BMJ open · 2025
Burden and trends of NASH-related liver cancer associated with high fasting plasma glucose in China and globally from 1990 to 2021: a population-based analysis of the global burden of disease study.
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Yao Youjian, Ji Caifa, Zhou ChenChen, Gui Mei
Аннотация
OBJECTIVES: To analyse the trends in the burden of non-alcoholic steatohepatitis (NASH)-related liver cancer associated with high fasting plasma glucose (HFPG) globally and in China from 1990 to 2021, and to project the burden over the next 15 years.
DESIGN: Population-based secondary analysis of data from the Global Burden of Disease (GBD) 2021 study.
SETTING: Global and Chinese populations included in the GBD 2021 database.
PARTICIPANTS: Data were derived from individuals aged 20 years and older included in the GBD 2021 study, covering both sexes across all age groups.
PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were mortality and disability-adjusted life years (DALYs) of NASH-related liver cancer associated with HFPG. Secondary outcomes included years lived with disability and years of life lost. Trends were described using the annual percentage change and average annual percentage change. Age-standardised mortality rates and DALY rates were projected to 2036.
RESULTS: In 2021, the burden of NASH-related liver cancer associated with HFPG was higher in men than in women in both the global and Chinese populations and was predominantly concentrated among older age groups. From 1990 to 2021, the burden substantially increased globally and in China, showing a significant upward trend. Projections indicate that the global burden will continue to rise among men but decline among women, whereas both sexes in China are expected to experience a decline in burden over the next 15 years.
CONCLUSIONS: From 1990 to 2021, the burden of NASH-related liver cancer associated with HFPG increased substantially in both global and Chinese populations. High-risk groups, including men, older individuals, those with elevated fasting plasma glucose and patients with NASH, should be closely monitored. Targeted screening and preventive strategies for these populations may help manage the disease burden. Future studies are needed to determine whether effective blood glucose control can reduce the risk of NASH-related liver cancer.
DESIGN: Population-based secondary analysis of data from the Global Burden of Disease (GBD) 2021 study.
SETTING: Global and Chinese populations included in the GBD 2021 database.
PARTICIPANTS: Data were derived from individuals aged 20 years and older included in the GBD 2021 study, covering both sexes across all age groups.
PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were mortality and disability-adjusted life years (DALYs) of NASH-related liver cancer associated with HFPG. Secondary outcomes included years lived with disability and years of life lost. Trends were described using the annual percentage change and average annual percentage change. Age-standardised mortality rates and DALY rates were projected to 2036.
RESULTS: In 2021, the burden of NASH-related liver cancer associated with HFPG was higher in men than in women in both the global and Chinese populations and was predominantly concentrated among older age groups. From 1990 to 2021, the burden substantially increased globally and in China, showing a significant upward trend. Projections indicate that the global burden will continue to rise among men but decline among women, whereas both sexes in China are expected to experience a decline in burden over the next 15 years.
CONCLUSIONS: From 1990 to 2021, the burden of NASH-related liver cancer associated with HFPG increased substantially in both global and Chinese populations. High-risk groups, including men, older individuals, those with elevated fasting plasma glucose and patients with NASH, should be closely monitored. Targeted screening and preventive strategies for these populations may help manage the disease burden. Future studies are needed to determine whether effective blood glucose control can reduce the risk of NASH-related liver cancer.