1990—2021年中国非酒精性脂肪性肝病疾病负担：与全球的对比分析

赵自豪; 魏涛华; 钱南南; 王玮琦; 杨文明; 宋宇琪

doi:10.16462/j.cnki.zhjbkz.2025.07.006

1990—2021年中国非酒精性脂肪性肝病疾病负担：与全球的对比分析

doi: 10.16462/j.cnki.zhjbkz.2025.07.006

赵自豪^{1, 2},
魏涛华^{2, 3, ,},
钱南南²,
王玮琦^{1, 2},
杨文明^{2, 3},
宋宇琪^{1, 2}

1.
安徽中医药大学第一临床医学院, 合肥 230031
2.
安徽中医药大学第一附属医院神经内科, 合肥 230031
3.
新安医学教育部重点实验室, 合肥 230031

基金项目:

国家自然科学基金 82305185

详细信息

通讯作者:
魏涛华, E-mail: weitaohua@foxmail.com

中图分类号: R575.5
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- 文章访问数: 56
- HTML全文浏览量: 15
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2025-01-11
- 修回日期: 2025-04-02
- 网络出版日期: 2025-08-11
- 刊出日期: 2025-07-10

Disease burden of cirrhosis caused by non-alcoholic fatty liver disease in China, 1990-2021: a comparative analysis with global trends

ZHAO Zihao^{1, 2},
WEI Taohua^{2, 3
, ,},
QIAN Nannan²,
WANG Weiqi^{1, 2},
YANG Wenming^{2, 3},
SONG Yuqi^{1, 2}

1.
First Clinical Medical College of Anhui University of Chinese Medicine, Hefei 230031, China
2.
Department of Encephalopathy, the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
3.
Key Laboratory of Xin′an Medical Science, Ministry of Education, Hefei 230031, China

Funds:

National Natural Science Foundation of China 82305185

More Information

Corresponding author: WEI Taohua, E-mail: weitaohua@foxmail.com

摘要

摘要: 目的分析1990—2021年中国与全球非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)疾病负担变化趋势，并预测未来趋势，为防治策略提供依据。方法基于2021年全球疾病负担数据库，提取1990—2021年中国与全球NAFLD的发病率、死亡率、伤残调整生命年等数据。采用Joinpoint回归模型计算年度变化百分比(annual percentage change, APC)和平均年度变化百分比(average annual percentage change, AAPC)，利用贝叶斯年龄-时期-队列模型(Bayesian age-period-cohort model, BAPC)预测2035年疾病负担。结果 2021年中国NAFLD的年龄标化发病率(621.18/10万)高于全球水平(592.78/10万)。1990—2021年中国标化伤残调整生命年(disability-adjusted life year, DALY)率(AAPC=-1.99%)和标化死亡率(AAPC=-1.72%)持续下降，但标化发病率呈上升趋势(AAPC=0.74%)。Joinpoint回归分析结果显示：(1)标化死亡率，1990—2015年阶段性下降，2015年后变化不显著；(2)标化发病率，1990—1999年缓慢上升(APC=0.19%~0.56%)，2000—2004年短暂下降(APC=-1.30%)，2004年后再次上升(APC=0.78%~2.21%)；(3)标化DALY率，1990—2015年总体下降(APC=-2.63%~-1.54%)，2015年后趋于平稳。全球标化DALY率和死亡率呈波动下降，但降幅小于中国。BAPC模型预测，至2035年，中国发病人数将增长26.50%，死亡人数下降38.43%；中国标化发病率增速(0.74%)低于全球，标化死亡率将继续下降。结论 1990—2021年中国NAFLD负担总体下降，但发病人数持续增长，预测到2035年，中国NAFLD患者的死亡数将下降，发病数将上升。提示需加强代谢性疾病早期干预，完善慢性肝病防治体系，以降低疾病流行风险。
- 肝硬化 /
- 疾病负担 /
- 预测分析 /
- 非酒精性脂肪性肝病
Abstract: Objective To analyze the trends in the disease burden of non-alcoholic fatty liver disease (NAFLD) and other chronic liver diseases-related cirrhosis in China and globally from 1990 to 2021, predicting future trajectories, and providing evidence for prevention strategies. Methods Data on incidence, mortality, and disability-adjusted life years of NAFLD and other chronic liver diseases-related cirrhosis were extracted from the Global Burden of Disease database. Joinpoint regression analysis was used to calculate annual percentage changes (APC) and average annual percentage changes (AAPC). A Bayesian age-period-cohort (BAPC) model was applied to project disease burden up to 2035. Results In 2021, China exhibited a higher age-standardized incidence rate of NAFLD and other chronic liver diseases-related cirrhosis (621.18 per 100 000) compared to the global average (592.78 per 100 000). From 1990 to 2021, China experienced declines in age-standardized DALY rate (AAPC=-1.99%) and mortality rate (AAPC=-1.72%), while the age-standardized incidence rate increased (AAPC=0.74%). Joinpoint analysis revealed: For standardized mortality rate, it phased declines during 1990-2015, with insignificant changes post-2015; For standardized incidence rate, it gradual rise from 1990-1999 (APC=0.19%-0.56%), followed by a transient decline (APC=-1.30%) in 2000-2004, and renewed increases post-2004 (APC=0.78%-2.21%); For DALY rate, the overall reduction during 1990-2015 (APC=-2.63%--1.54%), stabilizing after 2015. Globally, age-standardized DALY and mortality rates declined with fluctuations but at slower rates than in China. BAPC projections indicated that by 2035, incident cases in China will rise by 26.50%, while deaths will decrease by 38.43%. The age-standardized incidence growth rate in China (0.74%) will remain significantly lower than the global rate, and age-standardized mortality is projected to continue declining. Conclusions Despite reductions in age-standardized disease burden in China from 1990 to 2021, the growing number of incident cases of NAFLD and related cirrhosis highlights persistent challenges in controlling these conditions. Prioritizing early intervention for metabolic disorders and strengthening prevention systems for chronic liver diseases are critical to mitigating future risks.
- Liver cirrhosis /
- Disease burden /
- Predictive analysis /
- Non-alcoholic fatty liver disease

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图 1 1990—2021年中国与全球NAFLD标化疾病负担变化趋势

NAFLD：非酒精性脂肪性肝病; A、C：依次为全球NAFLD标化发病率、死亡率；B、D：依次为中国NAFLD标化发病率、死亡率。

Figure 1. Trends in the standardized disease burden of liver cirrhosis caused by NAFLD in China and globally from 1990 to 2021

NAFLD: non-alcoholic fatty liver disease; A, C: the standardized incidence and mortality rates of liver cirrhosis caused by global NAFLD; B, D: the standardized incidence and mortality rates of liver cirrhosis caused by China NAFLD.

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图 2 1990—2021年中国NAFLD发病率、死亡率、DALY率预测趋势

DALY：伤残调整生命年；NAFLD：非酒精性脂肪性肝病；A~C：依次为中国NAFLD全人群、男性、女性的发病率；D~F: 依次为中国NAFLD全人群、男性、女性的死亡率；G~1：中国NAFLD全人群、男性、女性的DALY率。

Figure 2. Predicted trends of cirrhosis incidence, mortality, and DALY caused by nonalcoholic fatty liver disease in China from 1990 to 2021

DALY: disability adjusted life year; FD: non-alcoholic faty liver disease; A-C: the incience rates of liver cirhosis caused by NAFLD in the overall poplation of China, as well as in males and female; D-F: the mortality rate of liver cirrhosis caused by NAFLD the overall population of China, as well as males and females; G-I: the rates of liver cirrhosis caused by NAFLD the overal population of China, as well as in males and females.

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表 1 1990—2021年中国与全球NAFLD疾病负担对比分析

Table 1. Comparative analysis of the disease burden of liver cirrhosis caused by nonalcoholic fatty liver disease including cirrhosis in China and globally from 1990 to 2021

年份Year	发病数 Number of cases	发病率 Incidence rate /100 000^-1	标化发病率 Standardized incidence rate /100 000^-1	死亡数 Number of deaths	死亡率 Mortality rate /100 000^-1	标化死亡率 Standardized mortality rate /100 000^-1	DALY率 DALY rate /100 000^-1
中国China
1990年year	6 179 750.14	525.29	495.16	4223.12	0.36	0.54	13.99
2021年year	9 561 142.65	672.02	621.18	6 339.03	0.45	0.31	7.61
AAPC/%	54.71	27.93	25.45	50.10	25.00	-42.59	-45.60
全球Global
1990年year	24 841 744.74	465.76	475.18	44 861.28	0.84	1.16	30.58
2021年year	48 310 980.97	612.20	592.78	97 403.37	1.23	1.14	30.90
AAPC/%	94.47	31.44	24.75	117.12	46.43	-1.72	1.05
注：NAFLD，非酒精性脂肪性肝病；DALY，伤残调整生命年；AAPC，平均年度变化百分比。 Note: NAFLD, non-alcoholic fatty liver disease; DALY, disability adjusted life year; AAPC, average annual percentage change.

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表 2 1990—2021年中国NAFLD疾病负担APC年度变化趋势

Table 2. Annual trends of APC in the disease burden of liver cirrhosis caused by nonalcoholic fatty liver disease in China from 1990 to 2021

年份 Year	标化死亡率 Standardized mortality rate/100 000^-1			标化发病率 Standardized incidence rate/100 000^-1			DALY率 DALY rate/100 000^-1
年份 Year	APC(95% CI)/%	t值 value	P值 value	APC(95% CI)/%	t值 value	P值 value	APC(95% CI)/%	t值 value	P值 value
1990—1995	-2.45(-3.22~-1.67)	-6.639	＜0.001	0.56(0.46~0.66)	11.823	＜0.001	-2.63(-3.32~-1.92)	-7.900	＜0.001
1995—1999	-4.23(-5.86~-2.57)	-5.373	＜0.001	0.19(0.05~0.33)	2.839	0.012	-4.38(-5.91~-2.84)	-5.953	＜0.001
1999—2004	-0.88(-1.89~0.15)	-1.818	0.089	-1.30(-1.44~-1.16)	-19.426	＜0.001	-1.54(-1.77~-1.30)	-13.858	＜0.001
2004—2010	-1.46(-2.20~-0.72)	-4.159	0.001	2.21(1.98~2.44)	20.616	＜0.001	-2.41(-3.87~-0.92)	-3.446	0.004
2010—2015	-2.06(-3.08~-1.03)	-4.234	0.001	2.04(1.94~2.14)	43.043	＜0.001	-1.04(2.60~0.55)	-1.395	0.183
2015—2021	-0.24(-0.85~0.36)	-0.858	0.404	0.78(0.70~0.85)	21.915	＜0.001	0.22(-1.40~1.86)	0.283	0.781
注：APC，年度变化百分比；NAFLD，非酒精性脂肪性肝病；DALY，伤残调整生命年。 Note: APC, annual percentage change; NAFLD, non-alcoholic fatty liver disease; DALY, disability-adjusted life year.

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