Research progress in nonalcoholic fatty liver disease: disease burden and medical expenses control_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Fang ,  LI Jian

Department of Operations Management, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LI Jian, Email: lijian@wchscu.cn

Keywords：

nonalcoholic fatty liver disease; burden of epidemiology; economic burden

DOI：

10.7507/1007-9424.202204032

Video：

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Objective To summarize the epidemiology of nonalcoholic fatty liver disease (NAFLD) and the epidemiological and economic burdens of NAFLD, so as to provide a reference for hospital management decision-making. Method The domestic and foreign guidelines relevant to NAFLD and the literatures relevant to epidemiological investigation and disease burden researches were summarized and its research progress was reviewed. Results The global prevalence of NAFLD was increasing over years. The incidence, mortality, and disability adjusted life years of liver cirrhosis and liver cancer caused by NAFLD had increased year by year. The patients relevant to NAFLD of inpatients and outpatients had increased obviously, and the overall medical expenses had also shown a rising trend. The possible reasons were health care awareness, new drug research, population aging, and excessive medical consumption. In addition, children and adolescents with NAFLD had a obviously increased risk of liver or extrahepatic diseases. Conclusions By understanding the epidemiological trend of NAFLD, it is a certain understanding of the disease burden of NAFLD and the related factors affecting the increase of its treatment cost. It is believed that it is necessary to further pay attention to and strengthen the genetic characteristics, pathogenesis, drug research and development, and early diagnosis of cirrhosis and liver cancer relevant to NAFLD in the future. At the same time, the NAFLD group of children and adolescents should not be ignored.

Citation： LIU Fang, LI Jian. Research progress in nonalcoholic fatty liver disease: disease burden and medical expenses control. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(8): 1115-1120. doi: 10.7507/1007-9424.202204032 Copy

1.	Wong MCS, Huang JLW, George J, et al. The changing epidemiology of liver diseases in the Asia-Pacific region. Nat Rev Gastroenterol Hepatol, 2019, 16(1): 57-73.
2.	McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology, 2021, 73 Suppl 1(Suppl 1): 4-13.
3.	Zhai M, Long J, Liu S, et al. The burden of liver cirrhosis and underlying etiologies: results from the global burden of disease study 2017. Aging (Albany NY), 2021, 13(1): 279-300.
4.	Argo CK, Northup PG, Al-Osaimi AM, et al. Systematic review of risk factors for fibrosis progression in non-alcoholic steatohepatitis. J Hepatol, 2009, 51(2): 371-379.
5.	Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease—meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 2016, 64(1): 73-84.
6.	Li J, Zou B, Yeo YH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol, 2019, 4(5): 389-398.
7.	Estes C, Anstee QM, Arias-Loste MT, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol, 2018, 69(4): 896-904.
8.	Zhou F, Zhou J, Wang W, et al. Unexpected rapid increase in the burden of NAFLD in China from 2008 to 2018: a systematic review and meta-analysis. Hepatology, 2019, 70(4): 1119-1133.
9.	Zhou J, Zhou F, Wang W, et al. Epidemiological features of NAFLD from 1999 to 2018 in China. Hepatology, 2020, 71(5): 1851-1864.
10.	Wu Y, Zheng Q, Zou B, et al. The epidemiology of NAFLD in Mainland China with analysis by adjusted gross regional domestic product: a meta-analysis. Hepatol Int, 2020, 14(2): 259-269.
11.	Wei JL, Leung JC, Loong TC, et al. Prevalence and severity of nonalcoholic fatty liver disease in non-obese patients: a population study using proton-magnetic resonance spectroscopy. Am J Gastroenterol, 2015, 110(9): 1306-1314.
12.	Hung MC, Chen CF, Tsou MT, et al. Relationship between gallstone disease and cardiometabolic risk factors in elderly people with non-alcoholic fatty liver disease. Diabetes Metab Syndr Obes, 2020, 13: 3579-3585.
13.	中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018更新版). 中华肝脏病杂志, 2018, 26(3): 195-203.
14.	Global Burden of Disease Liver Cancer Collaboration, Akinyemiju T, Abera S, et al. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level: results from the global burden of disease study 2015. JAMA Oncol, 2017, 3(12): 1683-1691.
15.	Golabi P, Paik JM, AlQahtani S, et al. Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: data from global burden of disease 2009–2019. J Hepatol, 2021, 75(4): 795-809.
16.	Younossi ZM, Otgonsuren M, Henry L, et al. Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009. Hepatology, 2015, 62(6): 1723-1730.
17.	Stine JG, Wentworth BJ, Zimmet A, et al. Systematic review with meta-analysis: risk of hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis compared to other liver diseases. Aliment Pharmacol Ther, 2018, 48(7): 696-703.
18.	Paik JM, Golabi P, Younossi Y, et al. The growing burden of disability related to nonalcoholic fatty liver disease: data from the global burden of disease 2007–2017. Hepatol Commun, 2020, 4(12): 1769-1780.
19.	Chan WK, Treeprasertsuk S, Imajo K, et al. Clinical features and treatment of nonalcoholic fatty liver disease across the Asia Pacific region-the GO ASIA initiative. Aliment Pharmacol Ther, 2018, 47(6): 816-825.
20.	Sarin SK, Kumar M, Eslam M, et al. Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol, 2020, 5(2): 167-228.
21.	Sayiner M, Otgonsuren M, Cable R, et al. Variables associated with inpatient and outpatient resource utilization among medicare beneficiaries with nonalcoholic fatty liver disease with or without cirrhosis. J Clin Gastroenterol, 2017, 51(3): 254-260.
22.	Younossi ZM, Blissett D, Blissett R, et al. The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe. Hepatology, 2016, 64(5): 1577-1586.
23.	Younossi ZM, Zheng L, Stepanova M, et al. Trends in outpatient resource utilizations and outcomes for medicare beneficiaries with nonalcoholic fatty liver disease. J Clin Gastroenterol, 2015, 49(3): 222-227.
24.	Tampi RP, Wong VW, Wong GL, et al. Modelling the economic and clinical burden of non-alcoholic steatohepatitis in East Asia: data from Hong Kong. Hepatol Res, 2020, 50(9): 1024-1031.
25.	Ogden CL, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA, 2012, 307(5): 483-490.
26.	Musaiger AO, Al-Mannai M, Al-Haifi AR, et al. Prevalence of overweight and obesity among adolescents in eight Arab countries: comparison between two international standards (ARABEAT-2). Nutr Hosp, 2016, 33(5): 567. doi: 10.20960/nh.567.
27.	Wiegand S, Keller KM, Röbl M, et al. Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents. Int J Obes (Lond), 2010, 34(10): 1468-1474.
28.	Zimmermann E, Gamborg M, Holst C, et al. Body mass index in school-aged children and the risk of routinely diagnosed non-alcoholic fatty liver disease in adulthood: a prospective study based on the Copenhagen School Health Records Register. BMJ Open, 2015, 5(4): e006998. doi: 10.1136/bmjopen-2014-006998.
29.	Berentzen TL, Gamborg M, Holst C, et al. Body mass index in childhood and adult risk of primary liver cancer. J Hepatol, 2014, 60(2): 325-330.
30.	Nobili V, Alisi A, Valenti L, et al. NAFLD in children: new genes, new diagnostic modalities and new drugs. Nat Rev Gastroenterol Hepatol, 2019, 16(9): 517-530.
31.	Yang YY, Xie L, Zhang NP, et al. Updates on novel pharmacotherapeutics for the treatment of nonalcoholic steatohepatitis. Acta Pharmacol Sin, 2022, 43(5): 1180-1190.
32.	Kieu TTM, Trinh HN, Pham HTK, et al. Direct non-medical and indirect costs of diabetes and its associated complications in Vietnam: an estimation using national health insurance claims from a cross-sectional survey. BMJ Open, 2020, 10(3): e032303. doi: 10.1136/bmjopen-2019-032303.
33.	李亚宁, 胡佳鑫, 许茜, 等. 医保情况和过度医疗现象调研报告. 广西质量监督导报, 2020, (5): 94-96.
34.	Allen AM, Van Houten HK, Sangaralingham LR, et al. Healthcare cost and utilization in nonalcoholic fatty liver disease: real-world data from a large U. S. claims database. Hepatology, 2018, 68(6): 2230-2238.
35.	李瑛. 医院有效控制医疗费用增长的策略研究. 经济与社会发展研究, 2021, (25): 248-251.
36.	Targher G, Corey KE, Byrne CD, et al. The complex link between NAFLD and type 2 diabetes mellitus—mechanisms and treatments. Nat Rev Gastroenterol Hepatol, 2021, 18(9): 599-612.
37.	赵建存, 宋英杰, 王振圣, 等. 苯丙氨酸/酪氨酸代谢途径及其相关产物与非酒精性脂肪肝的关系. 中国普外基础与临床杂志, 2022, 29(3): 404-409.
38.	Dulai PS, Singh S, Patel J, et al. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology, 2017, 65(5): 1557-1565.
39.	Campos-Murguía A, Ruiz-Margáin A, González-Regueiro JA, et al. Clinical assessment and management of liver fibrosis in non-alcoholic fatty liver disease. World J Gastroenterol, 2020, 26(39): 5919-5943.
40.	Younossi Z, Stepanova M, Ong JP, et al. Nonalcoholic steatohepatitis is the fastest growing cause of hepatocellular carcinoma in liver transplant candidates. Clin Gastroenterol Hepatol, 2019, 17(4): 748-755.

1. Wong MCS, Huang JLW, George J, et al. The changing epidemiology of liver diseases in the Asia-Pacific region. Nat Rev Gastroenterol Hepatol, 2019, 16(1): 57-73.
2. McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology, 2021, 73 Suppl 1(Suppl 1): 4-13.
3. Zhai M, Long J, Liu S, et al. The burden of liver cirrhosis and underlying etiologies: results from the global burden of disease study 2017. Aging (Albany NY), 2021, 13(1): 279-300.
4. Argo CK, Northup PG, Al-Osaimi AM, et al. Systematic review of risk factors for fibrosis progression in non-alcoholic steatohepatitis. J Hepatol, 2009, 51(2): 371-379.
5. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease—meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 2016, 64(1): 73-84.
6. Li J, Zou B, Yeo YH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol, 2019, 4(5): 389-398.
7. Estes C, Anstee QM, Arias-Loste MT, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol, 2018, 69(4): 896-904.
8. Zhou F, Zhou J, Wang W, et al. Unexpected rapid increase in the burden of NAFLD in China from 2008 to 2018: a systematic review and meta-analysis. Hepatology, 2019, 70(4): 1119-1133.
9. Zhou J, Zhou F, Wang W, et al. Epidemiological features of NAFLD from 1999 to 2018 in China. Hepatology, 2020, 71(5): 1851-1864.
10. Wu Y, Zheng Q, Zou B, et al. The epidemiology of NAFLD in Mainland China with analysis by adjusted gross regional domestic product: a meta-analysis. Hepatol Int, 2020, 14(2): 259-269.
11. Wei JL, Leung JC, Loong TC, et al. Prevalence and severity of nonalcoholic fatty liver disease in non-obese patients: a population study using proton-magnetic resonance spectroscopy. Am J Gastroenterol, 2015, 110(9): 1306-1314.
12. Hung MC, Chen CF, Tsou MT, et al. Relationship between gallstone disease and cardiometabolic risk factors in elderly people with non-alcoholic fatty liver disease. Diabetes Metab Syndr Obes, 2020, 13: 3579-3585.
13. 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018更新版). 中华肝脏病杂志, 2018, 26(3): 195-203.
14. Global Burden of Disease Liver Cancer Collaboration, Akinyemiju T, Abera S, et al. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level: results from the global burden of disease study 2015. JAMA Oncol, 2017, 3(12): 1683-1691.
15. Golabi P, Paik JM, AlQahtani S, et al. Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: data from global burden of disease 2009–2019. J Hepatol, 2021, 75(4): 795-809.
16. Younossi ZM, Otgonsuren M, Henry L, et al. Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009. Hepatology, 2015, 62(6): 1723-1730.
17. Stine JG, Wentworth BJ, Zimmet A, et al. Systematic review with meta-analysis: risk of hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis compared to other liver diseases. Aliment Pharmacol Ther, 2018, 48(7): 696-703.
18. Paik JM, Golabi P, Younossi Y, et al. The growing burden of disability related to nonalcoholic fatty liver disease: data from the global burden of disease 2007–2017. Hepatol Commun, 2020, 4(12): 1769-1780.
19. Chan WK, Treeprasertsuk S, Imajo K, et al. Clinical features and treatment of nonalcoholic fatty liver disease across the Asia Pacific region-the GO ASIA initiative. Aliment Pharmacol Ther, 2018, 47(6): 816-825.
20. Sarin SK, Kumar M, Eslam M, et al. Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol, 2020, 5(2): 167-228.
21. Sayiner M, Otgonsuren M, Cable R, et al. Variables associated with inpatient and outpatient resource utilization among medicare beneficiaries with nonalcoholic fatty liver disease with or without cirrhosis. J Clin Gastroenterol, 2017, 51(3): 254-260.
22. Younossi ZM, Blissett D, Blissett R, et al. The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe. Hepatology, 2016, 64(5): 1577-1586.
23. Younossi ZM, Zheng L, Stepanova M, et al. Trends in outpatient resource utilizations and outcomes for medicare beneficiaries with nonalcoholic fatty liver disease. J Clin Gastroenterol, 2015, 49(3): 222-227.
24. Tampi RP, Wong VW, Wong GL, et al. Modelling the economic and clinical burden of non-alcoholic steatohepatitis in East Asia: data from Hong Kong. Hepatol Res, 2020, 50(9): 1024-1031.
25. Ogden CL, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA, 2012, 307(5): 483-490.
26. Musaiger AO, Al-Mannai M, Al-Haifi AR, et al. Prevalence of overweight and obesity among adolescents in eight Arab countries: comparison between two international standards (ARABEAT-2). Nutr Hosp, 2016, 33(5): 567. doi: 10.20960/nh.567.
27. Wiegand S, Keller KM, Röbl M, et al. Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents. Int J Obes (Lond), 2010, 34(10): 1468-1474.
28. Zimmermann E, Gamborg M, Holst C, et al. Body mass index in school-aged children and the risk of routinely diagnosed non-alcoholic fatty liver disease in adulthood: a prospective study based on the Copenhagen School Health Records Register. BMJ Open, 2015, 5(4): e006998. doi: 10.1136/bmjopen-2014-006998.
29. Berentzen TL, Gamborg M, Holst C, et al. Body mass index in childhood and adult risk of primary liver cancer. J Hepatol, 2014, 60(2): 325-330.
30. Nobili V, Alisi A, Valenti L, et al. NAFLD in children: new genes, new diagnostic modalities and new drugs. Nat Rev Gastroenterol Hepatol, 2019, 16(9): 517-530.
31. Yang YY, Xie L, Zhang NP, et al. Updates on novel pharmacotherapeutics for the treatment of nonalcoholic steatohepatitis. Acta Pharmacol Sin, 2022, 43(5): 1180-1190.
32. Kieu TTM, Trinh HN, Pham HTK, et al. Direct non-medical and indirect costs of diabetes and its associated complications in Vietnam: an estimation using national health insurance claims from a cross-sectional survey. BMJ Open, 2020, 10(3): e032303. doi: 10.1136/bmjopen-2019-032303.
33. 李亚宁, 胡佳鑫, 许茜, 等. 医保情况和过度医疗现象调研报告. 广西质量监督导报, 2020, (5): 94-96.
34. Allen AM, Van Houten HK, Sangaralingham LR, et al. Healthcare cost and utilization in nonalcoholic fatty liver disease: real-world data from a large U. S. claims database. Hepatology, 2018, 68(6): 2230-2238.
35. 李瑛. 医院有效控制医疗费用增长的策略研究. 经济与社会发展研究, 2021, (25): 248-251.
36. Targher G, Corey KE, Byrne CD, et al. The complex link between NAFLD and type 2 diabetes mellitus—mechanisms and treatments. Nat Rev Gastroenterol Hepatol, 2021, 18(9): 599-612.
37. 赵建存, 宋英杰, 王振圣, 等. 苯丙氨酸/酪氨酸代谢途径及其相关产物与非酒精性脂肪肝的关系. 中国普外基础与临床杂志, 2022, 29(3): 404-409.
38. Dulai PS, Singh S, Patel J, et al. Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology, 2017, 65(5): 1557-1565.
39. Campos-Murguía A, Ruiz-Margáin A, González-Regueiro JA, et al. Clinical assessment and management of liver fibrosis in non-alcoholic fatty liver disease. World J Gastroenterol, 2020, 26(39): 5919-5943.
40. Younossi Z, Stepanova M, Ong JP, et al. Nonalcoholic steatohepatitis is the fastest growing cause of hepatocellular carcinoma in liver transplant candidates. Clin Gastroenterol Hepatol, 2019, 17(4): 748-755.

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Research progress in nonalcoholic fatty liver disease: disease burden and medical expenses control

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