实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (1): 45-48.doi: 10.3969/j.issn.1672-5069.2026.01.012

• 非酒精性脂肪性肝病 • 上一篇    下一篇

1990年~2021年全球非酒精性脂肪性肝病疾病负担流行趋势研究*

李慧丽, 李灵, 赵懿儒, 潘修成, 王霞   

  1. 221002 江苏省徐州市 徐州医科大学附属医院感染性疾病科
  • 收稿日期:2025-04-23 出版日期:2026-01-10 发布日期:2026-02-04
  • 通讯作者: 王霞,E-mail:crwx2015@126.com
  • 作者简介:李慧丽,女,30岁,硕士研究生,住院医师。E-mail:lihuili120257@163.com
  • 基金资助:
    *国家科技重大专项研究项目(编号:2018ZX10302206-001-003)

Global burden and epidemic trends of non-alcoholic fatty liver disease from 1990 to 2021

Li Huili, Li Ling, Zhao Yiru, et al   

  1. Department of Infectious Diseases,Affiliated Hospital, Xuzhou Medical University,Xuzhou 221002,Jiangsu Province, China
  • Received:2025-04-23 Online:2026-01-10 Published:2026-02-04

摘要: 目的 研究过去30年全球非酒精性脂肪性肝病(NAFLD)流行趋势和疾病负担,为制定预防和管理政策提供依据。方法 基于2021年全球疾病负担(GBD)数据,应用年度百分比变化(APC)和估计年度百分比变化(EAPC)评估NAFLD疾病负担的变化趋势,采用Joinpoint回归分析模型识别和定量描述其显著性变化特点。应用Pearson相关系数评估NAFLD疾病负担的地域差异。结果 自1990年~2021年,全球范围内NAFLD患病率呈显著性增长趋势,其粗患病数从5.6亿例增至12.7亿例,增长幅度高达125%,EAPC为1.4(95% CI:-1.33~4.2);经Joinpoint回归分析发现,自2008年~2015年期间NAFLD增长趋势尤为显著;在区域层面,发现NAFLD患病率和发病率与社会人口指数(SDI)呈倒U形相关,即随着SDI升高,NAFLD患病率和发病率也呈先上升后下降的趋势;研究结果表明代谢因素,如高空腹血糖是NAFLD发生的主要驱动因素,在近30年中,代谢因素在NAFLD发病中的占比显著增加;在全球多数地区,由NAFLD进展为肝硬化、非酒精性脂肪性肝炎(NASH),乃至肝细胞癌的发病率均呈上升态势。结论 总体而言,在过去的30年里,NAFLD疾病负担在全球范围内显著增加,其流行特征在区域、国家、年龄和性别间存在显著的异质性,显示构建多维度、分层级的精准防控体系非常必要。本研究可为防治NAFLD和制定精准干预策略提供关键性的流行病学依据。

关键词: 非酒精性脂肪性肝病, 全球疾病负担, 代谢综合征, 社会人口指数

Abstract: Objective The aim of this study was to investigate global disease burden and epidemic trends and non-alcoholic fatty liver disease (NAFLD) over the past three decades in the world. Methods Based on the global burden of disease (GBD) data in 2021,this study retrieve relevant data of NAFLD all over the world. The analysis was conducted by using annual percentage change (APC), estimated annual percentage change (EAPC) and percentage change to assess epidemic trends of NAFLD burden and employed a Joinpoint regression analysis model to quantitatively describe its significant points of change. Pearson correlation coefficient was applied to evaluate geographical disparities in the NAFLD disease burden. Results From 1990 to 2021, the prevalence of NAFLD worldwide increased significantly; the crude number of cases rose from 564.43 million to 1267.87 million, with an increase rate as high as 125%, and the EAPC was 1.4 (95% confidence interval: -1.33-4.2); the Joinpoint regression analysis showed that the NAFLD prevalence particularly significantly increased during the period from 2008 to 2015; the prevalence and incidence of NAFLD had an inverted U-shaped changes as the sociodemographic index (SDI) varied, e.g., with the increase of SDI, the prevalence and incidence of NAFLD showed a trend of rising first and falling thereafter; in terms of risk factors, the research indicated that metabolic factors, such as high fasting blood glucose was the main drivers of NAFLD, and in the past 30 years, the proportion of metabolic factors in the pathogenesis of NAFLD had significantly increased; furthermore, the incidences of liver cirrhosis, non-alcoholic steatohepatitis (NASH), and even primary liver cancer derived from NAFLD increased in most regions around the world. Conclusion Overall, over the past 30 years, the disease burden of NAFLD has significantly increased globally, and its epidemic characteristics show significant heterogeneity at different regions, countries, ages and genders, indicating the necessity of constructing a multi-dimensional and hierarchical precise prevention and control system. This study might provide a key epidemiological evidence for the precise management and intervention strategies of the entity.

Key words: Non-alcoholic fatty liver disease, Global burden of disease, Metabolic syndrome, Socio-demographic index