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Ait Hssain A, Vahedian-Azimi A, Schmidt M, Saif Ibrahim A, Ramanathan K, Fawzy Hassan I, Sahebkar A. Epidemiology and outcomes of patients with tuberculosis requiring extracorporeal membrane oxygenation: An ELSO registry analysis. Intensive Crit Care Nurs 2024; 86:103841. [PMID: 39378527 DOI: 10.1016/j.iccn.2024.103841] [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: 06/30/2024] [Revised: 08/16/2024] [Accepted: 09/10/2024] [Indexed: 10/10/2024]
Abstract
PURPOSE This study aimed to analyze data from the Extracorporeal Life Support Organization (ELSO) registry to elucidate the epidemiology and outcomes of patients with tuberculosis necessitating extracorporeal membrane oxygenation (ECMO), an intervention typically employed in treating severe acute respiratory distress syndrome (ARDS), but infrequently reported in tuberculosis contexts. METHODS A retrospective analysis was conducted utilizing the ELSO registry data spanning from 2003 to 2022, specifically targeting patients with tuberculosis who underwent ECMO. Primary outcomes included survival to hospital discharge, while secondary outcomes encompassed pre-ECMO support, ECMO duration, complications, and discharge destinations. Univariate and multivariate Cox proportional hazard regression analyses were employed to identify factors influencing survival rates. RESULTS The analysis included 169 patients with tuberculosis, with a median ECMO support duration of 233 h. The weaning success rate was recorded at 62.7 %, and 55 % of patients achieved survival to hospital discharge. Complications arose in 69.8 % of cases, predominantly mechanical complications (46.6 %). Multivariate Cox regression analysis identified complications (HR: 0.448, 95 % CI: 0.222-0.748, P=0.001), infections (HR: 0.483, 95 % CI: 0.241-0.808, P=0.001), and prolonged intervals from admission to ECMO initiation (HR: 0.698, 95 % CI: 0.396-0.901, P=0.018) as significant factors correlated with decreased survival likelihood. CONCLUSION ECMO presents as a viable treatment option for patients with tuberculosis; however, timely initiation and meticulous management are critical to mitigate complications and enhance patient outcomes. IMPLICATION FOR CLINICAL PRACTICE Accurate identification of optimal ECMO initiation timing for eligible patients with tuberculosis can significantly enhance clinical outcomes in critical care settings, such as intensive care units.
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Affiliation(s)
- Ali Ait Hssain
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar; Department of Medicine, Weill Cornell Medical College, Doha, Qatar; College of Health and Life Science, Hamad Bin Khalifa University, Doha, Qatar
| | - Amir Vahedian-Azimi
- Nursing Care Research Center, Clinical Sciences Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Matthieu Schmidt
- Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris-Université Pierre et Marie Curie, Paris 6, France
| | - Abdulsalam Saif Ibrahim
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar; Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Kollengode Ramanathan
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Cardiothoracic Intensive Care Unit, National University Heart Centre, National University Hospital, National University Health System, Singapore
| | - Ibrahim Fawzy Hassan
- Medical Intensive Care Unit, Hamad General Hospital, Doha, Qatar; Department of Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Amirhossein Sahebkar
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Dormechele W, Bonsu EO, Boadi C, Adams MO, Hlormenu BA, Addo SK, Bossman BB, Addo IY. Determinants of intention to conceal tuberculosis status among family members: an analysis of seven Sub-Saharan African countries. BMC Infect Dis 2024; 24:175. [PMID: 38331730 PMCID: PMC10854020 DOI: 10.1186/s12879-024-09064-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/27/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a significant public health burden in Sub-Saharan Africa (SSA), accounting for about 25% of global TB cases. In several communities, TB diagnosis, treatment, and control have become a critical challenge, largely due to the intention to conceal TB status among family members. It is therefore crucial to understand the factors associated with the intentions to conceal TB status among family members in SSA. METHODS This quantitative study utilised data from the most recent Demographic and Health Surveys (DHS). The objective was to examine the factors associated with the intention to conceal the TB status of family members. The sample consisted of 58,849 individuals aged 10 years or older from seven SSA countries. Binary logistic regression was employed to assess the associations between TB status concealment and various socio-demographic and economic variables. RESULTS The overall prevalence of TB status concealment intentions for the seven countries was 28.0% (95% CI: 27.6-28.4). Malawi and Eswatini accounted for the highest (47.3%) and lowest (3.0%) prevalence of TB concealment intentions respectively. TB status concealment intentions decreased with increasing age (p < 0.001). Living in rural areas was associated with lower odds of intending to conceal the TB of family members compared to living in urban areas (aOR = 0.92; p = 0.008). Higher education levels were associated with lower odds of TB status concealment intentions (aOR = 0.50; p < 0.001) compared to lower education levels. As participants wealth index increased, the odds of TB status concealment intentions decreased (aOR = 0.83; p < 0.001). Country of residence also showed significant associations with individuals in Ghana (aOR = 4.51; p < 0.001), Lesotho (aOR = 2.08; p < 0.001), Malawi (aOR = 4.10; p < 0.001), Namibia (aOR = 4.40; p < 0.001), and Sao-Tome and Principe (aOR = 5.56; p < 0.001) showing higher odds of TB status concealment intentions compared to Eswatini. CONCLUSIONS The findings conclude that several social determinants of health, including age, urbanicity, education, and wealth contribute to TB status concealment intentions for family members. Considering these factors is important for designing targeted interventions to improve TB control in the sample. In light of the unavailability of cultural variables in the dataset, future research can leverage qualitative approaches to conduct a more comprehensive exploration of the cultural factors linked to TB status concealment intentions in the population.
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Affiliation(s)
| | - Emmanuel Osei Bonsu
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Caleb Boadi
- Department of Operations and Management Information Systems, University of Ghana, Accra, Ghana
| | | | | | | | | | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia.
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Rios-Blancas MJ, Pando-Robles V, Razo C, Carcamo CP, Mendoza W, Pacheco-Barrios K, Miranda JJ, Lansingh VC, Demie TG, Saha M, Okonji OC, Yigit A, Cahuana-Hurtado L, Chacón-Uscamaita PR, Bernabe E, Culquichicon C, Chirinos-Caceres JL, Cárdenas R, Alcalde-Rabanal JE, Barrera FJ, Quintanilla BPA, Shorofi SA, Wickramasinghe ND, Ferreira N, Almidani L, Gupta VK, Karimi H, Alayu DS, Benziger CP, Fukumoto T, Mostafavi E, Redwan EMM, Gebrehiwot M, Khatab K, Koyanagi A, Krapp F, Lee S, Noori M, Qattea I, Rosenthal VD, Sakshaug JW, Wagaye B, Zare I, Ortega-Altamirano DV, Murillo-Zamora E, Vervoort D, Silva DAS, Oulhaj A, Herrera-Serna BY, Mehra R, Amir-Behghadami M, Adib N, Cortés S, Dang AK, Nguyen BT, Mokdad AH, Hay SI, Murray CJL, Lozano R, García PJ. Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019. Front Public Health 2023; 11:1189861. [PMID: 37427272 PMCID: PMC10325574 DOI: 10.3389/fpubh.2023.1189861] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/25/2023] [Indexed: 07/11/2023] Open
Abstract
Background Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru's healthcare system performance. Methods Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region. Results The Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8-70.3) to 80.3 (77.2-83.2) years. This increase was driven by the decline in under-5 mortality (-80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5-10.1) and reached 7.5 million (6.1-9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region. Conclusion In the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.
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Affiliation(s)
- Maria Jesus Rios-Blancas
- School of Public Health of Mexico, National Institute of Public Health, Cuernavaca, Mexico
- Carlos Slim Foundation, Mexico City, Mexico
| | - Victoria Pando-Robles
- Infectious Disease Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Christian Razo
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
| | - Cesar P. Carcamo
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
| | - Kevin Pacheco-Barrios
- Spaulding Rehabilitation Hospital, Harvard University, Boston, MA, United States
- Universidad San Ignacio de Loyola (University of Saint Ignatius of Loyola), Lima, Peru
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia (Cayetano Heredia Peruvian University), Lima, Peru
- Department of Medicine, Universidad Peruana Cayetano Heredia (Cayetano Heredia Peruvian University), Lima, Peru
| | - Van Charles Lansingh
- HelpMeSee, New York, NY, United States
- Mexican Institute of Ophthalmology, Queretaro, Mexico
| | - Takele Gezahegn Demie
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Manika Saha
- Department of Humanities and Social Sciences, Deakin University, Melbourne, VIC, Australia
- Department of Human-Centred Computing, Monash University, Melbourne, VIC, Australia
| | | | - Arzu Yigit
- Department of Health Management, Süleyman Demirel Üniversitesi (Süleyman Demirel University), Isparta, Türkiye
| | - Lucero Cahuana-Hurtado
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Pamela R. Chacón-Uscamaita
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Bernabe
- Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, United Kingdom
| | - Carlos Culquichicon
- Universidad Privada Norbert Wiener, Centro de Investigación Epidemiológica en Salud Global, Lima, Peru
| | | | - Rosario Cárdenas
- Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico
| | | | | | | | - Seyed Afshin Shorofi
- Medical-Surgical Nursing, Mazandaran University of Medical Sciences, Sari, Iran
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | | | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Louay Almidani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Doheny Image Reading and Research Lab (DIRRL) - Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Vivek Kumar Gupta
- Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Hanie Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Daniel Shewaye Alayu
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | | | | | - Ebrahim Mostafavi
- Department of Medicine, Stanford University, Palo Alto, CA, United States
- Stanford Cardiovascular Institute, Stanford University, Palo Alto, CA, United States
| | - Elrashdy Moustafa Mohamed Redwan
- Department Biological Sciences, King Abdulaziz University, Jeddah, Egypt
- Department of Protein Research, Research and Academic Institution, Alexandria, Egypt
| | - Mesfin Gebrehiwot
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Khaled Khatab
- Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Fiorella Krapp
- Instituto de Medicina Tropical Alexander von Humboldt (Alexander von Humboldt Institute for Tropical Medicine), Cayetano Heredia University, Lima, Peru
- Doctoral School of Biomedical Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Seung Lee
- Department of Precision Medicine, Sungkyunkwan University, Suwon-si, Republic of Korea
| | - Maryam Noori
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Ibrahim Qattea
- Department of Neonatology, Case Western Reserve University, Cleveland, OH, United States
| | - Victor Daniel Rosenthal
- International Nosocomial Infection Control Consortium, Independent Consultant, Buenos Aires, Argentina
| | - Joseph W. Sakshaug
- Institute for Employment Research, University of Warwick, Coventry, United Kingdom
- Department of Statistics, Ludwig Maximilians University, Munich, Germany
| | - Birhanu Wagaye
- Department of Public Health Nutrition, Wollo University, Dessie, Ethiopia
- Infection Prevention and Control and Water, Sanitation and Hygiene Unit, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Iman Zare
- Research and Development Department, Sina Medical Biochemistry Technologies Co. Ltd., Shiraz, Iran
| | | | - Efrén Murillo-Zamora
- Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Mexico
- Postgraduate in Medical Sciences, Universidad de Colima, Colima, Mexico
| | - Dominique Vervoort
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States
| | | | - Abderrahim Oulhaj
- Department of Epidemiology and Population Health, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Brenda Yuliana Herrera-Serna
- Departamento de Salud Oral (Department of Oral Health), Universidad Autónoma de Manizales (Autonomous University of Manizales), Manizales, Colombia
| | - Rahul Mehra
- Food Science and Technology, Maharishi Markandeshwar (Deemed to be University), Ambala, Haryana, India
| | - Mehrdad Amir-Behghadami
- Road Traffic Injury Research Center, Iranian International Safe Community Support Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Service Management, Iranian Center of Excellence in Health Management, Tabriz, Iran
| | - Nasrin Adib
- Department of Veterinary Pathobiology, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Sandra Cortés
- Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile
- Research Line in Environmental Exposures and Health Effects at Population Level, Centro de Desarrollo Urbano Sustentable (CEDEUS), Advanced Center for Chronic Diseases (ACCDIS), Santiago, Chile
| | - Anh Kim Dang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Binh Thanh Nguyen
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Ali H. Mokdad
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Simon I. Hay
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Christopher J. L. Murray
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Rafael Lozano
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
| | - Patricia J. García
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Ghazy RM, Sallam M, Ashmawy R, Elzorkany AM, Reyad OA, Hamdy NA, Khedr H, Mosallam RA. Catastrophic Costs among Tuberculosis-Affected Households in Egypt: Magnitude, Cost Drivers, and Coping Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032640. [PMID: 36768005 PMCID: PMC9915462 DOI: 10.3390/ijerph20032640] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 05/31/2023]
Abstract
Despite national programs covering the cost of treatment for tuberculosis (TB) in many countries, TB patients still face substantial costs. The end TB strategy, set by the World Health Organization (WHO), calls for "zero" TB households to be affected by catastrophic payments by 2025. This study aimed to measure the catastrophic healthcare payments among TB patients in Egypt, to determine its cost drivers and determinants and to describe the coping strategies. The study utilized an Arabic-validated version of the TB cost tool developed by the WHO for estimating catastrophic healthcare expenditure using the cluster-based sample survey with stratification in seven administrative regions in Alexandria. TB payments were considered catastrophic if the total cost exceeded 20% of the household's annual income. A total of 276 patients were interviewed: 76.4% were males, 50.0% were in the age group 18-35, and 8.3% had multidrug-resistant TB. Using the human capital approach, 17.0% of households encountered catastrophic costs compared to 59.1% when using the output approach. The cost calculation was carried out using the Egyptian pound converted to the United States dollars based on 2021 currency values. Total TB cost was United States dollars (USD) 280.28 ± 29.9 with a total direct cost of USD 103 ± 10.9 and a total indirect cost of USD 194.15 ± 25.5. The direct medical cost was the main cost driver in the pre-diagnosis period (USD 150.23 ± 26.89 pre diagnosis compared to USD 77.25 ± 9.91 post diagnosis, p = 0.013). The indirect costs (costs due to lost productivity) were the main cost driver in the post-diagnosis period (USD 4.68 ± 1.18 pre diagnosis compared to USD 192.84 ± 25.32 post diagnosis, p < 0.001). The households drew on multiple financial strategies to cope with TB costs where 66.7% borrowed and 25.4% sold household property. About two-thirds lost their jobs and another two-thirds lowered their food intake. Being female, delay in diagnosis and being in the intensive phase were significant predictors of catastrophic payment. Catastrophic costs were high among TB households in Alexandria and showed wide variation according to the method used for indirect cost estimation. The main cost driver before diagnosis was the direct medical costs, while it was the indirect costs, post diagnosis.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
| | - Rasha Ashmawy
- Department of Clinical Research, Maamora Chest Hospital, Alexandria 21923, Egypt
| | | | - Omar Ahmed Reyad
- Internal Medicine and Cardiology Clinical Pharmacy Department, Alexandria University Main Hospital, Alexandria 21526, Egypt
| | - Noha Alaa Hamdy
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt
| | - Heba Khedr
- MDR-TB Center, Maamora Chest Hospital, Alexandria 21912, Egypt
| | - Rasha Ali Mosallam
- Department of Health Administration and Behavioral Science, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
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Li Z, Yang N, He L, Wang J, Ping F, Li W, Xu L, Zhang H, Li Y. Estimates and trends of the global burden of NASH-related liver cancer attributable to high fasting plasma glucose in 1990-2019: analysis of data from the 2019 Global Burden of Disease Study. Diabetol Metab Syndr 2023; 15:6. [PMID: 36647090 PMCID: PMC9843876 DOI: 10.1186/s13098-022-00976-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/27/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Experimental and epidemiological studies have indicated an association between diabetes exposure and an increased risk of liver cancer due to nonalcoholic steatohepatitis (NASH). However, to date, no systematic study has specifically investigated the burden of NASH-related liver cancer due to exposure to high fasting plasma glucose (HFPG) levels worldwide. METHODS The number and rate of deaths and disability-adjusted life years (DALYs) from HFPG-induced NASH-related liver cancer were estimated based on the results of the 2019 Global Burden of Disease Study. The estimated annual percentage changes (EAPCs) for age-standardized death or DALYs rates were calculated using a generalized linear model with a Gaussian distribution to quantify the temporal trends in the global burden of NASH-related liver cancer attributable to HFPG. The strength and direction of the association between the sociodemographic index (SDI) and death or DALY rate were measured using Spearman's rank-order correlation. RESULTS Globally, approximately 7.59% of all DALY and 8.76% of all mortalities of NASH-related liver cancer in 2019 were due to HFPG. The age-standardized death and DALY rates of NASH-related liver cancer attributable to HFPG increased from 1990 to 2019. The corresponding EAPCs were 0.69 (95% UI 0.48-0.89), and 0.30 (95% UI 0.05-0.56), respectively. This increasing pattern was most obvious in the high- and low-SDI regions. The age-standardized mortality and DALYs rate of NASH-related liver cancer attributable to HFPG varies considerably worldwide, with the middle SDI region having the highest death and DALY rates in 2019 (DALY 0.96 [95% UI 0.23-2.18]; death 0.05 [95% UI 0.01-0.11]). CONCLUSION The burden of NASH-related liver cancer attributable to HFPG has increased over the past three decades, particularly in regions with high and low SDI.
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Affiliation(s)
- Ziyi Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China
| | - Na Yang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China
| | - Liyun He
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China
| | - Jialu Wang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China
| | - Fan Ping
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China
| | - Wei Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China
| | - Lingling Xu
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China
| | - Huabing Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China.
| | - Yuxiu Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, China.
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