Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030
Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030
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DOI：
10.1016/j.jhep.2018.05.036
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发表时间：
2018-10-01
影响因子：
25.7
通讯作者：
Razavi, Homie
中科院分区：
文献类型：
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作者：
Estes, Chris;Anstee, Quentin M.;Razavi, Homie
背景与目的：在全球范围内，非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）日益成为肝硬化和肝细胞癌的病因。随着肥胖症、糖尿病和代谢综合征的流行继续增加，预计这一负担还会增加。本分析的目的是使用马尔可夫模型预测NAFLD疾病负担，使用当前可用的数据。方法：基于成人肥胖和2型糖尿病（DM）患病率的数据，使用一个模型来估计八个国家的NAFLD和NASH疾病进展。发表的估计和专家共识被用来建立和验证模型预测。结果：如果肥胖和糖尿病在未来趋于平稳，我们预计在2016-2030年期间，NAFLD病例总数将适度增长（0-30%），其中中国由于城市化而增长最快，日本由于人口减少而增长最低。然而，与此同时，NASH患病率将增加15-56%，而由于人口老龄化/人口增长，肝脏死亡率和晚期肝病将增加一倍以上。结论：NAFLD和NASH代表了一个巨大且日益严重的公共卫生问题，需要努力了解这种流行病并减轻疾病负担。如果肥胖和糖尿病继续以当前和历史的速度增长，NAFLD和NASH的患病率预计都会增加。由于这两种疾病都是可逆的，提高认识和诊断以及促进饮食和运动的公共卫生运动可以帮助控制未来疾病负担的增长。总结：非酒精性脂肪性肝病和非酒精性脂肪性肝炎可导致晚期肝病。随着肥胖和糖尿病的流行不断增加，这两种情况正变得越来越普遍。建立了一个数学模型，以了解与非酒精性脂肪性肝病和非酒精性脂肪性肝炎相关的疾病负担如何随时间变化。结果表明，在未来几年中，晚期肝病病例和肝脏相关死亡率将增加。(C) 2018年欧洲肝脏研究协会。Elsevier B.V.出版
Background & Aims: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are increasingly a cause of cirrhosis and hepatocellular carcinoma globally. This burden is expected to increase as epidemics of obesity, diabetes and metabolic syndrome continue to grow. The goal of this analysis was to use a Markov model to forecast NAFLD disease burden using currently available data.Methods: A model was used to estimate NAFLD and NASH disease progression in eight countries based on data for adult prevalence of obesity and type 2 diabetes mellitus (DM). Published estimates and expert consensus were used to build and validate the model projections.Results: If obesity and DM level off in the future, we project a modest growth in total NAFLD cases (0-30%), between 2016-2030, with the highest growth in China as a result of urbanization and the lowest growth in Japan as a result of a shrinking population. However, at the same time, NASH prevalence will increase 15-56%, while liver mortality and advanced liver disease will more than double as a result of an aging/ increasing population.Conclusions: NAFLD and NASH represent a large and growing public health problem and efforts to understand this epidemic and to mitigate the disease burden are needed. If obesity and DM continue to increase at current and historical rates, both NAFLD and NASH prevalence are expected to increase. Since both are reversible, public health campaigns to increase awareness and diagnosis, and to promote diet and exercise can help manage the growth in future disease burden.Lay summary: Non-alcoholic fatty liver disease and nonalcoholic steatohepatitis can lead to advanced liver disease. Both conditions are becoming increasingly prevalent as the epidemics of obesity and diabetes continue to increase. A mathematical model was built to understand how the disease burden associated with non-alcoholic fatty liver disease and non-alcoholic steatohepatitis will change over time. Results suggest increasing cases of advanced liver disease and liver-related mortality in the coming years. (C) 2018 European Association for the Study of the Liver. Published by Elsevier B.V.