Текст слайда:
Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease.
Background: Nonalcoholic fatty liver disease (NAFLD) and resulting nonalcoholic steatohepatitis (NASH) are highly prevalent in the US, where they are a growing cause of cirrhosis and hepatocellular carcinoma (HCC), and increasingly, an indicator for liver transplantation.
Methods: 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.
Results: Prevalent NAFLD cases are forecasted to increase 21%, from 83.1 (2015) to 100.9 million (2030), while prevalent NASH cases will increase 63% from 16.52 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 nearly 800,000 excess liver deaths.
Conclusions: With continued high rates of adult obesity and DM, and an aging population, NAFLD-related liver disease and mortality will increase in the US. Strategies to slow the growth of NAFLD cases and therapeutic options are necessary to mitigate disease burden. This article is protected by copyright. All rights reserved.
Estes C., Razavi H., Loomba R., Younossi Z., Sanyal A.J. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2017 Aug 12. doi: 10.1002/hep.29466. [Epub ahead of print]
В США значительно возрастает бремя неалкогольной жировой болезни печени
Разработана модель оценки прогрессирования НЖБП. Заболеваемость НЖБП рассчитывалась на основании установленных за предшествующие годы и прогнозируемых изменений распространенности ожирения и сахарного диабета 2-го типа среди взрослого населения.
Предполагается, что распространенность НЖБП возрастет на 21% с 83,1 млн (30% среди людей старше 15 лет и 25,8% среди всех возрастов) в 2015 году до 100,9 млн (33,5 и 28,4% соответственно) в 2030-ом.
Количество случаев НАСГ увеличится на 63% – с 16,5 до 27 млн случаев.
Число пациентов с прогрессирующими заболеваниями печени возрастет на 160%, примерно с 3,3 млн до 7,9 млн к 2030 году.
Заболеваемость декомпенсированным циррозом печени увеличится на 168%, в то время как частота ГЦК – на 137%.
Рост показателей смертности от заболеваний печени составит 178%, по оценкам – 78,3 тыс. в 2030 году.