Global Prevalence of Advanced Liver Fibrosis and Cirrhosis in the General Population: A Systematic Review and Meta-analysis.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Mohammad Zamani, Shaghayegh Alizadeh-Tabari, Veeral Ajmera, Siddharth Singh, Mohammad Hassan Murad, Rohit Loomba
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Abstract

Background & aims: Limited data exist regarding the estimate of the prevalence of advanced liver fibrosis and cirrhosis in the general population. Therefore, we conducted a systematic review and meta-analysis to evaluate the global prevalence and risk factors of advanced fibrosis and cirrhosis.

Methods: We searched Embase, PubMed, Scopus, and Web of Science from inception to April 30 2024, with no language restriction. We included cross-sectional studies reporting the prevalence of advanced liver fibrosis and/or cirrhosis in a sample of at least 100 individuals aged ≥18 years from the general population. Subjects with cirrhosis were included in the advanced fibrosis group. The pooled prevalence proportions utilizing a random-effects model and 95% confidence intervals (CIs) were estimated using global data.

Results: A total of 46 studies fulfilled the eligibility criteria, comprising approximately 8 million participants from 21 countries. The pooled prevalence rates of advanced liver fibrosis and cirrhosis in the general population were 3.3% (95% CI, 2.4%-4.2%) and 1.3% (95% CI, 0.9%-1.7%) worldwide, respectively. A trend was observed for an increase in the prevalence of advanced fibrosis (P = .004) and cirrhosis (P = .034) after 2016. There were significant geographic variations in the advanced fibrosis and cirrhosis prevalence at continental and national levels (P < .0001). Potential risk factors for cirrhosis were viral hepatitis, diabetes, excessive alcohol intake, obesity, and male sex.

Conclusions: The prevalence of advanced fibrosis and cirrhosis is considerable and increasing worldwide with significant geographic variation. Further research is needed to better understand the risk factors and how to mitigate them worldwide to address the growing global burden of cirrhosis.

全球普通人群中晚期肝纤维化和肝硬化的患病率:系统回顾和荟萃分析。
背景和目的:关于晚期肝纤维化和肝硬化在普通人群中发病率的估计数据有限。因此,我们进行了一项系统回顾和荟萃分析,以评估晚期肝纤维化和肝硬化的全球患病率和风险因素:我们检索了从开始到 2024 年 4 月 30 日的 Embase、PubMed、Scopus 和 Web of Science,没有语言限制。我们纳入了报告晚期肝纤维化和/或肝硬化患病率的横断面研究,样本至少为 100 名年龄≥18 岁的普通人群。肝硬化受试者被纳入晚期肝纤维化组。利用随机效应模型和95%置信区间(CIs)对全球数据进行了汇总流行比例估算:共有 46 项研究符合资格标准,包括来自 21 个国家的约 800 万名参与者。全球总人口中晚期肝纤维化和肝硬化的合并患病率分别为 3.3% (95% CI: 2.4-4.2) 和 1.3% (95% CI: 0.9-1.7)。2016年后,晚期纤维化(p=0.004)和肝硬化(p=0.034)的患病率呈上升趋势。在非洲大陆和国家层面,晚期纤维化和肝硬化的流行率存在明显的地域差异(p结论:晚期肝纤维化和肝硬化的患病率相当高,并且在全球范围内呈上升趋势,地域差异显著。需要进一步开展研究,以更好地了解风险因素以及如何在全球范围内减轻这些因素的影响,从而应对日益加重的全球肝硬化负担。
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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍: Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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