Modelling NAFLD disease burden in four Asian regions-2019-2030
Modelling NAFLD disease burden in four Asian regions-2019-2030
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DOI：
10.1111/apt.15673
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发表时间：
2020-04-01
影响因子：
7.6
通讯作者：
Razavi, Homie
中科院分区：
文献类型：
--
作者：
Estes, Chris;Chan, Henry L. Y.;Razavi, Homie
背景非酒精性脂肪性肝病(NAFLD)和非酒精性脂肪性肝炎(NASH)在亚太地区肝脏疾病中所占比例越来越大。本地区许多地区正经历着代谢综合征在快速老龄化人口中的流行。目的通过建模来估计NAFLD人口的增长，包括最有可能经历晚期肝病和相关死亡的显著纤维化病例。方法使用疾病进展模型总结和预测香港、新加坡、韩国和台湾地区NAFLD人口的纤维化进程。每个地区的成人肥胖患病率的变化被用来推断NAFLD发病率的长期趋势。结果在所研究的地区，2019-2030年间NAFLD的流行病例预计将增加6%-20%，而NASH的流行病例将增加20%-35%。预计到2030年，肝细胞癌的发病率将增加65%-85%，失代偿性肝硬变的发病率将增加65%-100%。同样，从2019年到2030年，与NAFLD相关的死亡率预计将增加65%至100%。非酒精性脂肪肝的疾病负担预计将随着该地区人口中代谢综合征和肥胖的上升趋势而增加。这将导致更多的晚期肝病病例和相关死亡。结论预防糖尿病和肥胖人口的增长将是减少亚太地区NAFLD相关疾病负担持续增加的关键因素。
Background Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) account for an increasing proportion of liver disease in the Asia-Pacific region. Many areas in the region are experiencing epidemics of metabolic syndrome among rapidly ageing populations.Aims To estimate using modelling the growth in NAFLD populations, including cases with significant fibrosis that are most likely to experience advanced liver disease and related mortality.Methods A disease progression model was used to summarise and project fibrosis progression among the NAFLD populations of Hong Kong, Singapore, South Korea and Taiwan. For each area, changes in the adult prevalence of obesity was used to extrapolate long-term trends in NAFLD incidence.Results In the areas studied, prevalent NAFLD cases were projected to increase 6%-20% during 2019-2030, while prevalent NASH cases increase 20%-35%. Incident cases of hepatocellular carcinoma are projected to increase by 65%-85%, while incident decompensated cirrhosis cases increase 65%-100% by 2030. Likewise, NAFLD-related mortality is projected to increase between 65% and 100% from 2019 to 2030. NAFLD disease burden is expected to increase alongside rising trends in metabolic syndrome and obesity among populations in the region. This leads to more cases of advanced liver disease and associated mortality.Conclusions Preventing the growth of diabetic and obese populations will be a key factor in reducing ongoing increases in NAFLD-related disease burden in the Asia-Pacific region.