Analysis and future trend prediction of the disease burden of liver cancer attributed to nonalcoholic steatohepatitis in China from 1990 to 2021_West China Medical Journal

Authors：

CHEN Jiahui ¹ , WANG Haibo ² , KE Lixin ³ , LI Jieyun ⁴ , WANG Zhifei ⁵ , WANG Ziyi ⁶ , ZHANG Qiang ⁷ ,  LU Cuncun ⁵

1. Clinical Skills Training Center, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
2. Department of Critical Care Medicine, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu 730000, P. R. China;
3. Department of Pediatrics, Medical Center of University of Groningen, Groningen 9713GZ, Netherlands;
4. School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China;
5. Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, P. R. China;
6. Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
7. The First Affiliated Hospital of Henan University of CM, Zhengzhou, Henan 450000, P. R. China;

Corresponding?author：

LU Cuncun, Email: lu17metrics@163.com

Keywords：

Disease burden; liver cancer; nonalcoholic steatohepatitis; trend

DOI：

10.7507/1002-0179.202408168

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Objective To analyze the disease burden of liver cancer caused by nonalcoholic steatohepatitis (NASH) among the Chinese population by utilizing the latest global burden of disease (GBD) 2021 data, and conduct a comparative analysis with the global situation, so as to provide references and lessons for the formulation of public health policies and disease management plans in China. Methods GBD 2021 database publicly released in May 2024 was searched and relevant disease burden data of liver cancer caused by NASH in China and globally from 1990 to 2021 was sorted out. Joinpoint regression model was employed to calculate the average annual percentage change (AAPC) of the age-standardized rates of various burden indicators in order to evaluate the changing characteristics of disease epidemiology over time. Meanwhile, Bayesian method was used to predict the number of incidences and deaths of liver cancer caused by NASH in China and globally from 2022 to 2045. Results Compared with 1990, in 2021, the number of incidences, prevalence, deaths, disability-adjusted life years, age-standardized incidence rate and age-standardized prevalence rate of liver cancer caused by NASH in the overall, male and female populations in China and globally all increased. Moreover, in 1990 and 2021, all the burden indicators of the Chinese male population were higher than those of the female population in the corresponding years. The overall trend analysis showed that during the 32 years from 1990 to 2021, the age-standardized incidence rate [AAPC=0.44%, 95%CI (0.35%, 0.53%), P<0.001] and the age-standardized prevalence rate [AAPC=0.92%, 95%CI (0.73%, 1.11%), P<0.001] of liver cancer caused by NASH in the overall population in China both showed a significant upward trend. In addition, in 1990 and 2021, the age-standardized rates of all the burden indicators of the overall population in China were higher than the global levels in the corresponding years. The prediction results of the Bayesian model showed that from 2022 to 2045, the number of incidences and deaths of liver cancer caused by NASH in the overall, male and female populations in China and globally will generally show an upward trend. Conclusions The disease burden of liver cancer caused by NASH in China and globally is generally on the rise. In order to curb the increasing disease burden, it is necessary to formulate relevant public health policies and disease management plans in a timely manner.

Citation： CHEN Jiahui, WANG Haibo, KE Lixin, LI Jieyun, WANG Zhifei, WANG Ziyi, ZHANG Qiang, LU Cuncun. Analysis and future trend prediction of the disease burden of liver cancer attributed to nonalcoholic steatohepatitis in China from 1990 to 2021. West China Medical Journal, 2025, 40(4): 546-553. doi: 10.7507/1002-0179.202408168 Copy

1.	中華醫學會肝病學分會. 代謝相關(非酒精性)脂肪性肝病防治指南(2024 年版). 中華肝臟病雜志, 2024, 32(5): 418-434.
2.	Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol, 2023, 79(6): 1542-1556.
3.	尚文茹, 柯立鑫, 王子怡, 等. 牛奶、咖啡攝入與非酒精性脂肪性肝病的因果關聯: 兩樣本孟德爾隨機化研究. 中國循證醫學雜志, 2023, 23(12): 1373-1377.
4.	Sookoian S, Pirola CJ. Resmetirom for treatment of MASH. Cell, 2024, 187(12): 2897-2897.e1.
5.	Lou TW, Yang RX, Fan JG. The global burden of fatty liver disease: the major impact of China. Hepatobiliary Surg Nutr, 2024, 13(1): 119-123.
6.	Llovet JM, Willoughby CE, Singal AG, et al. Nonalcoholic steatohepatitis-related hepatocellular carcinoma: pathogenesis and treatment. Nat Rev Gastroenterol Hepatol, 2023, 20(8): 487-503.
7.	李于, 溫劍. 非酒精性脂肪性肝炎促進原發性肝癌的病因與防治策略. 西南醫科大學學報, 2024, 47(1): 1-5.
8.	Qi X, Li J, Caussy C, et al. Epidemiology, screening, and co-management of type 2 diabetes mellitus and metabolic-dysfunction associated steatotic liver disease. Hepatology, 2024: 1-18.
9.	胡漂, 孔東明, 朱仲鑫. 1990—2019 年中國人群非酒精性脂肪肝疾病負擔分析. 中國預防醫學雜志, 2022, 23(4): 260-264.
10.	范建高, 楊榮. 全球非酒精性脂肪性肝病的流行趨勢與疾病負擔. 中華消化雜志, 2023, 43(4): 248-252.
11.	許耀瓏, 趙佳欣, 楊立剛. 非酒精性脂肪性肝病流行現狀及危險因素研究進展. 中國全科醫學, 2024, 27(30): 3825-3834.
12.	GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2133-2161.
13.	GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2162-2203.
14.	GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2100-2132.
15.	Flaxman AD, Vos T, Murray CJL. An integrative metaregression framework for descriptive epidemiology. University of Washington Press, 2015.
16.	李輝章, 杜靈彬. Joinpoint 回歸模型在腫瘤流行病學時間趨勢分析中的應用. 中華預防醫學雜志, 2020, 54(8): 908-912.
17.	陳東宇, 楊曉雨, 王紅心, 等. 基于 Joinpoint 回歸和年齡-時期-隊列模型分析中國皮膚癌的長期發病趨勢. 中華疾病控制雜志, 2022, 26(7): 756-765.
18.	張記收, 王夢龍, 劉劍芳, 等. 基于 2019 年全球疾病負擔研究數據分析 1990—2019 年中國高血壓心臟病疾病負擔變化趨勢. 中華高血壓雜志, 2023, 31(2): 141-149.
19.	Rue H, Martino S, Chopin N. Approximate Bayesian inference for latent Gaussian models by using integrated nested Laplace approximations. J R Stat Soc Series B Stat Methodol, 2009, 71(2): 319-392.
20.	劉珊山, 于曉輝, 秦建偉. 1990—2019 年中國肝硬化疾病負擔變化趨勢分析. 臨床肝膽病雜志, 2024, 40(4): 726-733.
21.	彭丹莉, 佘欣, 毛國飛, 等. 1990—2019 年中國肝癌發病與死亡年齡-時期-隊列模型分析及預測. 現代醫學, 2024, 52(1): 102-107.
22.	Lu R, Liu Y, Hong T. Epidemiological characteristics and management of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis in China: a narrative review. Diabetes Obes Metab, 2023, 25(Suppl 1): 13-26.
23.	張澍, 鐘明, 張俊慧. 非酒精性脂肪性肝炎預防與干預的研究進展. 現代預防醫學, 2023, 50(14): 2676-2682.
24.	Tilg H, Byrne CD, Targher G. NASH drug treatment development: challenges and lessons. Lancet Gastroenterol Hepatol, 2023, 8(10): 943-954.
25.	盧存存, 王海博, 柯立鑫, 等. 基于網絡藥理學與分子對接探討舒肝寧注射液治療非酒精性脂肪性肝病的潛在作用機制. 華西醫學, 2024, 39(12): 1911-1916.
26.	Sanyal AJ, Bedossa P, Fraessdorf M, et al. A Phase 2 randomized trial of survodutide in MASH and fibrosis. N Engl J Med, 2024, 391(4): 311-319.
27.	Chen X, Shi J, Lai Y, et al. Systematic analysis of randomised controlled trials of Chinese herb medicine for non-alcoholic steatohepatitis (NASH): implications for future drug development and trial design. Chin Med, 2023, 18(1): 58.
28.	孫懿, 黃鑫宇, 屈雅琴, 等. 基于網絡藥理學和實驗驗證探討石榴皮對非酒精性脂肪性肝炎的作用機制. 中國現代應用藥學, 2023, 40(17): 2384-2392.

1. 中華醫學會肝病學分會. 代謝相關(非酒精性)脂肪性肝病防治指南(2024 年版). 中華肝臟病雜志, 2024, 32(5): 418-434.
2. Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol, 2023, 79(6): 1542-1556.
3. 尚文茹, 柯立鑫, 王子怡, 等. 牛奶、咖啡攝入與非酒精性脂肪性肝病的因果關聯: 兩樣本孟德爾隨機化研究. 中國循證醫學雜志, 2023, 23(12): 1373-1377.
4. Sookoian S, Pirola CJ. Resmetirom for treatment of MASH. Cell, 2024, 187(12): 2897-2897.e1.
5. Lou TW, Yang RX, Fan JG. The global burden of fatty liver disease: the major impact of China. Hepatobiliary Surg Nutr, 2024, 13(1): 119-123.
6. Llovet JM, Willoughby CE, Singal AG, et al. Nonalcoholic steatohepatitis-related hepatocellular carcinoma: pathogenesis and treatment. Nat Rev Gastroenterol Hepatol, 2023, 20(8): 487-503.
7. 李于, 溫劍. 非酒精性脂肪性肝炎促進原發性肝癌的病因與防治策略. 西南醫科大學學報, 2024, 47(1): 1-5.
8. Qi X, Li J, Caussy C, et al. Epidemiology, screening, and co-management of type 2 diabetes mellitus and metabolic-dysfunction associated steatotic liver disease. Hepatology, 2024: 1-18.
9. 胡漂, 孔東明, 朱仲鑫. 1990—2019 年中國人群非酒精性脂肪肝疾病負擔分析. 中國預防醫學雜志, 2022, 23(4): 260-264.
10. 范建高, 楊榮. 全球非酒精性脂肪性肝病的流行趨勢與疾病負擔. 中華消化雜志, 2023, 43(4): 248-252.
11. 許耀瓏, 趙佳欣, 楊立剛. 非酒精性脂肪性肝病流行現狀及危險因素研究進展. 中國全科醫學, 2024, 27(30): 3825-3834.
12. GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2133-2161.
13. GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2162-2203.
14. GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2100-2132.
15. Flaxman AD, Vos T, Murray CJL. An integrative metaregression framework for descriptive epidemiology. University of Washington Press, 2015.
16. 李輝章, 杜靈彬. Joinpoint 回歸模型在腫瘤流行病學時間趨勢分析中的應用. 中華預防醫學雜志, 2020, 54(8): 908-912.
17. 陳東宇, 楊曉雨, 王紅心, 等. 基于 Joinpoint 回歸和年齡-時期-隊列模型分析中國皮膚癌的長期發病趨勢. 中華疾病控制雜志, 2022, 26(7): 756-765.
18. 張記收, 王夢龍, 劉劍芳, 等. 基于 2019 年全球疾病負擔研究數據分析 1990—2019 年中國高血壓心臟病疾病負擔變化趨勢. 中華高血壓雜志, 2023, 31(2): 141-149.
19. Rue H, Martino S, Chopin N. Approximate Bayesian inference for latent Gaussian models by using integrated nested Laplace approximations. J R Stat Soc Series B Stat Methodol, 2009, 71(2): 319-392.
20. 劉珊山, 于曉輝, 秦建偉. 1990—2019 年中國肝硬化疾病負擔變化趨勢分析. 臨床肝膽病雜志, 2024, 40(4): 726-733.
21. 彭丹莉, 佘欣, 毛國飛, 等. 1990—2019 年中國肝癌發病與死亡年齡-時期-隊列模型分析及預測. 現代醫學, 2024, 52(1): 102-107.
22. Lu R, Liu Y, Hong T. Epidemiological characteristics and management of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis in China: a narrative review. Diabetes Obes Metab, 2023, 25(Suppl 1): 13-26.
23. 張澍, 鐘明, 張俊慧. 非酒精性脂肪性肝炎預防與干預的研究進展. 現代預防醫學, 2023, 50(14): 2676-2682.
24. Tilg H, Byrne CD, Targher G. NASH drug treatment development: challenges and lessons. Lancet Gastroenterol Hepatol, 2023, 8(10): 943-954.
25. 盧存存, 王海博, 柯立鑫, 等. 基于網絡藥理學與分子對接探討舒肝寧注射液治療非酒精性脂肪性肝病的潛在作用機制. 華西醫學, 2024, 39(12): 1911-1916.
26. Sanyal AJ, Bedossa P, Fraessdorf M, et al. A Phase 2 randomized trial of survodutide in MASH and fibrosis. N Engl J Med, 2024, 391(4): 311-319.
27. Chen X, Shi J, Lai Y, et al. Systematic analysis of randomised controlled trials of Chinese herb medicine for non-alcoholic steatohepatitis (NASH): implications for future drug development and trial design. Chin Med, 2023, 18(1): 58.
28. 孫懿, 黃鑫宇, 屈雅琴, 等. 基于網絡藥理學和實驗驗證探討石榴皮對非酒精性脂肪性肝炎的作用機制. 中國現代應用藥學, 2023, 40(17): 2384-2392.

West China Medical Journal

Analysis and future trend prediction of the disease burden of liver cancer attributed to nonalcoholic steatohepatitis in China from 1990 to 2021

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