Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease

Hepatology - Tập 67 Số 1 - Trang 123-133 - 2018
Chris Estes1, Homie Razavi1, Rohit Loomba2, Zobair M. Younossi3, Arun J. Sanyal4
1Center for Disease Analysis,Lafayette,CO
2Division of Gastroenterology, Department of Internal Medicine,University of California,San Diego,CA
3Department of Medicine, Inova Fairfax Hospital, Falls Church, VA
4Division of Gastroenterology, Hepatology and Nutrition,Virginia Commonwealth University School of Medicine,Richmond,VA

Tóm tắt

Nonalcoholic fatty liver disease (NAFLD) and resulting nonalcoholic steatohepatitis (NASH) are highly prevalent in the United States, where they are a growing cause of cirrhosis and hepatocellular carcinoma (HCC) and increasingly an indicator for liver transplantation. A Markov model was used to forecast NAFLD disease progression. Incidence of NAFLD was based on historical and projected changes in adult prevalence of obesity and type 2 diabetes mellitus (DM). Assumptions were derived from published literature where available and validated using national surveillance data for incidence of NAFLD‐related HCC. Projected changes in NAFLD‐related cirrhosis, advanced liver disease, and liver‐related mortality were quantified through 2030. Prevalent NAFLD cases are forecasted to increase 21%, from 83.1 million (2015) to 100.9 million (2030), while prevalent NASH cases will increase 63% from 16.52 million to 27.00 million cases. Overall NAFLD prevalence among the adult population (aged ≥15 years) is projected at 33.5% in 2030, and the median age of the NAFLD population will increase from 50 to 55 years during 2015‐2030. In 2015, approximately 20% of NAFLD cases were classified as NASH, increasing to 27% by 2030, a reflection of both disease progression and an aging population. Incidence of decompensated cirrhosis will increase 168% to 105,430 cases by 2030, while incidence of HCC will increase by 137% to 12,240 cases. Liver deaths will increase 178% to an estimated 78,300 deaths in 2030. During 2015‐2030, there are projected to be nearly 800,000 excess liver deaths. Conclusion: With continued high rates of adult obesity and DM along with an aging population, NAFLD‐related liver disease and mortality will increase in the United States. Strategies to slow the growth of NAFLD cases and therapeutic options are necessary to mitigate disease burden. (Hepatology 2018;67:123‐133).

Từ khóa


Tài liệu tham khảo

2015, Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009, Hepatology, 62, 1723, 10.1002/hep.28123

2010, Population‐based risk factors and resource utilization for HCC: US perspective, Curr Med Res Opin, 26, 2183, 10.1185/03007995.2010.506375

2013, The global NAFLD epidemic, Nat Rev Gastroenterol Hepatol, 10, 686, 10.1038/nrgastro.2013.171

2012, The diagnosis and management of non‐alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology, Gastroenterology, 142, 1592, 10.1053/j.gastro.2012.04.001

2007, The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD, Hepatology, 45, 846, 10.1002/hep.21496

2005, The natural history of nonalcoholic fatty liver disease: a population‐based cohort study, Gastroenterology, 129, 113, 10.1053/j.gastro.2005.04.014

2012, Association between nonalcoholic fatty liver disease and risk for hepatocellular cancer, based on systematic review, Clin Gastroenterol Hepatol, 10, 1342, 10.1016/j.cgh.2012.10.001

2015, Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States, Gastroenterology, 148, 547, 10.1053/j.gastro.2014.11.039

2014, Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma in the U.S, Hepatology, 59, 2188, 10.1002/hep.26986

2016, Global epidemiology of non‐alcoholic fatty liver disease‐meta‐analytic assessment of prevalence, incidence and outcomes, Hepatology, 64, 73, 10.1002/hep.28431

2015, Economic and quality‐of‐life implications of non‐alcoholic fatty liver disease, Pharmacoeconomics, 33, 1245, 10.1007/s40273-015-0316-5

2016, The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe, Hepatology, 64, 1577, 10.1002/hep.28785

2015, Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta‐analysis of paired‐biopsy studies, Clin Gastroenterol Hepatol, 13, 643, 10.1016/j.cgh.2014.04.014

2002, Nonalcoholic fatty liver disease, N Engl J Med, 346, 1221, 10.1056/NEJMra011775

2015, Nonalcoholic fatty liver disease: a systematic review, JAMA, 313, 2263, 10.1001/jama.2015.5370

2013, Noninvasive predictors of nonalcoholic steatohepatitis in Korean patients with histologically proven nonalcoholic fatty liver disease, Clin Mol Hepatol, 19, 120, 10.3350/cmh.2013.19.2.120

2013, Prevalence of nonalcoholic fatty liver disease in the United States: the Third National Health and Nutrition Examination Survey, 1988‐1994, Am J Epidemiol, 178, 38, 10.1093/aje/kws448

2011, Will the increased prevalence of nonalcoholic steatohepatitis (NASH) in the age of better hepatitis C virus therapy make NASH the deadlier disease?, Hepatology, 54, 1118, 10.1002/hep.24634

2011, Systematic review: the epidemiology and natural history of non‐alcoholic fatty liver disease and non‐alcoholic steatohepatitis in adults, Aliment Pharmacol Ther, 34, 274, 10.1111/j.1365-2036.2011.04724.x

2005, Design and validation of a histological scoring system for nonalcoholic fatty liver disease, Hepatology, 41, 1313, 10.1002/hep.20701

2017, Prevalence of nonalcoholic steatohepatitis‐associated cirrhosis in the United States: An analysis of National Health and Nutrition Examination Survey data, Am J Gastroenterol, 112, 581, 10.1038/ajg.2017.5

1982, Liver pathology in aircrew, Aviat Space Environ Med, 53, 14

2004, Nonalcoholic fatty liver disease, Ann Hepatol, 3, 93, 10.1016/S1665-2681(19)32100-3

2011, Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle‐aged population utilizing ultrasound and liver biopsy: a prospective study, Gastroenterology, 140, 124, 10.1053/j.gastro.2010.09.038

2006, Similarities and differences in outcomes of cirrhosis due to nonalcoholic steatohepatitis and hepatitis C, Hepatology, 43, 682, 10.1002/hep.21103

2011, The natural history of nonalcoholic fatty liver disease with advanced fibrosis or cirrhosis: an international collaborative study, Hepatology, 54, 1208, 10.1002/hep.24491

2013, Predictors of all‐cause mortality and liver‐related mortality in patients with non‐alcoholic fatty liver disease (NAFLD), Dig Dis Sci, 58, 3017, 10.1007/s10620-013-2743-5

2015, NAFLD: a multisystem disease, J Hepatol, 62, S47

2016, Nonalcoholic fatty liver disease and risk of incident cardiovascular disease: a meta‐analysis, J Hepatol, 65, 589, 10.1016/j.jhep.2016.05.013

2014, Prevalence of childhood and adult obesity in the United States, 2011‐2012, JAMA, 311, 806, 10.1001/jama.2014.732

2014, Changing hepatocellular carcinoma incidence and liver cancer mortality rates in the United States, Am J Gastroenterol., 109, 542, 10.1038/ajg.2014.11

2015, High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels, J Clin Endocrino Metab, 100, 2231, 10.1210/jc.2015-1966

2011, The current economic burden of cirrhosis, Gastroenterol Hepatol, 7, 661

2007, Hepatology outpatient service provision in secondary care: a study of liver disease incidence and resource costs, Clin Med (Lond), 7, 119

2016, Trends in the burden of nonalcoholic fatty liver disease in a United States cohort of veterans, Clin Gastroenterol Hepatol, 14, 301, 10.1016/j.cgh.2015.08.010

2011, Management of hepatocellular carcinoma: an update, Hepatology, 53, 1020, 10.1002/hep.24199

2016, Nonalcoholic steatohepatitis is associated with increased mortality in obese patients undergoing bariatric surgery, Clin Gastroenterol Hepatol, 14, 1619, 10.1016/j.cgh.2015.10.010

2009, Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease, Clin Gastroenterol Hepatol, 7, 1104, 10.1016/j.cgh.2009.05.033

2010, Simple non‐invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non‐alcoholic fatty liver disease, Gut, 59, 1265, 10.1136/gut.2010.216077

2013, Modeling the impact of prevention policies on future diabetes prevalence in the United States: 2010‐2030, Popul Health Metr, 11, 18, 10.1186/1478-7954-11-18

2016, Presence of diabetes mellitus and steatosis is associated with liver stiffness in a general population: the Rotterdam study, Hepatology, 63, 138, 10.1002/hep.27981

2011, Non‐alcoholic fatty liver disease and mortality among US adults: prospective cohort study, BMJ, 343, d6891, 10.1136/bmj.d6891

2012, Nonalcoholic fatty liver disease (NAFLD): is it really a serious condition?, Hepatology, 56, 1580, 10.1002/hep.26031

Thông tin
Thông tin xuất bản

Hepatology

Tập 67 Số 1

123-133

Thông tin tác giả