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Mak LY, Liu K, Chirapongsathorn S, Yew KC, Tamaki N, Rajaram RB, Panlilio MT, Lui R, Lee HW, Lai JCT, Kulkarni AV, Premkumar M, Lesmana CRA, Hsu YC, Huang DQ. Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions. Nat Rev Gastroenterol Hepatol 2024:10.1038/s41575-024-00967-4. [PMID: 39147893 DOI: 10.1038/s41575-024-00967-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 08/17/2024]
Abstract
Globally, nearly half of deaths from cirrhosis and chronic liver diseases (CLD) and three-quarters of deaths from hepatocellular carcinoma (HCC) occur in the Asia-Pacific region. Chronic hepatitis B is responsible for the vast majority of liver-related deaths in the region. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common form of CLD, affecting an estimated 30% of the adult population. Compared with people of European descent, people from the Asia-Pacific region carry more genetic variants associated with MASLD and its progression. Alcohol is a fast-growing cause of CLD and HCC in Asia as a result of the rising per-capita consumption of alcohol. Drug-induced liver injury is under-recognized and probably has a high prevalence in this region. The epidemiological and outcome data of acute-on-chronic liver failure are heterogeneous, and non-unified definitions across regions contribute to this heterogeneity. CLDs are severely underdiagnosed, and effective treatments and vaccinations are underutilized. In this Review, we highlight trends in the burden of CLD and HCC in the Asia-Pacific region and discuss the rapidly changing aetiologies of liver disease. We examine the multiple gaps in the care cascade and propose mitigating strategies and future directions.
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Affiliation(s)
- Lung-Yi Mak
- The University of Hong Kong, Hong Kong, China
| | - Ken Liu
- The University of Sydney, Sydney, Australia
| | | | | | | | | | | | - Rashid Lui
- The Chinese University of Hong Kong, Hong Kong, China
| | - Hye Won Lee
- Yonsei University College of Medicine, Seoul, Korea
| | | | - Anand V Kulkarni
- Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Yao Chun Hsu
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine and Graduate Institute of Medicine, I-Shou University, Kaohsiung, Taiwan
- School of Medicine and Graduate Institute of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Daniel Q Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Division of Gastroenterology and Hepatology, National University Hospital, Singapore, Singapore.
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Fang L. A Multiprong Approach to Curb Underage Drinking: Addressing a Centuries-Old Practice in China. Am J Public Health 2024; 114:763-765. [PMID: 38870433 PMCID: PMC11224621 DOI: 10.2105/ajph.2024.307738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Affiliation(s)
- Lin Fang
- Lin Fang is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON
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Feng X, Huang N, Wu Y, Gao F, Chen X, Zhang C, Zhang B, Sun T. Alcoholic Liver Disease in China: A Disease Influenced by Complex Social Factors That Should Not Be Neglected. J Clin Transl Hepatol 2024; 12:677-684. [PMID: 38993514 PMCID: PMC11233974 DOI: 10.14218/jcth.2024.00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 07/13/2024] Open
Abstract
Alcoholic liver disease (ALD) encompasses liver damage caused by chronic, excessive alcohol consumption. It manifests initially as marked hepatocellular steatosis and can progress to steatohepatitis, liver fibrosis, and cirrhosis. With China's rapid economic growth, coupled with a complex social background and the influence of a deleterious wine culture, the number of patients with ALD in China has increased significantly; the disease has become a social and health problem that cannot be ignored. In this review, we briefly described the social factors affecting ALD in China and elaborated on differences between alcoholic and other liver diseases in terms of complications (e.g., cirrhosis, upper gastrointestinal bleeding, hepatic encephalopathy, hepatocellular carcinoma, addiction, and other extrahepatic diseases). We also emphasized that ALD was more dangerous and difficult to treat than other liver diseases due to its complications, and that precise and effective treatment measures were lacking. In addition, we considered new ideas and treatment methods that may be generated in the future.
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Affiliation(s)
- Xiaofeng Feng
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Nafei Huang
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yuqin Wu
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fei Gao
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiaomei Chen
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chenyi Zhang
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Bing Zhang
- Hangzhou First People's Hospital, Hangzhou, Zhejiang, China
| | - Tao Sun
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Rehm J, Shield K, Hassan AS, Franklin A. The role of alcohol control policies in the reversal of alcohol consumption levels and resulting attributable harms in China. Alcohol 2024:S0741-8329(24)00096-X. [PMID: 39009173 DOI: 10.1016/j.alcohol.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/05/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024]
Abstract
Yearly adult per capita consumption of alcohol in China between 2016 and 2019 decreased by 2.4 litres of pure alcohol, or 33%. According to the World Health Organization, this decrease in consumption was accompanied by reductions in alcohol-attributable mortality of 23% between 2015 and 2019. This paper examines the contribution of alcohol control policies in China to these public health gains. A systematic search of the literature was conducted on alcohol control policies and their effectiveness in China as part of a larger search of all countries in WHO Western Pacific Region. In addition to articles on empirical evidence on the impact of such alcohol control policies, we also searched for reviews. The plausibility of changes of traditional alcohol control policies (taxation increases, availability restrictions, restriction on advertisement and marketing, drink-driving laws, screening and brief interventions) in explaining reductions of consumption levels and attributable mortality rates was explored. There was some progress in the successful implementation of strict drink-driving policies, which could explain reductions in traffic injuries, including fatalities. Other traditional alcohol control policies seem to have played a minimal role in reducing alcohol consumption and attributable harms during the time period 2016-2019. However, an anti-corruption campaign was extensive enough to have substantially contributed to these reductions. The campaign prohibited the consumption of alcoholic beverages in everyday life of government officials and thus contributed to a de-normalization of alcohol. While this anti-corruption campaign was the only policy to potentially explain marked decreases in levels of alcohol consumption and attributable mortality, more detailed research is required to determine exactly how the campaign achieved these decreases.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, Canada, M5S 2S1; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, Canada, M5S 2S1; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at the Public Health Institute of Catalonia, Roc Boronat Street 81 - 95, 08005, Barcelona, Catalonia, Spain; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, Canada, M5T 3M7; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8(th) floor, Toronto, Ontario, Canada, M5T 1R8; Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, Canada, M5S 1A8; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany; Program on Substance Abuse & WHO European Region Collaboration Centre, Public Health Agency of Catalonia, Roc Boronat Street 81 - 95, 08005, Barcelona, Catalonia, Spain.
| | - Kevin Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, Canada, M5S 2S1; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, Canada, M5S 2S1; PAHO/WHO Collaborating Centre at CAMH, Toronto, Canada & WHO European Region Collaborating Centre at the Public Health Institute of Catalonia, Roc Boronat Street 81 - 95, 08005, Barcelona, Catalonia, Spain; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, Canada, M5T 3M7
| | - Ahmed S Hassan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, Canada, M5S 2S1; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, Canada, M5T 3M7
| | - Ari Franklin
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, Canada, M5S 2S1
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Gao Y, Liu K, Fang S. Analysis and projections of disease burden for different risk factors and sexes of ischemic stroke in young adults in China. Sci Rep 2024; 14:13339. [PMID: 38858463 PMCID: PMC11164860 DOI: 10.1038/s41598-024-63920-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024] Open
Abstract
To estimate the rate of death, and disability-adjusted life years (DALYs) and project the disease burden of ischemic stroke due to relevant risk factors in young adults age 20-49 years by sex in China. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used. The age-standardized mortality (ASMR), age-standardized DALYs rate (ASDR), and estimated annual percentage changes (EAPC) were calculated to evaluate the temporal trends from 1990 to 2019. We also used the NORDPRED model to predict ASMR for ischemic stroke due to related risk factors in Chinese young adults over the next 10 years. From 1990 to 2019, the general age-standardized mortality [from 2.39 (1.97 to 2.99) in 1990 to 1.8 (1.41 to 2.18) in 2019, EAPC = - 1.23] and DALYs rates (from 171.7 (140.34 to 212.36) in 1990 to 144.4 (114.29 to 177.37) in 2019, EAPC = - 0.86) decreased for ischemic stroke in young adults in China. ASMR and ASDR decreased for all level 1 risk factors (including behavioral, environmental/occupational, and metabolic) from 1990 to 2019, with the slightest decrease for metabolic risks [ASMR from 1.86 (1.39 to 2.41) in 1990 to 1.53 (1.15 to 1.92) in 2019, ASDR from 133.68 (99.96 to 173.89) in 1990 to 123.54 (92.96 to 156.98) in 2019] and the largest decrease for environmental/occupational risks [ASMR from 1.57 (1.26 to 1.98) in 1990 to 1.03 (0.78 to 1.29) in 2019, ASDR from 110.91 (88.44 to 138.34) in 1990 to 80.03 (61.87 to 100.33) in 2019]. In general, high body-mass index, high red meat intake, and ambient particulate matter pollution contributed to the large increase in ASMR and ASDR between 1990 and 2019. Significant reductions in ASMR and ASDR were observed in low vegetables intake, household air pollution from solid fuels, lead exposure, and low fiber intake. In addition, there were sex differences in the ranking of ASMR attributable to risks in ischemic stroke. The disease burden of ischemic stroke attributable to relevant risk factors in young adults in China is greater and has a faster growth trend or a slower decline trend in males than in females (except for secondhand smoke). The apparent increasing trend of ASMR attributable to high fasting plasma glucose, high systolic blood pressure, high body-mass index, and high red meat intake was observed in males but not in females. The projected analysis showed an increasing trend in ASMR between 1990 and 2030 for all specific metabolic risks for males, but a decreasing trend for females. ASMR attributable to ambient particulate matter pollution showed an increasing trend from 1990 to 2030 for both males and females. The burden of ischemic stroke in young adults in China showed a downward trend from 1990 to 2019. Specific risk factors associated with the burden of ischemic stroke varied between the sexes. Corresponding measures need to be developed in China to reduce the disease burden of ischemic stroke among young adults.
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Affiliation(s)
- Ying Gao
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, No. 1 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, People's Republic of China
| | - Kangding Liu
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, No. 1 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, People's Republic of China
| | - Shaokuan Fang
- Department of Neurology, Neuroscience Centre, The First Hospital of Jilin University, No. 1 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, People's Republic of China.
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Li T, Liu P, Gao Y, Ji X, Lin Y. Advancements in Fatigue Detection: Integrating fNIRS and Non-Voluntary Attention Brain Function Experiments. SENSORS (BASEL, SWITZERLAND) 2024; 24:3175. [PMID: 38794028 PMCID: PMC11125156 DOI: 10.3390/s24103175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Driving fatigue is a significant concern in contemporary society, contributing to a considerable number of traffic accidents annually. This study explores novel methods for fatigue detection, aiming to enhance driving safety. METHODS This study utilizes electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) to monitor driver fatigue during simulated driving experiments lasting up to 7 h. RESULTS Analysis reveals a significant correlation between behavioral data and hemodynamic changes in the prefrontal lobe, particularly around the 4 h mark, indicating a critical period for driver performance decline. Despite a small participant cohort, the study's outcomes align closely with established fatigue standards for drivers. CONCLUSIONS By integrating fNIRS into non-voluntary attention brain function experiments, this research demonstrates promising efficacy in accurately detecting driving fatigue. These findings offer insights into fatigue dynamics and have implications for shaping effective safety measures and policies in various industrial settings.
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Affiliation(s)
- Ting Li
- Institute of Biomedical Engineering, Chinese Academy Medical Sciences & Peking Union Medical College, Tianjin 300192, China; (P.L.); (X.J.)
| | - Peishuai Liu
- Institute of Biomedical Engineering, Chinese Academy Medical Sciences & Peking Union Medical College, Tianjin 300192, China; (P.L.); (X.J.)
| | - Yuan Gao
- Institute of Integrated Circuit Science and Engineering, University of Electronical Science and Technology of China, Chengdu 611731, China;
| | - Xiang Ji
- Institute of Biomedical Engineering, Chinese Academy Medical Sciences & Peking Union Medical College, Tianjin 300192, China; (P.L.); (X.J.)
| | - Yu Lin
- North Carolina State University, Raleigh, NC 27695, USA;
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Liu H, Wang X, Wang L, Yin P, Liu F, Wei L, Wang Y, Zhou M, Qi J, Rao H. Mortality Burden of Liver Cancer in China: An Observational Study From 2008 to 2020. J Clin Transl Hepatol 2024; 12:371-380. [PMID: 38638380 PMCID: PMC11022066 DOI: 10.14218/jcth.2023.00455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/19/2024] [Accepted: 02/29/2024] [Indexed: 04/20/2024] Open
Abstract
Background and Aims China accounts for nearly half of liver cancer deaths globally. A better understanding of the current liver cancer mortality will be helpful to establishing priorities for intervention and to decreasing the disease burden of liver cancer. The study aimed to explore and predict the mortality burden of liver cancer in China. Methods Data were extracted from the Disease Surveillance Point system of the Chinese Center for Disease Control and Prevention from 2008 to 2020. Crude and age-standardized liver cancer mortality rates were reported by sex, urban or rural residence, and region. Trends in liver cancer mortality rates from 2008 to 2020 were estimated as average annual percentage change (AAPC). The changing trend of live cancer mortality in the future is also predicted. Results In 2020, the crude mortality of liver cancer was 25.57/100,000, and males and people lived in rural areas had higher age-standardized liver cancer mortality rates than females and people lived in people in urban areas. Crude mortality and age-standardized mortality rates in southwest provinces (Guangxi, Sichuan, Tibet) and in a northeast province (Heilongjiang) were higher than that in other provinces, and age-specific mortality rates increased with age. From 2008 to 2020, liver cancer mortality rates decreased, but people under 50 years of age had a higher AAPC than those over 50 years of age, possibly because of the adoption of hepatitis B virus vaccination in newborns and children. Furthermore, the mortality of liver cancer in 2021-2030 is predicted to have a downward trend. Conclusions Liver cancer mortality rates declined in China from 2008 to 2020. Future interventions to control liver cancer mortality need to focus on people of male sex, older age, and living in rural areas or less developed provinces.
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Affiliation(s)
- Huixin Liu
- Department of Clinical Epidemiology and Biostatistics, Peking University People's Hospital, Beijing, China
| | - Xiaoxiao Wang
- Peking University People’s Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing, China
| | - Lijun Wang
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Liu
- Peking University People’s Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing, China
| | - Lai Wei
- Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Yu Wang
- Chinese Foundation for Hepatitis Prevention and Control, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinlei Qi
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huiying Rao
- Peking University People’s Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing, China
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Li Y, Wang H, Leng X, Gao J, Li C, Huang D. Polysaccharides from Eucommia ulmoides Oliv. Leaves Alleviate Acute Alcoholic Liver Injury by Modulating the Microbiota-Gut-Liver Axis in Mice. Foods 2024; 13:1089. [PMID: 38611393 PMCID: PMC11011369 DOI: 10.3390/foods13071089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
The interplay among gut microbiota, intestines, and liver is crucial in preventing acute alcoholic liver injury. In this study, the hepatoprotective potential of polysaccharides from Eucommia ulmoides Oliv. leaves (EULP) on acute alcoholic liver injury in Kunming male mice was investigated. The structural features suggested that the EULP appeared as a heterogeneous mixture of polysaccharides with a molecular weight of 186132 Da. A 14-day pretreatment of EULP ameliorated acute alcoholic-induced hepatic inflam mation (TNF-α, IL-6, and IL-10), oxidative stress (GSH, SOD, and T-AOC), and liver damage (ALT and AST) via enhancing intestinal barrier (Occludin, Claudin 1, and ZO-1) and modulating microbiome, which subsequently inhibiting endotoxemia and balancing the homeostasis of the gut-liver axis. EULP restored the composition of intestinal flora with an increase in the relative abundance of Lactobacillaceae and a decrease in Lachnospiraceae and Verrucomicrobiaceae. Notably, prolonged EULP pretreatment (14 days) but no single gavage of EULP achieved excellent hepatoprotection. These findings endorsed the potential of EULP as a functional food for mitigating acute alcoholic-induce d liver damage, attributed to its anti-inflammatory, antioxidant, and prebiotic properties facilitated by the microbiota-gut-liver axis.
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Affiliation(s)
- Yingzhi Li
- State Key Laboratory of Food Science and Resources, China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China; (Y.L.); (H.W.); (X.L.); (J.G.); (C.L.)
| | - Huimei Wang
- State Key Laboratory of Food Science and Resources, China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China; (Y.L.); (H.W.); (X.L.); (J.G.); (C.L.)
| | - Xueping Leng
- State Key Laboratory of Food Science and Resources, China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China; (Y.L.); (H.W.); (X.L.); (J.G.); (C.L.)
| | - Jiaming Gao
- State Key Laboratory of Food Science and Resources, China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China; (Y.L.); (H.W.); (X.L.); (J.G.); (C.L.)
| | - Chang Li
- State Key Laboratory of Food Science and Resources, China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China; (Y.L.); (H.W.); (X.L.); (J.G.); (C.L.)
| | - Danfei Huang
- State Key Laboratory of Food Science and Resources, China-Canada Joint Lab of Food Science and Technology (Nanchang), Key Laboratory of Bioactive Polysaccharides of Jiangxi Province, Nanchang University, 235 Nanjing East Road, Nanchang 330047, China; (Y.L.); (H.W.); (X.L.); (J.G.); (C.L.)
- International Institute of Food Innovation Co., Ltd., Nanchang 330200, China
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Dai JJ, Liu YY, Zhang ZH. Changes in the etiology of liver cirrhosis and the corresponding management strategies. World J Hepatol 2024; 16:146-151. [PMID: 38495283 PMCID: PMC10941737 DOI: 10.4254/wjh.v16.i2.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 02/27/2024] Open
Abstract
We read with interest the article by Xing Wang, which was published in the recent issue of the World Journal of Hepatology 2023; 15: 1294-1306. This article focuses particularly on the prevalence and trends in the etiology of liver cirrhosis (LC), prognosis for patients suffering from cirrhosis-related complications and hepatocellular carcinoma (HCC), and management strategies. The etiology of cirrhosis varies according to geographical, economic, and population factors. Viral hepatitis is the dominant cause in China. Vaccination and effective treatment have reduced the number of people with viral hepatitis, but the overall number is still large. Patients with viral hepatitis who progress over time to LC and HCC remain an important population to manage. The increased incidence of metabolic syndrome and alcohol consumption is likely to lead to a potential exponential increase in metabolic dysfunction-associated steatotic liver disease (MASLD)-associated LC and alcoholic liver disease in the future. Investigating the evolution of the etiology of LC is important for guiding the direction of future research and policy development. These changing trends indicate a need for greater emphasis on tackling obesity and diabetes, and implementing more effective measures to regulate alcohol consumption in order to reduce the occurrence of MASLD. In an effort to help cope with these changing trends, the authors further proposed countermeasures for healthcare authorities doctors, and patients.
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Affiliation(s)
- Jin-Jin Dai
- Department of Infectious Diseases, Suzhou Hospital of Anhui Medical University, Suzhou 234000, Anhui Province, China
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Yue-Ying Liu
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Zhen-Hua Zhang
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
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Wang X, Luo JN, Wu XY, Zhang QX, Wu B. Study of liver cirrhosis over twenty consecutive years in adults in Southern China. World J Hepatol 2023; 15:1294-1306. [PMID: 38223413 PMCID: PMC10784809 DOI: 10.4254/wjh.v15.i12.1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Liver cirrhosis (LC) is a prevalent and severe disease in China. The burden of LC is changing with widespread vaccination of hepatitis B virus (HBV) and antiviral therapy. However, the recent transition in etiologies and clinical features of LC cases requiring hospitalization is unclear. AIM To identify the transition in etiologies and clinical characteristics of hospitalized LC patients in Southern China. METHODS In this retrospective, cross-sectional study we included LC inpatients admitted between January 2001 and December 2020. Medical data indicating etiological diagnosis and LC complications, and demographic, laboratory, and imaging data were collected from our hospital-based dataset. The etiologies of LC were mainly determined according to the discharge diagnosis, and upper gastrointestinal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatocellular carcinoma (HCC), portal vein thrombosis, hepatorenal syndrome, and acute-on-chronic liver failure (ACLF) were considered LC-related complications in our study. Changing trends in the etiologies and clinical characteristics were investigated using logistic regression, and temporal trends in proportions of separated years were investigated using the Cochran-Armitage test. In-hospital prognosis and risk factors associated with in-hospital mortality were also investigated. RESULTS A total of 33143 patients were included in the study [mean (SD) age, 51.7 (11.9) years], and 82.2% were males. The mean age of the study population increased from 51.0 years in 2001-2010 to 52.0 years in 2011-2020 (P < 0.001), and the proportion of female patients increased from 16.7% in 2001-2010 to 18.2% in 2011-2020 (P = 0.003). LC patients in the decompensated stage at diagnosis decreased from 68.1% in 2001-2010 to 64.6% in 2011-2020 (P < 0.001), and the median score of model for end-stage liver disease also decreased from 14.0 to 11.0 (P < 0.001). HBV remained the major etiology of LC (75.0%) and the dominant cause of viral hepatitis-LC (94.5%) during the study period. However, the proportion of HBV-LC decreased from 82.4% in 2001-2005 to 74.2% in 2016-2020, and the proportion of viral hepatitis-LC decreased from 85.2% in 2001-2005 to 78.1% in 2016-2020 (both P for trend < 0.001). Meanwhile, the proportions of LC caused by alcoholic liver disease, autoimmune hepatitis and mixed etiology increased by 2.5%, 0.8% and 4.5%, respectively (all P for trend < 0.001). In-hospital mortality was stable at 1.0% in 2011-2020, whereas HCC and ACLF manifested the highest increases in prevalence among all LC complications (35.8% to 41.0% and 5.7% to 12.4%, respectively) and were associated with 6-fold and 4-fold increased risks of mortality (odds ratios: 6.03 and 4.22, respectively). CONCLUSION LC inpatients have experienced changes in age distribution and etiologies of cirrhosis over the last 20 years in Southern China. HCC and ACLF are associated with the highest risk of in-hospital mortality among LC complications.
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Affiliation(s)
- Xing Wang
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Jin-Ni Luo
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Xiao-Ying Wu
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Qi-Xian Zhang
- Patient Case Management Division, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Bin Wu
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China.
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11
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Luo M, Bauman A, Phongsavan P, Ding D. Retirement transition and smoking and drinking behaviors in older Chinese adults: Analysis from the CHARLS study. Prev Med Rep 2023; 36:102408. [PMID: 37744741 PMCID: PMC10511792 DOI: 10.1016/j.pmedr.2023.102408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Smoking and drinking are important public problems and a substantial part of work culture in mainland China. However, little is known about the effect of retirement on these behaviors. Thus, this study examined the relationships between retirement transition, smoking and excessive drinking among older Chinese adults. Methods Repeated longitudinal data from a nationally representative sample of Chinese adults were collected in 2011, 2013, 2015 and 2018. Respondents completed a structured questionnaire regarding work status and health behaviors. Modified mixed-effects Poisson regression models were used to explore the associations, with additional analyses stratified by gender. Results Of the 10,378 participants included, 62.6% and 20.1% of men reported current smoking and excessive drinking at study entry; compared to 4.4% and 1.5% of women, respectively. There was no significant association between retirement and smoking. We found a dose-response relationship between time in retirement and excessive drinking in the adjusted model where those who retired >= 2 years ago had a 30% lower risk of excessive drinking (risk ratio (RR) = 0.70, 95% confidence interval (CI) = 0.56-0.86), and those who retired < 2 years ago had a 16% lower risk of excessive drinking (RR = 0.84, 95%CI = 0.73-0.97), compared with those who remained working. This pattern remained when analyzed separately for men and women, although not all results reached statistical significance. Discussion Chinese older adults are more likely to reduce drinking following retirement. Such evidence supports the positive framing of retirement in public discourse and the need for workplace interventions to address excessive drinking in China.
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Affiliation(s)
- Mengyun Luo
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, People’s Republic of China
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
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12
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Hu A, Zhao X, Room R, Hao W, Xiang X, Jiang H. The effects of alcohol tax policies on alcohol consumption and alcohol use disorders in Mainland of China: an interrupted time series analysis from 1961-2019. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:746-755. [PMID: 38059570 DOI: 10.1080/00952990.2023.2280948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023]
Abstract
Background: Overwhelming evidence suggests that increasing alcohol taxes is an effective strategy for curbing alcohol consumption. However, research on the effects of such strategies in low- and middle-income nations is limited.Objective: The aim is to explore the temporal effect of alcohol tax policy in China.Methods: We employ interrupted time series analysis to investigate the temporal effects of tax policy changes on alcohol consumption and related consequences in Mainland China from 1961 to 2019. The study population, the total population of mainland region of China, aged more than 15 years.Results: The results show that the volume tax policy, which was announced in 2000 and implemented in 2001, led to an immediate reduction in the alcohol consumption (coefficient = -0.429, p < .001). Following the implementation of higher alcohol taxes in 1998 and 2001, the prevalence of alcohol use disorders (AUDs) and related years lived with disability (YLDs) gradually decreased. The relaxation of tax policy in 2006 led to a significant increase in alcohol consumption, both immediately (coefficient = 0.406, p < .001) and in the middle term (coefficient = 0.495, p < .001), as well as contribute to an immediate or medium term significant increase in the prevalence of AUDs (coefficient = 0.038, p = .010; coefficient = 0.032, p < .001) and YLDs (coefficient = 4.363, p = .001; coefficient = 4.226, p < .001).Conclusion: This study demonstrates that changes in alcohol consumption and related consequences (increase or decrease) have followed corresponding changes in alcohol tax policies (easing or tightening), indicating that increasing alcohol taxes can be an effective strategy in China for controlling alcohol consumption and related harms.
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Affiliation(s)
- Aqian Hu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoxi Zhao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Robin Room
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Wei Hao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaojun Xiang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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13
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Shen G, Yang S, Wu L, Chen Y, Hu Y, Zhou F, Wang W, Liu P, Wu F, Liu Y, Wang F, Chen L. The oxytocin receptor rs2254298 polymorphism and alcohol withdrawal symptoms: a gene-environment interaction in mood disorders. Front Psychiatry 2023; 14:1085429. [PMID: 37520225 PMCID: PMC10380931 DOI: 10.3389/fpsyt.2023.1085429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 07/04/2023] [Indexed: 08/01/2023] Open
Abstract
Objective Alcohol use disorder (AUD) is a common mental disorder characterized by repeated withdrawal episodes. Negative emotions during withdrawal are the primary factors affecting successful abstinence. Oxytocin is a critical modulator of emotions. OXTR, the oxytocin receptor, may also be a promising candidate for treating alcohol withdrawal symptoms. Previous studies indicated that people with different genotypes of OXTR rs2254298 were reported to suffer from more significant depressive or heightened anxiety symptoms when experiencing early adversity. The present study aims to explore the modulatory role of the polymorphism OXTR rs2254298 on mood disorders during alcohol withdrawal and to help researchers better understand and develop effective relapse prevention and interventions for alcohol use disorders. Methods We recruited 265 adult Chinese Han men with AUD. Anxiety and depressive symptoms were measured using the Self-Rating Anxiety Scale and Self-Rating Depression Scale. Alcohol dependence levels were measured using Michigan Alcoholism Screening Test. Genomic DNA extraction and genotyping from participants' peripheral blood samples. Result First, a multiple linear regression was used to set the alcohol dependence level, OXTR.rs2254298, interaction terms as the primary predictor variable, and depression or anxiety as an outcome; age and educational years were covariates. There was a significant interaction between OXTR rs2254298 and alcohol dependence level on anxiety (B = 0.23, 95% confidence interval [CI]: 0.01-0.45) but not on depression (B = -0.06, 95% CI: -0.30 - 0.18). The significance region test showed that alcohol-dependent men who are GG homozygous were more likely to experience anxiety symptoms than subjects with the A allele (A allele: β = 0.27, p < 0.001; GG homozygote: β = 0.50, p < 0.001). Finally, re-parameterized regression analysis demonstrated that this gene-environment interaction of OXTR rs2254298 and alcohol dependence on anxiety fits the weak differential susceptibility model (R2 = 0.17, F (5,259) = 13.46, p < 0.001). Conclusion This study reveals a gene-environment interactive effect between OXTR rs2254298 and alcohol withdrawal on anxiety but not depression. From the perspective of gene-environment interactions, this interaction fits the differential susceptibility model; OXTR rs2254298 GG homozygote carriers are susceptible to the environment and are likely to experience anxiety symptoms of alcohol withdrawal.
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Affiliation(s)
- Guanghui Shen
- Wenzhou Seventh People’s Hospital, Wenzhou, China
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shizhuo Yang
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
| | - Liujun Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Applied Psychology (Ningbo) Research Center, Wenzhou Medical University, Ningbo, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Yingjie Chen
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Yueling Hu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Fan Zhou
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wei Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Peining Liu
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fenzan Wu
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
- Laboratory of Translational Medicine, Affiliated Cixi Hospital, Wenzhou Medical University, Ningbo, China
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
- Key Laboratory of Psychosomatic Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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14
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A Thermodynamic and Kinetic Study on Electrochemical Esterification in Aroma-Enhanced Distilled Liquor (Baijiu). Catalysts 2023. [DOI: 10.3390/catal13030478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
The development of low-alcohol Baijiu is consistent with demand for the industry’s sustainable development. However, the ester aroma of low-alcohol Baijiu is insipid and unstable—mainly due to the hydrolysis of esters during shelf life—thus reducing the industry scale of low-alcohol Baijiu to a significantly small range. An electrochemical method for improving low-alcohol Baijiu’s ester concentration and stability was investigated from the aspects of thermodynamics and kinetics. The key finding is that the new Baijiu’s ester content obtained through distillation is relatively high, exceeding its content in the thermodynamic equilibrium state. Thus, the ester will be hydrolyzed during shelf life. The idea of applying electrochemical catalytic esterification technology to the production of low-alcohol Baijiu in this study is directly derived from the production practice of Baijiu factories; it provides a direction for the further optimization of low-alcohol Baijiu to facilitate the production of an alternative product that will contribute to public health.
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