NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS DRIVING THE GLOBAL BURDEN OF CHRONIC LIVER DISEASE (CLD) AMONG ADOLESCENTS AND YOUNG ADULTS
DDW ePoster Library. Younossi Z. 05/22/21; 320153; Sa350
Abstract
Discussion Forum (0)
Engage with the presenter here during ePoster Session: NAFLD and NASH
On Saturday, May 22, 2021 12:15 - 1 p.m. EDT

Number: Sa350
NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS DRIVING THE GLOBAL BURDEN OF CHRONIC LIVER DISEASE (CLD) AMONG ADOLESCENTS AND YOUNG ADULTS

Society: AASLD
Track: Liver Diseases and Transplantation
Category: NAFLD and NASH

Author(s): James M. Paik1,3, Khaled W. Kabbara1, Katherine Eberly1, Youssef Younossi2, Linda Henry2, Zobair M. Younossi1,3,41 Center for Liver Diseases, Department of Medicine, Inova Fairfax Medical Campus, FALLS CHURCH, Virginia, United States; 2 Center for Outcomes Research in Liver Diseases, Washington DC, District of Columbia, United States; 3 Beatty Liver and Obesity Research Program, Inova Health System, FALLS CHURCH, Virginia, United States; 4 Inova Medicine, Inova Health System, FALLS CHURCH, Virginia, United States

Background: Hepatitis B, C (HBV and HCV) and NAFLD are common causes of pediatric CLD. As prevalence of obesity is increasing in all age groups, understanding the global burden of CLD among adolescents and young adults is important.
Aim: Describe the global burden of liver cancer (LC) and cirrhosis among adolescents (aged 15 to 19 years); late adolescents (aged 20 to 24 years) and young adults (aged 25 to 29 years) using Global Burden of Disease (GBD 2009-2019).
Methods: The GBD study estimation methods were used to assess incidence, deaths, and disability-adjusted life-years (DALYs) related to LC and cirrhosis. Results were analyzed according to 21 GBD regions. Annual percent change (APC) is calculated by using Joinpoint regression program, version 4.6.0.0 (Statistical Research and Applications Branch, National Cancer Institute).
Results: In 2019, worldwide, there were a total of 534,364 and 2,051,554 incident cases of LC and cirrhosis and associated 484,577 and 1,472,012 deaths, contributing 12.5 and 46.2 million DALYs. Of these, adolescents and young adults (15-29 years) accounted for 1.2% of LC incidence, 0.9% of LC deaths, and 2.2% of LC DALYs and 11.3% of cirrhosis incidence, 3.8% of cirrhosis deaths, and 8.0% of cirrhosis DALYs.
Among adolescents and young adults, the highest burden of LC DALYs was observed in East Asia (38.3%), South Asia (17.9%), Southeast Asia (9.8%), North Africa and Middle East (7.1%) and Western Sub-Saharan Africa (6.1%), whereas the highest burden of cirrhosis DALYs was observed in South Asia (45.9%), Southeast Asia (12.4%), Western Sub-Saharan Africa (10.0%), and Eastern Sub-Saharan Africa (9.1%).
Of LC and Cirrhosis deaths [adolescents (16.7% and 19.6%); late adolescents (27.9% and 30.8%); and young adults (55.4% and 49.6%)], HBV was responsible for 67.2% and 18.6%, followed by NAFLD (11.0% and 5.0%) and HCV (3.1% and 20.0%); respectively.
From 2009 through 2019, LC annual death rate decreased among adolescents (APC=-0.86%) and late adolescents (-0.84%). Among CLD etiologies, LC death rates decreased for HBV and HCV while these rates increased for NAFLD [adolescents (+1.06%); late adolescents (+0.94%); and young adults (+0.74%) (p<.001)]. Similar patterns were observed in cirrhosis death rate.
From 2009 through 2019, some regions experienced worsening trends in LC death rate (9 out of 21 regions among adolescents and young adults), with the steepest increases (+1% to +2%) in Caribbean, Eastern Europe and Central Latin America. These worsening trends were driven by a worsening trend in LC death from NAFLD (15 out of 21 regions among adolescents and young adults) Figure.
Conclusions: Although the global burden of HBV and HCV among adolescents and young adults is decreasing, global burden of NAFLD is on the rise. This data should inform policy makers to address the global public health challenges of NAFLD among all age groups.
Engage with the presenter here during ePoster Session: NAFLD and NASH
On Saturday, May 22, 2021 12:15 - 1 p.m. EDT

Number: Sa350
NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS DRIVING THE GLOBAL BURDEN OF CHRONIC LIVER DISEASE (CLD) AMONG ADOLESCENTS AND YOUNG ADULTS

Society: AASLD
Track: Liver Diseases and Transplantation
Category: NAFLD and NASH

Author(s): James M. Paik1,3, Khaled W. Kabbara1, Katherine Eberly1, Youssef Younossi2, Linda Henry2, Zobair M. Younossi1,3,41 Center for Liver Diseases, Department of Medicine, Inova Fairfax Medical Campus, FALLS CHURCH, Virginia, United States; 2 Center for Outcomes Research in Liver Diseases, Washington DC, District of Columbia, United States; 3 Beatty Liver and Obesity Research Program, Inova Health System, FALLS CHURCH, Virginia, United States; 4 Inova Medicine, Inova Health System, FALLS CHURCH, Virginia, United States

Background: Hepatitis B, C (HBV and HCV) and NAFLD are common causes of pediatric CLD. As prevalence of obesity is increasing in all age groups, understanding the global burden of CLD among adolescents and young adults is important.
Aim: Describe the global burden of liver cancer (LC) and cirrhosis among adolescents (aged 15 to 19 years); late adolescents (aged 20 to 24 years) and young adults (aged 25 to 29 years) using Global Burden of Disease (GBD 2009-2019).
Methods: The GBD study estimation methods were used to assess incidence, deaths, and disability-adjusted life-years (DALYs) related to LC and cirrhosis. Results were analyzed according to 21 GBD regions. Annual percent change (APC) is calculated by using Joinpoint regression program, version 4.6.0.0 (Statistical Research and Applications Branch, National Cancer Institute).
Results: In 2019, worldwide, there were a total of 534,364 and 2,051,554 incident cases of LC and cirrhosis and associated 484,577 and 1,472,012 deaths, contributing 12.5 and 46.2 million DALYs. Of these, adolescents and young adults (15-29 years) accounted for 1.2% of LC incidence, 0.9% of LC deaths, and 2.2% of LC DALYs and 11.3% of cirrhosis incidence, 3.8% of cirrhosis deaths, and 8.0% of cirrhosis DALYs.
Among adolescents and young adults, the highest burden of LC DALYs was observed in East Asia (38.3%), South Asia (17.9%), Southeast Asia (9.8%), North Africa and Middle East (7.1%) and Western Sub-Saharan Africa (6.1%), whereas the highest burden of cirrhosis DALYs was observed in South Asia (45.9%), Southeast Asia (12.4%), Western Sub-Saharan Africa (10.0%), and Eastern Sub-Saharan Africa (9.1%).
Of LC and Cirrhosis deaths [adolescents (16.7% and 19.6%); late adolescents (27.9% and 30.8%); and young adults (55.4% and 49.6%)], HBV was responsible for 67.2% and 18.6%, followed by NAFLD (11.0% and 5.0%) and HCV (3.1% and 20.0%); respectively.
From 2009 through 2019, LC annual death rate decreased among adolescents (APC=-0.86%) and late adolescents (-0.84%). Among CLD etiologies, LC death rates decreased for HBV and HCV while these rates increased for NAFLD [adolescents (+1.06%); late adolescents (+0.94%); and young adults (+0.74%) (p<.001)]. Similar patterns were observed in cirrhosis death rate.
From 2009 through 2019, some regions experienced worsening trends in LC death rate (9 out of 21 regions among adolescents and young adults), with the steepest increases (+1% to +2%) in Caribbean, Eastern Europe and Central Latin America. These worsening trends were driven by a worsening trend in LC death from NAFLD (15 out of 21 regions among adolescents and young adults) Figure.
Conclusions: Although the global burden of HBV and HCV among adolescents and young adults is decreasing, global burden of NAFLD is on the rise. This data should inform policy makers to address the global public health challenges of NAFLD among all age groups.
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