{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T06:38:28Z","timestamp":1793860708817,"version":"4.6.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Department of Science and Technology of Hunan Province","award":["2021SK2032"],"award-info":[{"award-number":["2021SK2032"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"DOI":"10.1186\/s12876-025-04264-5","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T08:17:52Z","timestamp":1758269872000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Global burden of cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2021"],"prefix":"10.1186","volume":"25","author":[{"given":"Ying","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzi","family":"Ming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"issue":"1","key":"4264_CR1","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1186\/s12889-024-17948-6","volume":"24","author":"XN Wu","year":"2024","unstructured":"Wu XN, et al. Global burden of liver cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2019. BMC Public Health. 2024;24(1):363.","journal-title":"BMC Public Health"},{"issue":"10127","key":"4264_CR2","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1016\/S0140-6736(18)30010-2","volume":"391","author":"A Forner","year":"2018","unstructured":"Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet. 2018;391(10127):1301\u201314.","journal-title":"Lancet"},{"issue":"1","key":"4264_CR3","doi-asserted-by":"publisher","first-page":"2328521","DOI":"10.1080\/07853890.2024.2328521","volume":"56","author":"Y Wang","year":"2024","unstructured":"Wang Y, et al. Global burden of liver cirrhosis 1990\u20132019 and 20 years forecast: results from the global burden of disease study 2019. Ann Med. 2024;56(1):2328521.","journal-title":"Ann Med"},{"issue":"1","key":"4264_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12072-015-9675-4","volume":"10","author":"SK Sarin","year":"2016","unstructured":"Sarin SK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2016;10(1):1\u201398.","journal-title":"Hepatol Int"},{"issue":"1","key":"4264_CR5","doi-asserted-by":"publisher","first-page":"5025","DOI":"10.1038\/s41598-022-09030-1","volume":"12","author":"G Malaguarnera","year":"2022","unstructured":"Malaguarnera G, et al. Serum folate deficiency in HCV related hepatocellular carcinoma. Sci Rep. 2022;12(1):5025.","journal-title":"Sci Rep"},{"key":"4264_CR6","doi-asserted-by":"publisher","first-page":"9954","DOI":"10.1038\/srep09954","volume":"5","author":"CS Hsu","year":"2015","unstructured":"Hsu CS, et al. Systematic review: impact of interferon-based therapy on HCV-related hepatocellular carcinoma. Sci Rep. 2015;5:9954.","journal-title":"Sci Rep"},{"issue":"1","key":"4264_CR7","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1038\/nrgastro.2017.109","volume":"15","author":"Z Younossi","year":"2018","unstructured":"Younossi Z, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15(1):11\u201320.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"6","key":"4264_CR8","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1016\/j.jhep.2024.06.036","volume":"81","author":"D Marti-Aguado","year":"2024","unstructured":"Marti-Aguado D, et al. Low-to-moderate alcohol consumption is associated with increased fibrosis in individuals with metabolic dysfunction-associated steatotic liver disease. J Hepatol. 2024;81(6):930\u201340.","journal-title":"J Hepatol"},{"issue":"4","key":"4264_CR9","doi-asserted-by":"publisher","first-page":"773","DOI":"10.3350\/cmh.2021.0383","volume":"28","author":"HS Shin","year":"2022","unstructured":"Shin HS, Jun BG, Yi SW. Impact of diabetes, obesity, and dyslipidemia on the risk of hepatocellular carcinoma in patients with chronic liver diseases. Clin Mol Hepatol. 2022;28(4):773\u201389.","journal-title":"Clin Mol Hepatol"},{"issue":"3","key":"4264_CR10","doi-asserted-by":"publisher","first-page":"e70001","DOI":"10.1111\/liv.70001","volume":"45","author":"EKJ Tham","year":"2025","unstructured":"Tham EKJ, et al. The global burden of cirrhosis and other chronic liver diseases in 2021. Liver Int. 2025;45(3):e70001.","journal-title":"Liver Int"},{"issue":"1","key":"4264_CR11","doi-asserted-by":"publisher","first-page":"7083","DOI":"10.1038\/s41598-025-91312-5","volume":"15","author":"Z Guo","year":"2025","unstructured":"Guo Z, et al. Global burden of MAFLD, MAFLD related cirrhosis and MASH related liver cancer from 1990 to 2021. Sci Rep. 2025;15(1):7083.","journal-title":"Sci Rep"},{"issue":"12 Suppl 2","key":"4264_CR12","doi-asserted-by":"publisher","first-page":"S343","DOI":"10.1093\/infdis\/jiaa668","volume":"224","author":"J Pattyn","year":"2021","unstructured":"Pattyn J, et al. Hepatitis B vaccines. J Infect Dis. 2021;224(12 Suppl 2):S343\u201351.","journal-title":"J Infect Dis"},{"issue":"4","key":"4264_CR13","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/j.cgh.2022.05.020","volume":"21","author":"HS Kim","year":"2023","unstructured":"Kim HS, et al. Admixture mapping in african americans identifies new risk loci for HCV-related cirrhosis. Clin Gastroenterol Hepatol. 2023;21(4):1023-1030 e39.","journal-title":"Clin Gastroenterol Hepatol."},{"key":"4264_CR14","doi-asserted-by":"crossref","unstructured":"Russo FP, Zanetto A, Pinto E, et al. Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?. Int J Mol Sci. 2022;23(1):500.","DOI":"10.3390\/ijms23010500"},{"issue":"11","key":"4264_CR15","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1038\/nrgastro.2016.138","volume":"13","author":"JP Allain","year":"2016","unstructured":"Allain JP, Opare-Sem O. Screening and diagnosis of HBV in low-income and middle-income countries. Nat Rev Gastroenterol Hepatol. 2016;13(11):643\u201353.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"3","key":"4264_CR16","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1016\/j.jhep.2016.10.013","volume":"66","author":"M Lemoine","year":"2017","unstructured":"Lemoine M, Thursz MR. Battlefield against hepatitis B infection and HCC in Africa. J Hepatol. 2017;66(3):645\u201354.","journal-title":"J Hepatol"},{"issue":"4","key":"4264_CR17","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1111\/liv.14744","volume":"41","author":"B Surial","year":"2021","unstructured":"Surial B, et al. Prevalence of liver cirrhosis in individuals with hepatitis B virus infection in sub-Saharan Africa: systematic review and meta-analysis. Liver Int. 2021;41(4):710\u20139.","journal-title":"Liver Int"},{"issue":"2","key":"4264_CR18","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1038\/s41575-022-00717-4","volume":"20","author":"MV Machado","year":"2023","unstructured":"Machado MV, Cortez-Pinto H. NAFLD, MAFLD and obesity: brothers in arms? Nat Rev Gastroenterol Hepatol. 2023;20(2):67\u20138.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"4264_CR19","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.metabol.2018.11.014","volume":"92","author":"SA Polyzos","year":"2019","unstructured":"Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: from pathophysiology to therapeutics. Metabolism. 2019;92:82\u201397.","journal-title":"Metabolism"},{"issue":"2","key":"4264_CR20","doi-asserted-by":"publisher","first-page":"235","DOI":"10.3350\/cmh.2023.0485","volume":"30","author":"MH Le","year":"2024","unstructured":"Le MH, et al. Global incidence of adverse clinical events in non-alcoholic fatty liver disease: a systematic review and meta-analysis. Clin Mol Hepatol. 2024;30(2):235\u201346.","journal-title":"Clin Mol Hepatol"},{"issue":"4","key":"4264_CR21","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1016\/j.jhep.2017.05.016","volume":"67","author":"M Romero-Gomez","year":"2017","unstructured":"Romero-Gomez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol. 2017;67(4):829\u201346.","journal-title":"J Hepatol"},{"key":"4264_CR22","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.metabol.2016.12.006","volume":"68","author":"CN Katsagoni","year":"2017","unstructured":"Katsagoni CN, et al. Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: a meta-analysis. Metabolism. 2017;68:119\u201332.","journal-title":"Metabolism"},{"issue":"3","key":"4264_CR23","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.jhep.2024.04.031","volume":"81","author":"European Association for the Study of the, L., D. European Association for the Study of, and O","year":"2024","unstructured":"European Association for the Study of the, L., D. European Association for the Study of, and O. European Association for the Study of, EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024;81(3):492\u2013542.","journal-title":"J Hepatol."},{"issue":"2","key":"4264_CR24","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1016\/j.jhep.2025.03.018","volume":"83","author":"European Association for the Study of the, L","year":"2025","unstructured":"European Association for the Study of the, L. EASL Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2025;83(2):502\u201383.","journal-title":"J Hepatol."},{"issue":"1","key":"4264_CR25","doi-asserted-by":"publisher","first-page":"94","DOI":"10.3350\/cmh.2020.0305","volume":"27","author":"M Tonon","year":"2021","unstructured":"Tonon M, Piano S. Alcohol-related cirrhosis: the most challenging etiology of cirrhosis is more burdensome than ever. Clin Mol Hepatol. 2021;27(1):94\u20136.","journal-title":"Clin Mol Hepatol"},{"issue":"2","key":"4264_CR26","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/S2468-1253(19)30342-5","volume":"5","author":"SK Sarin","year":"2020","unstructured":"Sarin SK, et al. Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol. 2020;5(2):167\u2013228.","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"7","key":"4264_CR27","doi-asserted-by":"publisher","first-page":"e2326346","DOI":"10.1001\/jamanetworkopen.2023.26346","volume":"6","author":"IM Karaye","year":"2023","unstructured":"Karaye IM, et al. Trends in alcohol-related deaths by sex in the US, 1999\u20132020. JAMA Netw Open. 2023;6(7):e2326346.","journal-title":"JAMA Netw Open"},{"issue":"9","key":"4264_CR28","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","volume":"7","author":"K Riazi","year":"2022","unstructured":"Riazi K, et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022;7(9):851\u201361.","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"8","key":"4264_CR29","doi-asserted-by":"publisher","first-page":"e568","DOI":"10.1016\/S2214-109X(16)30101-2","volume":"4","author":"S Nayagam","year":"2016","unstructured":"Nayagam S, et al. Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis. Lancet Glob Health. 2016;4(8):e568\u201378.","journal-title":"Lancet Glob Health"},{"issue":"10","key":"4264_CR30","doi-asserted-by":"publisher","first-page":"2356","DOI":"10.1111\/liv.14550","volume":"40","author":"JG Walker","year":"2020","unstructured":"Walker JG, et al. Cost and cost-effectiveness of a simplified treatment model with direct-acting antivirals for chronic hepatitis C in Cambodia. Liver Int. 2020;40(10):2356\u201366.","journal-title":"Liver Int"},{"issue":"1","key":"4264_CR31","doi-asserted-by":"publisher","first-page":"4089","DOI":"10.1038\/s41598-020-60986-4","volume":"10","author":"Y Zhuo","year":"2020","unstructured":"Zhuo Y, et al. Estimating the price at which hepatitis C treatment with direct-acting antivirals would be cost-saving in Japan. Sci Rep. 2020;10(1):4089.","journal-title":"Sci Rep"},{"issue":"45","key":"4264_CR32","doi-asserted-by":"publisher","first-page":"8301","DOI":"10.3748\/wjg.v19.i45.8301","volume":"19","author":"SK Reddy","year":"2013","unstructured":"Reddy SK. Nonalcoholic fatty liver disease is associated with benign gastrointestinal disorders. World J Gastroenterol. 2013;19(45):8301\u201311.","journal-title":"World J Gastroenterol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-04264-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-025-04264-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-04264-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T13:35:32Z","timestamp":1759757732000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-025-04264-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,19]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4264"],"URL":"https:\/\/doi.org\/10.1186\/s12876-025-04264-5","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,19]]},"assertion":[{"value":"15 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2025","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original publication was updated to replace several supplemental figures that were unable to be opened.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"641"}}