1990～2023年金砖国家非酒精性脂肪性肝病疾病负担变化*

doi:10.3969/j.issn.1672-5069.2026.04.008

摘要/Abstract

摘要： 目的分析1990～2023年金砖国家(巴西、俄罗斯、印度、中国、南非)非酒精性脂肪性肝病(NAFLD)疾病负担性别差异和演变趋势。方法基于2023年全球疾病负担研究(GBD 2023)数据,提取金砖国家NAFLD发病率和伤残调整生命年(DALYs)数据。采用年龄标准化率进行国家间比较,应用线性混合效应模型分析长期趋势,应用广义线性模型评估性别差异的影响因素,并通过贝叶斯年龄-时期-队列模型(BAPC)预测未来负担。结果 2023年,金砖国家NAFLD发病数随年龄增长男女性别比逐渐下降,并在特定年龄组出现性别逆转,其中中国出现性别逆转的年龄最早(30～34岁年龄组),印度最晚(60～64岁年龄组);1990～2023年期间金砖国家NAFLD发病数及相关死亡率均呈持续上升趋势,其中印度NAFLD发病人数增长幅度最高[42.4% (95%CI: 42.1～43.3), 平均年度百分比变化(AAPC)=1.16,俄罗斯死亡率增长幅度最高[431.5% (95%CI: 409.6～456.2), AAPC=6.18;1990～2023年DALYs趋势分析并采用BAPC预测显示,中国和印度疾病负担正逐年减轻,而俄罗斯和南非则持续上升,巴西疾病负担则长期维持在相对稳定的水平。结论金砖国家NAFLD疾病负担向中青年男性和高龄女性集中,其变化呈现显著的国家、年龄和性别差异,需制定差异化的国家防控策略,加强重点人群的早期筛查和干预。

关键词: 非酒精性脂肪性肝病, 全球疾病负担, 性别差异, 流行病学, 金砖国家

Abstract: Objective The aim of study was to investigate gender differences in the burden of non-alcoholic fatty liver disease (NAFLD among the BRICS countries, e.g., Brazil, Russia, India, China and South Africa, and to analyze the epidemiologic trends in disease burden from 1990 to 2023. Methods Data on the incidence and disability adjusted life years (DALYs) of NAFLD in the BRICS countries were extracted from the Global Burden of Disease Study 2023 (GBD 2023). Age-standardized rates were applied for cross-country comparisons, and long-term trends were analyzed by using linear mixed-effects models. Factors influencing gender differences were assessed with generalized linear models. Future burden was predicted by using Bayesian age-period-cohort model (BAPC). Results In 2023, the incidence of NAFLD in BRICS countries exhibited a progressive decline in the male-to-female ratio with elderly age, culminated in a gender reversal within specific age groups, notably, earliest onset of this reversal (30 to 34 year-old) in China, whereas in India demonstrated the most delayed occurrence (60 to 64 year-old); from 1990 to 2023, both the incidence and mortality rates associated with NAFLD across BRICS nations demonstrated a sustained upward trends, and the highest increase in NAFLD incidence [42.4% (95% CI: 42.1-43.3) and average annual percent change (AAPC)=1.16 in India, while the most obvious rise in mortality [431.5% (95% CI: 409.6-456.2) and AAPC=6.18] in Russia; disability-adjusted life year trends analysis and prediction based on the Bayesian age-period-cohort model from 1990 to 2023 revealed different trends among BRICS countries, e.g., a progressive decline in disease burdens in China and India, a continuous increase in Russia and South Africa, and a relatively stable disease burden in Brazil throughout the study period. Conclusion Prevalence of NAFLD in BRICS countries is common in middle-aged and young male adults and elderly female, with a significant differencewith countries, ages and gender.

Key words: Non-alcoholic fatty liver disease, Global burden of disease, Gender, Epidemiology, BRICS countries

赵懿孺, 谢伟龙, 石丽莎, 潘修成, 王霞. 1990～2023年金砖国家非酒精性脂肪性肝病疾病负担变化^*[J]. 实用肝脏病杂志, 2026, 29(4): 509-512.

Zhao Yiru, Xie Weilong, Shi Lisha, et al. Changes in the burden of non-alcoholic fatty liver disease in BRICS countries between 1990 and 2023[J]. Journal of Practical Hepatology, 2026, 29(4): 509-512.

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1990～2023年金砖国家非酒精性脂肪性肝病疾病负担变化^*

Changes in the burden of non-alcoholic fatty liver disease in BRICS countries between 1990 and 2023

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