1990年至2021年全球、区域和国家因吸烟导致的非酒精性脂肪肝负担

IF 6.1 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Ecotoxicology and Environmental Safety Pub Date : 2025-08-06 DOI:10.1016/j.ecoenv.2025.118818

Pengyue Zhang , Jie Zhu , Xinlei Chen , Chunhui Tao , Jianmei Zhou , Zhenhua Zhang , Xiaodan Hong

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引用次数: 0

摘要

烟草是一种主要的环境污染物，吸烟是公认的非酒精性脂肪性肝病（NAFLD）的危险因素。然而，吸烟相关NAFLD的全球流行病学负担仍不清楚。本研究旨在量化1990年至2021年吸烟导致的NAFLD负担，重点关注残疾调整生命年（DALYs）、死亡率和时间趋势。方法从全球疾病负担研究2021中提取数据，并在全球、区域和国家层面进行分析。包括年龄、性别、地区和社会人口指数（SDI）。主要测量指标包括年龄标准化DALY率（ASDR）、年龄标准化死亡率（ASMR）和平均年变化百分比（AAPCs）。趋势进一步按年龄、性别和SDI分层。结果在全球范围内，吸烟导致NAFLD的ASMR呈上升趋势（AAPCASMR=0.27[95 % CI, 0.17-0.37], P <； 0.001）。1990年至2021年期间，增幅最大的是大洋洲和拉丁美洲南部。ASDR的AAPC分别为2.89[95 %CI, 2.5 ~ 3.29]和2.84[95 %CI, 2.16 ~ 3.52]。男性的负担明显更高，DALY率随年龄增长而上升，在65-69岁达到峰值(8.84/10万；95 % ui: 2.77-15.69)。SDI与疾病负担呈负u型相关。联结点分析显示，中低SDI地区和高SDI地区的女性发病率呈上升趋势。结论尽管吸烟率有所下降，但吸烟相关NAFLD的负担持续上升，尤其是在中低收入地区和高收入女性中。迫切需要加强烟草控制和有针对性的NAFLD预防策略。

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Global, regional, and national burdens of non-alcoholic fatty liver disease attributable to smoking from 1990 to 2021

Background

Tobacco is a major environmental pollutant, and smoking is a recognized risk factor for non-alcoholic fatty liver disease (NAFLD). However, the global epidemiological burden of smoking-related NAFLD remains unclear. This study aimed to quantify the burden of NAFLD attributable to smoking from 1990 to 2021, focusing on disability-adjusted life years (DALYs), mortality rates, and temporal trends.

Methods

Data were extracted from the Global Burden of Disease Study 2021 and analyzed at global, regional, and national levels. Age, sex, region, and socio-demographic index (SDI) were included. Key measures included age-standardized DALY rates (ASDR), age-standardized mortality rates (ASMR), and average annual percentage changes (AAPCs). Trends were further stratified by age, sex, and SDI.

Results

Globally, the ASMR of NAFLD attributable to smoking demonstrated a upward trend (AAPC_ASMR=0.27[95 % CI, 0.17–0.37], P < 0.001). The most substantial increases from 1990 to 2021 were observed in Australasia and Southern Latin America. The AAPC for ASDR was 2.89[95 %CI, 2.5–3.29] and 2.84[95 %CI, 2.16–3.52], respectively. The burden was significantly higher in males, with DALY rates rising with age and peaking at 65–69 years (8.84/100,000; 95 % UI: 2.77–15.69). An inverse U-shaped association between SDI and disease burden was noted. Join-point analysis revealed increasing trends in low-medium SDI regions and among females in high-SDI regions.

Conclusion

Despite declining smoking prevalence, the burden of smoking-related NAFLD continues to rise, especially in low-middle income regions and high-income females. Strengthened tobacco control and targeted NAFLD prevention strategies are urgently needed.

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来源期刊

Ecotoxicology and Environmental Safety 环境科学-毒理学

CiteScore

12.10

自引率

5.90%

发文量

1234

审稿时长

88 days

期刊介绍： Ecotoxicology and Environmental Safety is a multi-disciplinary journal that focuses on understanding the exposure and effects of environmental contamination on organisms including human health. The scope of the journal covers three main themes. The topics within these themes, indicated below, include (but are not limited to) the following: Ecotoxicology、Environmental Chemistry、Environmental Safety etc.