London-Non-alcoholic worldwide Fatty liver Illness (NAFLD) has caused and overtaken an increase in the number of deaths from liver cancer over the last decade Alcoholic liver disease, Hepatitis BWhen Hepatitis CAccording to an analysis of the 2019 World Disease Burden Survey.
Zobair Younossi, MD and MPH, professor and chairman of the School of Medicine at Innova Fairfax Medical Campus in Falls Church, Virginia, said the global increase in liver cancer deaths and chronic liver disease reflects changes in underlying health patterns. It states that it is. International Liver Conference (ILC) 2022.
“NAFLD and NASH [nonalcoholic steatohepatitis] It is rapidly becoming the main cause Cirrhosis “Liver cancer in the world,” said Younossi. Medscape Medical News.. “We’ve known about rising prevalence for some time, but now we’re catching up with mortality results,” he said.
“The conclusion of this study is that the burden of this disease is [NAFLD] Is rising and will be the most important disease in the next decade or so, “he added,” the largest annual increase in mortality from liver cancer or chronic cirrhosis is associated with NAFLD. “
Specifically, during the decade 2009-2019, the annual rate of change in liver cancer mortality (APC) + 1.33% worldwide was driven by the fact that NAFLD’s APC was + 2.47%. rice field. By comparison, APC for alcoholic liver disease was + 1.91%.For hepatitis B and APC were + 0.21%. For hepatitis C, APC was + 1.12%.
Dr. Alexander Crag, MD, Ph.D., Professor of Hepatology and Professor of SDU’s Odense Liver Research Center and Odense University Hospital in Denmark, who chaired the session attended by this presentation, emphasized the importance of recognizing the contribution of NAFLD. I admitted. For liver cancer mortality.
“Liver disease is on the rise. These are the fastest-growing causes of death in the UK and faster than heart disease and other cancers, especially NAFLD, which is the fastest-growing cause of liver cancer. Yes, it’s a major cause in France and the United States. The nation, “he said.
Crag also emphasized the cost of disease management.
“Management of fatty liver disease in Europe is estimated at € 35 billion in direct medical care, so we need to do something right now,” he emphasized.
“The global burden of NAFLD is so great that we need tools for both prevention and treatment,” Krag said. “Lifestyle changes are’easy’and the cost to the government is negligible. For young people, this needs to be taken very seriously. At the political level, this can be easily done, for example by banning junk food. In addition to food advertising, you can also educate young people and their families. Good medicine also helps. “
NAFLD: Liver Symptoms of Type 2 Diabetes
About 25% to 30% There is NAFLD of the world population, 3% to 5% I have NASH. Younossi emphasized that the US Transplant Database shows that NAFLD is the second indication of all. Liver transplant domestic. NAFLD is also Hepatocellular carcinoma..
He said there are about 2 billion cases of chronic liver disease worldwide. He said that over time, all types of liver disease have increased, as reflected in the changing annual rate.
“With the global obesity pandemic Type 2 diabetes Promotes an increase in NAFLD, but even among lean people, the prevalence of NAFLD is about 9%. Along with diabetic eye and kidney complications, this is a liver symptom of type 2 diabetes. “
To assess global liver disease and mortality, Younossi and his colleagues look at the Global Disease Burden Study, which collected data from approximately 7,000 researchers in 22 different regions of the world (156 countries). I turned.
They calculated incidence, prevalence, mortality, and disability-adjusted life years (DALYs) in relation to liver cancer and chronic liver disease, including APC. They associated the data with four liver disease changes: NAFLD, alcoholic liver disease, hepatitis B infection, and hepatitis C infection.
The cases of NAFLD reported in this study were diagnosed by ultrasound or other imaging.Importantly, the prevalence of NAFLD Use of alcohol Among the various people, Younossi explained.
In 2019, they globally reached an overall prevalence of liver disease of 1.69 billion (liver cancer, 0.04%; chronic liver disease, 99.96%) and an incidence of 2.59 million (liver cancer, 20.7%; chronic). He reported that he had liver disease (79.3). %), Mortality rate is 1.95 million (liver cancer, 24.8%, chronic liver disease, 75.3%), DALY is 58.7 million (liver cancer, 21.3%, chronic liver disease, 78.7%).
Between 2009 and 2019, deaths from liver cancer increased by 27.2% and deaths from chronic liver disease increased by 10.6%. DALYs for liver cancer increased by 21.9% and DALYs for chronic liver disease increased by 5.1%.
In contrast to the increased mortality from liver cancer, the mortality from chronic liver disease decreased (APC, -0.18%). This decrease was due to a decrease in hepatitis B (APC, -1.83%). APCs for hepatitis C (+ 0.37%), alcoholic liver disease (+ 0.45%), and NAFLD (+ 1.33%) increased.
“We were so good at vaccination of people that the burden of hepatitis B-related mortality was reduced,” Younossi said.
NAFLD “explosion” in the Middle East, North Africa and East Asia
Increases in NAFLD can be seen in all parts of the world, but by region the breakdown is that NAFLD is predominantly “exploding” in the Middle East (mainly Egypt, Iran, Turkey), North Africa, and East Asia. Younossi said. In addition, there is a significant increase in West and South America.
“We knew that the prevalence was high in the Middle East, but we also found that the mortality rate was high, so we’re linking these data together,” says Younossi.
Lack of consciousness
Younossi emphasized the fact that awareness among the general public, primary care providers, and policy makers is very low. “From my point of view, raising awareness of NAFLD is a top priority, and that is the value of this research.”
He added that the more manageable the test, the more people will notice it.
“Several non-invasive tests have been developed, so there is no need to have a liver biopsy to diagnose these patients in the future,” he said. “Currently, some excellent treatments are being developed.”
“WHO [World Health Organization] We haven’t mentioned NAFLD as a significant non-communicable disease, and we need to change that too, “Younossi added.
International Liver Conference (ILC) 2022: Summary GS008. Announced on June 24, 2022.
Younossi receives and consults research lands for Abbott, Allagan, Bristol Myers Squibb, Echo Sens, Genfit, Gilead Sciences, Intercept, Madridgal, Merck and Novo Nordisk. Karg does not disclose the relevant financial relationship.
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