{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:00:15Z","timestamp":1793466015451,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Alcohol\u2010associated liver disease (ALD) is a general term for liver diseases caused by long\u2010term and excessive alcohol consumption, which poses a serious threat to human health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The data were collected from the estimates of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) in 2021. We focused on the impacts of age, gender, risk factors and the socio\u2010demographic index (SDI). Additionally, the trends in the prevalence, deaths, and Disability\u2010Adjusted Life Years (DALYs) of ALD from 1990 to 2021 were calculated through the Estimated Annual Percentage Change (EAPC). The Norepred model was employed to predict the prevalence and deaths of ALD by gender until 2046.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1990 to 2021, the prevalence and deaths of ALD increased. In 2021, the prevalence, deaths, and DALYs of ALD were higher among men aged over 55. The age\u2010standardised prevalence rate (ASPR) of liver cancer due to alcohol use was positively correlated with the SDI, while the age\u2010standardised mortality (ASMR) and age\u2010standardised DALYs rate (ASDR) of cirrhosis due to alcohol were negatively correlated with the SDI. The highest disease burden of ALD was observed in Eastern Europe and Central Asia. The prevalence and deaths increased significantly from 1990 to 2021 and are projected to continue increasing until 2046. A high body mass index (BMI) and smoking are major risk factors for ALD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ALD poses a significant global health burden, which is particularly pronounced among the elderly over 55\u2009years old. A high BMI and smoking are key risk factors for ALD\u2010related deaths.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70283","type":"journal-article","created":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T08:17:17Z","timestamp":1755937037000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Global Burden of Alcohol\u2010Associated Liver Disease Across 204 Countries, 1990\u20132021: GBD 2021 Findings"],"prefix":"10.1111","volume":"45","author":[{"given":"Yubo","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of China Medical University  Shenyang China"},{"name":"108K Class 84, the First Clinical College China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Medical Basic Experimental Teaching Center China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Basic Experimental Teaching Center China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Liaoning Health Industry Group Bengang General Hospital, the Fifth Clinical College Of China Medical University  Benxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyu","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Allergy The Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7782-0731","authenticated-orcid":false,"given":"Lixuan","family":"Sang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quansheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Allergy The Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,23]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31583"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24043735"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.10.041"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-023-04166-8"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01374-X"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2022.05.015"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2018.09.013"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21551"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30010-2"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu020"},{"key":"e_1_2_14_13_1","volume-title":"Public Health Successes and Missed Opportunities. 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