[Analysis of the burden of non-alcoholic fatty liver disease-related cirrhosis in China from 1990 to 2021].

Objective

To assess the disease burden of non-alcoholic fatty liver disease (NAFLD)-related cirrhosis in China from 1990 to 2021.

Methods

Data were obtained from the Global Burden of Disease (GBD) 2021 study. The age-standardized rate was calculated using the direct standardization method with the GBD world standard population as the reference. The Joinpoint model was used to calculate the change of NAFLD-related cirrhosis in China, and the age-period-cohort analysis was used to estimate the independent effects of age, period, and cohort.

Results

In 2021, the age-standardized incidence rate (ASIR) of NAFLD-related cirrhosis in China was 621/100 000, with the age-standardized prevalence rate (ASPR) of 15 606/100 000 and the age-standardized mortality rate (ASMR) of 0.31/100 000. The average annual percentage change (AAPC) of ASIR of the whole population from 1990 to 2021 was 0.74% (95%CI: 0.69%, 0.78%). There was a decreasing trend in the ASMR of the whole population with an AAPC of -1.73% (95%CI:-2.06%, -1.40%). The age effect showed a fluctuating downward trend in the overall incidence rate with age. The overall mortality rate showed an increasing trend. The period effect showed that the period rate ratios (RR) first decreased and then increased, with the highest incidence risk in 2017-2021. The period RR of incidence rate was 1.16 (95%CI: 1.11, 1.21). The trend of RR change in mortality rate showed a decreasing tendency, with the highest mortality risk in 1992-1996. The RR of mortality risk was 1.50 (95%CI: 1.43, 1.58). The cohort effect showed a significant increase in incidence risk and a decreasing trend in mortality risk from 1977 to 2002.

Conclusion

The overall disease burden of NAFLD-related cirrhosis in China has shown a continuous upward trend from 1990 to 2021, and there are significant gender and age differences.