Danpanichkul P, Ng CH, Muthiah MD, Duangsonk K, Kongarin S, Srisurapanont K, Pingwang P, Songmueang N, Nonthasoot C, Manosroi W, Nathisuwan S, Li F, Yang JD, Chen VL, Kim D, Noureddin M, Huang DQ, Wijarnpreecha K. Metabolic Syndrome and Metabolic Dysfunction-Associated Steatotic Liver Disease in Premenopausal Women: Global Trends and Projections to 2040. Mayo Clin Proc 2024; 99:1615-1628. [PMID: 38551541 DOI: 10.1016/j.mayocp.2023.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/10/2023] [Accepted: 12/28/2023] [Indexed: 10/05/2024]
Abstract
OBJECTIVE To quantify the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) and related metabolic disorders in premenopausal women. PATIENTS AND METHODS Between 2010 and 2019, global evaluations of prevalence, mortality, disability-adjusted life years (DALYs), and their age-standardized rate (ASR) were conducted for metabolic conditions such as MASLD, type 2 diabetes mellitus, dyslipidemia, hypertension (HTN), obesity, and polycystic ovarian syndrome. Subgroup assessments were conducted according to geographical regions and the sociodemographic index. The predictive models were established to estimate mortality and DALYs through 2040. RESULTS In 2019, the most significant ASR of deaths was found in HTN (11.37; 9.52 to 13.45), followed by obesity (10.49; 7.57 to 13.64). In contrast, the greatest ASR of DALYs was attributed to obesity (816.13; 581.41 to 1073.32), followed by HTN (634.73; 536.75 to 744.77). The mortality rates for dyslipidemia (-0.55%) and HTN (-0.72%) have been decreasing over time, but there has been an increase in obesity (+0.58%), type 2 diabetes mellitus (+0.85%), and MASLD (+0.51%). Lower sociodemographic index countries exhibit a higher disability-to-prevalence ratio. In 2040, obesity is predicted to cause the most deaths (+41.59% from 2019). CONCLUSION The escalating impact of metabolic syndrome, the rising trends in death rates linked to obesity, and the disparities based on region and socioeconomic status in premenopausal women underscore the alarming increase in the global burden of metabolic syndrome.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Chiang Mai University, Chiang Mai, Thailand; Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Cheng Han Ng
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Mark D Muthiah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kwanjit Duangsonk
- Department of Microbiology, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | | | | | - Worapaka Manosroi
- Division of Endocrinology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistics Center, Chiang Mai University, Chiang Mai, Thailand
| | - Surakit Nathisuwan
- Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Thailand
| | - Fang Li
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, TX, USA
| | - Daniel Q Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA.
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16
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Danpanichkul P, Suparan K, Dutta P, Kaeosri C, Sukphutanan B, Pang Y, Kulthamrongsri N, Jaisa-Aad M, Ng CH, Teng M, Nakano M, Morishita A, Alkhouri N, Yang JD, Chen VL, Kim D, Fallon MB, Diaz LA, Arab JP, Mantzoros CS, Noureddin M, Lazarus JV, Wijarnpreecha K. Disparities in metabolic dysfunction-associated steatotic liver disease and cardiometabolic conditions in low and lower middle-income countries: a systematic analysis from the global burden of disease study 2019. Metabolism 2024; 158:155958. [PMID: 38942169 DOI: 10.1016/j.metabol.2024.155958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/08/2024] [Accepted: 06/23/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE Metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic conditions affect populations across economic strata. Nevertheless, there are limited epidemiological studies addressing these diseases in low (LICs) and lower-middle-income countries (lower MICs). Therefore, an analysis of the trend of MASLD and cardiometabolic conditions in these countries is necessary. METHODS From 2000 to 2019, jointpoint regression analysis was employed to calculate the prevalence, mortality, and disability-adjusted life years (DALYs) for cardiometabolic conditions including MASLD, type 2 diabetes mellitus (T2DM), dyslipidemia (DLP), hypertension (HTN), obesity, peripheral artery disease (PAD), atrial fibrillation and flutter (AF/AFL), ischemic heart disease (IHD), stroke, and chronic kidney disease from HTN and T2DM, in LICs and lower MICs (according to the World Bank Classification 2019) using the Global Burden of Disease 2019 data. RESULTS Among the eleven cardiometabolic conditions, MASLD (533.65 million), T2DM (162.96 million), and IHD (76.81 million) had the highest prevalence in LICs and Lower MICs in 2019. MASLD represented the largest proportion of global prevalence in these countries (43 %). From 2000 to 2019, mortality in LICs and lower MICs increased in all cardiometabolic conditions, with obesity-related mortality having the highest increase (+134 %). During this timeframe, there were increased age-standardized death rates (ASDR) from obesity, PAD, and AF/AFL. From all conditions, the DALYs-to-prevalence ratio was higher in LICs and lower MICs than the global average. CONCLUSION The burden of MASLD and cardiometabolic conditions is increasing worldwide, with LICs and lower MICs experiencing higher (DALYs) disability per prevalence. As these conditions are preventable, counteracting these trends requires not only the modification of ongoing actions but also the strategizing of immediate interventions.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Priyata Dutta
- Department of Internal Medicine, Trinity Health, Ann Arbor, MI, USA
| | | | | | - Yanfang Pang
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi 533000, China; National Immunological Laboratory of Traditional Chinese Medicine, Baise, Guangxi 533000, China; Key Laboratory of Research on Clinical Molecular Diagnosis for High Incidence Diseases in Western Guangxi, Baise, Guangxi 533000, China; Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Narathorn Kulthamrongsri
- Department of Internal Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
| | | | - Cheng Han Ng
- Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Margaret Teng
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Masahito Nakano
- Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Asahiro Morishita
- Department of Gastroenterology and Neurology, Kagawa University, Kita-gun, Kagawa 761-0793, Japan
| | - Naim Alkhouri
- Department of Hepatology, Arizona Liver Health, Chandler, AZ, USA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael B Fallon
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA
| | - Luis Antonio Diaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile; MASLD Research Center, Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, CA, USA; The Global NASH Council, Washington, DC, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile; Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Medicine, Boston VA Healthcare System, Boston, MA, USA
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, TX, USA
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington, DC, USA; CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA; BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
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17
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Danpanichkul P, Suparan K, Sukphutanan B, Kaeosri C, Tothanarungroj P, Sirimangklanurak S, Kalligeros M, Polpichai N, Pang Y, Wijarnpreecha K, Sripongpun P, Chamroonkul N, Nguyen MH, Liangpunsakul S, Piratvisuth T, Kaewdech A. Changes in the epidemiological trends of primary liver cancer in the Asia-Pacific region. Sci Rep 2024; 14:19544. [PMID: 39174722 PMCID: PMC11341810 DOI: 10.1038/s41598-024-70526-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/19/2024] [Indexed: 08/24/2024] Open
Abstract
Primary liver cancer is the third leading cause of cancer-related mortality. The increasing prevalence of metabolic syndrome and alcohol consumption, along with the existing burden of viral hepatitis, could significantly heighten the impact of primary liver cancer. However, the specific effects of these factors in the Asia-Pacific region, which comprises more than half of the global population, remain largely unexplored. This study aims to analyze the epidemiology of primary liver cancer in the Asia-Pacific region. We evaluated regional and national data from the Global Burden of Disease study spanning 2010 to 2019 to assess the age-standardized incidence, mortality, and disability-adjusted life years associated with primary liver cancer in the Asia-Pacific region. During the study period, there were an estimated 364,700 new cases of primary liver cancer and 324,100 deaths, accounting for 68 and 67% of the global totals, respectively. Upward trends were observed in the age-standardized incidence rates of primary liver cancer due to metabolic dysfunction-associated fatty liver disease (MASLD) and alcohol-associated liver disease (ALD) in the Asia-Pacific region, as well as an increase in primary liver cancer from Hepatitis B virus infection in the Western Pacific region. Notably, approximately 17% of new cases occurred in individuals aged 15-49 years. Despite an overall decline in the burden of primary liver cancer in the Asia-Pacific region over the past decade, increases in incidence were noted for several etiologies, including MASLD and ALD. However, viral hepatitis remains the leading cause, responsible for over 60% of the total burden. These findings underscore the urgent need for comprehensive strategies to address the rising burden of primary liver cancer in the Asia-Pacific region.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | | | - Markos Kalligeros
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Natchaya Polpichai
- Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL, USA
| | - Yanfang Pang
- Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
- National Immunological Laboratory of Traditional Chinese Medicine, Baise, Guangxi, China
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA
- Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Pimsiri Sripongpun
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Naichaya Chamroonkul
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Mindie H Nguyen
- Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, California, USA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Teerha Piratvisuth
- NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand
| | - Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
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18
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Tsochatzis EA, Valenti L, Thiele M, Péloquin S, Lazure P, Masson MH, Allen AM, Lazarus JV, Noureddin M, Rinella M, Tacke F, Murray S. Use of non-invasive diagnostic tools for metabolic dysfunction-associated steatohepatitis: A qualitative exploration of challenges and barriers. Liver Int 2024; 44:1990-2001. [PMID: 38634796 DOI: 10.1111/liv.15941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/04/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND AND AIMS Non-invasive tests (NITs) are underutilized for diagnosis and risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD), despite good accuracy. This study aimed to identify challenges and barriers to the use of NITs in clinical practice. METHODS We conducted a qualitative exploratory study in Germany, Italy, United Kingdom and United States. Phase 1 participants (primary care physicians, hepatologists, diabetologists, researchers, healthcare administrators, payers and patient advocates; n = 29) were interviewed. Phase 2 participants (experts in MASLD; n = 8) took part in a group discussion to validate and expand on Phase 1 findings. Finally, we triangulated perspectives in a hybrid deductive/inductive thematic analysis. RESULTS Four themes hindering the use of NITs emerged: (1) limited knowledge and awareness; (2) unclear referral pathways for patients affected by liver conditions; (3) uncertainty over the value of NITs in monitoring and managing liver diseases; and (4) challenges justifying system-level reimbursement. Through these themes, participants perceived a stigma associated with liver diseases, and primary care physicians generally lacked awareness, adequate knowledge and skills to use recommended NITs. We identified uncertainties over the results of NITs, specifically to guide lifestyle intervention or to identify patients that should be referred to a specialist. Participants indicated an ongoing need for research and development to improve the prognostic value of NITs and communicating their cost-effectiveness to payers. CONCLUSIONS This qualitative study suggests that use of NITs for MASLD is limited due to several individual and system-level barriers. Multi-level interventions are likely required to address these barriers.
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Affiliation(s)
- Emmanuel A Tsochatzis
- UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Precision Medicine, Biological Resource Center Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maja Thiele
- Center for Liver Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | | | | | | | - Alina M Allen
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA
| | - Mazen Noureddin
- Houston Research Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Mary Rinella
- Prizker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Frank Tacke
- Department of Hepatology & Gastroenterology, Charité Universitätsmedizin Berlin, Berlin, Germany
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19
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Danpanichkul P, Chen VL, Chaiyakunapruk N, Auttapracha T, Kongarin S, Ng CH, Duangsonk K, Muthiah MD, Sukphutanan B, Sim B, Huang DQ, Seko Y, Lee BP, Takahashi H, Noureddin M, Lazarus JV, Díaz LA, Arab JP, Mellinger JL, Liangpunsakul S, Wijarnpreecha K. Socio-economic association of alcohol use disorder and cardiovascular and alcohol-associated liver disease from 2010 to 2019. Aliment Pharmacol Ther 2024; 60:340-349. [PMID: 38808961 DOI: 10.1111/apt.18095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/23/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUNDS AND AIMS Alcohol use leads to disabilities and deaths worldwide. It not only harms the liver but also causes alcohol use disorder (AUD) and heart disease. Additionally, alcohol consumption contributes to health disparities among different socio-economic groups. METHODS We estimated global and regional trends in the burden of AUD, liver disease, and cardiovascular disease from alcohol using the methodology of the Global Burden of Disease study. RESULTS In 2019, the highest disability-adjusted life years rate per 100,000 population was due to AUD (207.31 [95% Uncertainty interval (UI) 163.71-261.66]), followed by alcohol-associated liver disease (ALD) (133.31 [95% UI 112.68-156.17]). The prevalence rate decreased for AUD (APC [annual percentage change] -0.38%) and alcohol-induced cardiomyopathy (APC -1.85%) but increased for ALD (APC 0.44%) and liver cancer (APC 0.53%). Although the mortality rate for liver cancer from alcohol increased (APC 0.30%), mortality rates from other diseases decreased. Between 2010 and 2019, the burden of alcohol-associated complications increased in countries with low and low-middle sociodemographic index (SDI), contributing more significantly to the global burden. CONCLUSION The global burden of AUD, liver, and cardiovascular disease has been high and increasing over the past decade, particularly for liver complications. Lower SDI countries are contributing more to this global burden. There is a pressing need for effective strategies to address this escalating burden.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA
| | | | | | - Cheng Han Ng
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mark D Muthiah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | | | - Benedix Sim
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Daniel Q Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
- MASLD Research Center, Division of Gastroenterology, University of California at San Diego, San Diego, California, USA
| | - Yuya Seko
- Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, Japan
| | - Brian P Lee
- Division of Gastroenterology and Liver Diseases, University of Southern California, Los Angeles, California, USA
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Jeffrey V Lazarus
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- The Global NASH Council, Washington, DC, USA
| | - Luis Antonio Díaz
- MASLD Research Center, Division of Gastroenterology, University of California at San Diego, San Diego, California, USA
- The Global NASH Council, Washington, DC, USA
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Jessica Leigh Mellinger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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Danpanichkul P, Chen VL, Tothanarungroj P, Kaewdech A, Kanjanakot Y, Fangsaard P, Wattanachayakul P, Duangsonk K, Kongarin S, Yang JD, Wong RJ, Noureddin M, Díaz LA, Arab JP, Liangpunsakul S, Wijarnpreecha K. Global epidemiology of alcohol-associated liver disease in adolescents and young adults. Aliment Pharmacol Ther 2024; 60:378-388. [PMID: 38828940 DOI: 10.1111/apt.18101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/10/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND AND AIMS The objective of the study was to analyse the prevalence, incidence, and death of alcohol-associated liver disease (ALD) among adolescents and young adults globally, continentally, and nationally, focusing on trends over time. METHODS The study analysed data from the Global Burden of Disease (GBD) study between 2000 and 2019. It examined ALD's prevalence, incidence, and death in adolescents and young adults aged 15-29, segmented by region, nation, and sociodemographic index. The analysis utilised Joinpoint regression modelling to calculate the annual per cent change (APC) in the rate of these parameters over time. RESULTS In 2019, there were 281,450 ALD prevalences, 18,930 incidences, and 3190 deaths among adolescents and young adults globally. From 2000 to 2019, the age-adjusted prevalence rate per 100,000 increased in the 25-29 age group (APC: +0.6%, p = 0.003), remained stable among ages 20-24 (p = 0.302) and ages 15-19 (p = 0.160). Prevalence increased significantly from age 15-19 to 20-24 (19-fold increase) and from age 20-24 to 25-29 (2.5-fold increase). ALD prevalence rates increased in all age groups in adolescents and young adults in Africa and the Eastern Mediterranean region. Around three-quarters of countries and territories experienced an increase in ALD incidence rates in young adults. CONCLUSION Over two decades, the burden of ALD among adolescents and young adults has increased globally. The study emphasises the importance of public health policies aimed at reducing alcohol consumption and preventing ALD among younger populations.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Yatawee Kanjanakot
- Department of Surgery, School of Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Panisara Fangsaard
- Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA
| | | | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Robert J Wong
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California, USA
- Gastroenterology Section, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
- MASLD Research Center, Division of Gastroenterology, University of California, San Diego, California, USA
- The Global NASH Council, Washington, The District Of Columbia, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Roudebush Veterans' Administration Medical Center, Indianapolis, Indiana, USA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
- Department of Internal Medicine, Banner-University Medical Center, Phoenix, Arizona, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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21
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Danpanichkul P, Ng CH, Muthiah M, Suparan K, Tan DJH, Duangsonk K, Sukphutanan B, Kongarin S, Harinwan N, Panpradist N, Takahashi H, Kawaguchi T, Vichitkunakorn P, Chaiyakunapruk N, Nathisuwan S, Huang D, Arab JP, Noureddin M, Mellinger JL, Wijarnpreecha K. From Shadows to Spotlight: Exploring the Escalating Burden of Alcohol-Associated Liver Disease and Alcohol Use Disorder in Young Women. Am J Gastroenterol 2024; 119:893-909. [PMID: 38147513 DOI: 10.14309/ajg.0000000000002642] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/06/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION The burden of alcohol-related complications is considerable, particularly alcohol-associated liver disease and alcohol use disorder (AUD). However, there are deficiencies in comprehensive epidemiological research focusing on these issues, especially among young women who display higher susceptibility to such complications compared with their male counterparts. We thus aimed to determine the global burden of these conditions in this vulnerable group. METHODS Leveraging data from the Global Burden of Disease Study 2019, we analyzed the prevalence, mortality, and disability-adjusted life years of alcohol-associated cirrhosis (AC), liver cancer from alcohol, and AUD in young women. The findings were categorized by region, nation, and sociodemographic index. RESULTS The highest age-standardized prevalence rates were observed in AUD (895.96 [95% uncertainty interval (UI) 722.6-1,103.58]), followed by AC (65.33 [95% UI 48.37-86.49]) and liver cancer from alcohol (0.13 [95% UI 0.09-0.19]) per 100,000 people. The highest age-standardized mortality rates were observed in AC (0.75 [95% UI 0.55-0.97]), followed by AUD (0.48 [95% UI 0.43-0.53]) and liver cancer from alcohol (0.06 [95% UI 0.04-0.09]). The highest burdens of AC and AUD were observed in Central Europe, whereas the high-income Asia Pacific had the highest burden of liver cancer from alcohol. DISCUSSION Throughout the past decade, the trend of AUD varied among regions while the impact of alcohol-associated liver disease has increased, requiring urgent public health strategy to mitigate these complications, particularly in female patients in Europe and the Asia-Pacific region.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Cheng Han Ng
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Mark Muthiah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Nateeluck Harinwan
- Department of Surgery, School of Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Nuttada Panpradist
- Global Center for Integrated Health for Women, Adolescents, and Children (Global WACh), Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Hirokazu Takahashi
- Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Polathep Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Surakit Nathisuwan
- Clinical Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Daniel Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Mazen Noureddin
- Houston Methodist and Houston Research Institute, Houston, Texas, USA
| | - Jessica Leigh Mellinger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine and Division of Gastroenterology and Hepatology, Phoenix, Arizona, USA
- Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA
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Danpanichkul P, Suparan K, Ng CH, Dejvajara D, Kongarin S, Panpradist N, Chaiyakunapruk N, Muthiah MD, Chen VL, Huang DQ, Díaz LA, Noureddin M, Arab JP, Wijarnpreecha K. Global and regional burden of alcohol-associated liver disease and alcohol use disorder in the elderly. JHEP Rep 2024; 6:101020. [PMID: 38515553 PMCID: PMC10956070 DOI: 10.1016/j.jhepr.2024.101020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND & AIMS Alcohol-associated liver diseases (ALDs) and alcohol use disorder (AUD) pose a global health risk. AUD is underrecognized in the elderly, and the burden of AUD complications, including ALD, may increase with aging populations and rising alcohol intake. However, there is a lack of epidemiological evidence on AUD and ALD in the elderly. METHODS Using the Global Burden of Disease Study 2019, we analyzed the prevalence, mortality, disability-adjusted life years (DALYs), age-standardized rates (ASRs), and temporal change from 2000 to 2019 of ALD and AUD in the overall population and the elderly (65-89 years). The findings were categorized by sex, region, nation, and sociodemographic index. RESULTS The prevalence rates of ALD in the elderly were higher than those in adolescents and young adults, whereas AUD levels were lower than those in adolescents and young adults. In 2019, there were 9.39 million cases (8.69% of cases in the overall population) of AUD, 3.23 million cases (21.8% of cases in the overall population) of alcohol-associated cirrhosis, and 68,468 cases (51.27% of cases in the overall population) of liver cancer from alcohol among the elderly. ASRs of the prevalence of ALD and AUD in the elderly increased in most regions; on the contrary, ASRs of death and DALYs decreased in most regions. Nevertheless, ASRs of death and DALYs from liver cancer from alcohol increased in many areas. CONCLUSIONS Our findings highlighted the increased prevalence of ALD in the elderly, with a burden of AUD comparable with that in the overall population. Public health strategies on ALD and AUD targeting the elderly are urgently needed. IMPACT AND IMPLICATIONS The burden of alcohol-associated liver disease (ALD) and alcohol use disorder (AUD) is increasing. Advances in healthcare and education have resulted in a remarkable spike in life expectancy and a consequential population aging. Nevertheless, little is known about the epidemiology of ALD and AUD in the elderly. Our study indicates the increasing burden of ALD and AUD in the elderly population, necessitating early detection, intervention, and tailored care to the unique needs and complexities faced by older individuals grappling with these conditions.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Cheng Han Ng
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | | | - Nuttada Panpradist
- Global Center for Integrated Health for Women, Adolescents, and Children (Global WACh), Department of Global Health, University of Washington, Seattle, WA, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Mark D. Muthiah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Vincent L. Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Q. Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Luis Antonio Díaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Mazen Noureddin
- Houston Methodist and Houston Research Institute, Houston, TX, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA
- Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
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23
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Danpanichkul P, Suparan K, Kim D, Wijarnpreecha K. What Is New in Metabolic Dysfunction-Associated Steatotic Liver Disease in Lean Individuals: From Bench to Bedside. J Clin Med 2024; 13:278. [PMID: 38202285 PMCID: PMC10780205 DOI: 10.3390/jcm13010278] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/02/2024] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects more than 30% of the world's adult population. While it is associated with obesity and metabolic syndrome, emerging evidence has shown that a substantial number of MASLD patients have a normal body mass index ("lean individuals with MASLD"). In this article, we provide an overview of the definition, epidemiology, pathogenesis, and clinical outcomes associated with lean individuals with MASLD and updates on current management.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ 85004, USA
- Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ 85006, USA
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24
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Danpanichkul P, Kongarin S, Permpatdechakul S, Polpichai N, Duangsonk K, Manosroi W, Chaiyakunapruk N, Mousa OY, Kim D, Chen VL, Wijarnpreecha K. The Surreptitious Burden of Nonalcoholic Fatty Liver Disease in the Elderly in the Asia-Pacific Region: An Insight from the Global Burden of Disease Study 2019. J Clin Med 2023; 12:6456. [PMID: 37892594 PMCID: PMC10607093 DOI: 10.3390/jcm12206456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/28/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) represents a significant health threat worldwide. The aging population and a rise in metabolic syndrome in Asia might influence the epidemiology of NAFLD among the elderly. However, there is a lack of understanding of the burden and recommendations for NAFLD in this group. Our study sought to investigate the trends in the NAFLD burden among the elderly in the Asia-Pacific region. We employed data from the Global Burden of Disease 2019 study for an in-depth analysis of the prevalence and disability-adjusted life years (DALYs) along with age-standardized rate (ASR) associated with NAFLD in elderly populations (age 65-89 years) across the Asia-Pacific region, including the Southeast Asia (SEA) and Western Pacific (WP) regions, from 2010 to 2019. This study also examined the trends and disparities in NAFLD burden across different nations and sexes. In 2019, there were over 120 million cases of NAFLD in the elderly in the Asia-Pacific region. The ASR of prevalence was higher in SEA compared to WP (36,995.37 vs. 32,821.78 per 100,000). ASR of prevalence increased with annual percentage change (APC) +0.95% in the WP while it increased by +0.87% in SEA. During the study period, the ASR of DALYs decreased in SEA (APC -0.41%) but remained stable in the WP region. The burden of NAFLD in the elderly population in Asia-Pacific has increased, underscoring the timely intervention to tackle this high and rising burden.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siwanart Kongarin
- Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | | | - Natchaya Polpichai
- Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL 60640, USA;
| | - Kwanjit Duangsonk
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Worapaka Manosroi
- Division of Endocrinology, Department of Internal Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA;
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT 84108, USA
| | - Omar Y. Mousa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Mayo Clinic Health System, Rochester, MN 55902, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Vincent L. Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 41809, USA
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ 85004, USA
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ 85006, USA
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