Changing trend of the disease burden of liver cirrhosis in China from 1990 to 2019 / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the prevalence of liver cirrhosis and the changing trend of the disease burden of liver cirrhosis in the Chinese population from 1990 to 2019， and to provide a data reference for formulating the prevention and treatment strategies for liver cirrhosis in China. MethodsThe Global Burden of Disease Study 2019 was used to collect the data on the incidence rate， mortality rate， disability-adjusted life years （DALY）， years of life lost （YLL）， and years lived with disability （YLD） of liver cirrhosis. The Joinpoint regression model was used to analyze the changing trend of disease burden； the age-period-cohort （APC） model was used to evaluate age， period， and cohort effects； R software BAPC package was used to predict future changes in disease burden. ResultsFrom 1990 to 2019 in China， there were increases in the numbers of liver cirrhosis cases and prevalent cases in the general population， as well as in the male and female populations， while there was a reduction in the number of deaths. From 1990 to 2019， the standardized incidence rate， standardized prevalence rate， and standardized mortality rate of liver cirrhosis in the Chinese population showed a downward trend， with a mean annual reduction of 0.62% （95% confidence interval ［CI］： -0.74% to -0.50%， t=9.99， P<0.001）， 0.44% （95%CI： -0.53% to -0.35%， t=13.18， P<0.001）， and 3.02% （95%CI： -3.12% to -2.93%， t=7.58， P<0.001）， respectively. From 1990 to 2019， the standardized DALY， YLL， and YLD rates of liver cirrhosis in the Chinese population also showed a downward trend， with a mean annual reduction of 3.27% （95%CI： -3.37% to -3.18%， t=6.22， P<0.001）， 3.32% （95%CI： -3.42% to -3.22%， t=9.31， P<0.001）， and 1.42% （95%CI： -1.49% to -1.34%， t=4.93， P<0.001）， respectively. From 1990 to 2019， the incidence rate of liver cirrhosis in the Chinese population first increased and then decreased with age， while the mortality rate showed an increasing trend， and the risks of disease onset and death showed a decreasing trend with time and birth cohort. The predictive model showed that the standardized incidence rate， prevalence rate， mortality rate， and DALY rate of liver cirrhosis in China will show a decreasing trend from 2020 to 2030. Alcohol was the most important risk factor for both male and female populations， followed by medication. ConclusionThe disease burden of liver cirrhosis in China shows a decreasing trend from 1990 to 2019， with sex and age differences， especially in the middle-aged male population. Effective measures should be taken for intervention.