Global burden of cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2021

作者：Ying Zhang, Ming Luo, Yingzi Ming · 发表于：BMC Gastroenterology · 年份：2025 · DOI：10.1186/s12876-025-04264-5 · 被引用次数：23 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Hepatitis C virus research

BACKGROUND: The global burden of cirrhosis and chronic liver diseases has remained substantial and continues to evolve in response to shifting etiological patterns. While viral hepatitis and alcohol use have historically dominated, non-alcoholic fatty liver disease (NAFLD) is emerging as a major contributor worldwide. A comprehensive understanding of these trends across regions and sociodemographic levels is essential for targeted public health interventions. METHODS: We analyzed data on cirrhosis and chronic liver diseases from 1990 to 2021 using estimates from the Global Burden of Disease (GBD) study. Age-standardized incidence rate (ASIR), prevalence rate (ASPR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR) were assessed globally and across sociodemographic index (SDI) levels. Estimated annual percentage change (EAPC) was calculated to quantify temporal trends. RESULTS: From 1990 to 2021, NAFLD-related cirrhosis was the only etiology with a significantly increasing ASIR (EAPC = 0.73; 95% CI: 0.69-0.77), while viral and alcohol-related cirrhosis showed stable or declining trends. In 2021, NAFLD became the leading global cause of incident cirrhosis. Although high-SDI countries demonstrated effective control of HBV and HCV-related mortality, NAFLD remains a major and growing challenge. The ASMR of NAFLD-related cirrhosis showed a fluctuating pattern overall but increased notably in several low- to middle-SDI countries, particularly in Eastern Europe (...