关键词: 肝脏疾病, 全球疾病负担研究, 年龄-时期-队列模型, 伤残调整寿命年

Abstract: Objective This study aimed to analyze the disease burden of liver diseases in China from 1990 to 2021, with emphasis on prevalence, mortality, and disability-adjusted life years (DALYs), and to predict the disease burden for the period of 2022 to 2035 in order to provide an epidemiological basis for precise prevention and control. Methods By using search of global burden of disease study(GBD) 2021 database, the characteristics of liver diseases burden in China were analyzed, including age-standardized prevalence, mortality, and DALY rates. Furthermore, an age-period-cohort (APC) model was applied to explore the age, period, and cohort effects on liver diseases, and an Bayesian age-period-cohort (BAPC) model was employed to forecast the liver disease trends from 2022 to 2035. Results From 1990 to 2021, the age-standardized prevalence, mortality, and DALYs of acute hepatitis, including hepatitis A, B, Cand E) in China showed a downward trend; the overall prevalence, mortality, and DALYs of liver cancer series diseases slightly decreased, but liver cancer caused by hepatitis B, C, alcohol and non-alcoholic hepatitis presented a trend of decreased mortality and DALYs with increased prevalence; the mortality and DALYs of non-alcoholic hepatitis, including cirrhosis, demonstrated a downward trend, while the prevalence was in upward trend;age effect analysis indicated that the DALY rates and mortality of liver diseases decreased with age, especially significant in the elderly population, the prevalence firstly decreased, andincreased with age thereafter; period and cohort effect analysis showed that the relative risk (RR) of prevalence fluctuated and increased over time, while the RR of mortality and DALY rates decreased over time; model projections from 2022 to 2035 indicated that age-standardised prevalence of liver diseases would continue to climb to an estimated 22 725.4 per 100 000, with an increase of 3.4% compared with 2021, while age-standardised mortality and DALY rates are expected to fall further to 14.5 and 436.8 per 100 000, representing a declines of 10.6 % and 8.0 %, respectively. Conclusion The standardized prevalence of liver diseases in China generally shows an upward trend, while the standardized mortality and standardized DALY rates show an overall downward trend, influenced by a combination of age, period and cohort factors. Prevention and control strategies should enhance the coverage of vaccination and screening measures to address the challenges brought by the increasing prevalence in the future.

Key words: Liver diseases, Global burden of disease, Age-period-cohort model, Disability-adjusted life year