Background and aim: Hepatitis C virus infection can lead to an enormous health burden worldwide. Investigating the changes in HCV-related burden between different countries could provide inferences for disease management. Hence, we aim to explore the temporal tendency of the disease burden associated with HCV infection in China, India, the United States, and the world.Methods: Detailed data on the total burden of disease related to HCV infection were collected from the Global Burden of Disease (GBD) 2019 database. Joinpoint regression models were used to simulate the optimal joinpoints of annual percent changes (APCs). Further analysis of the age composition of each index over time and the relationship between ASRs and the socio-demographic Index (SDI) were explored. Finally, three factors (population growth, population aging, and age-specific changes) were deconstructed for the changes in the number of incidences, deaths, and DALYs.Results: It was estimated that 6.2 million new HCV infections, 0.54 million HCV-related deaths, and 15.3 million DALYs worldwide in 2019, with an increase of 25.4, 59.1, and 43.6%, respectively, from 1990, are mainly due to population growth and aging. China experienced a sharp drop in age-standardized rates in 2019, the United States showed an upward trend, and India exhibited a fluctuating tendency in the burden of disease. The incidence was increasing in all locations recently.Conclusion: HCV remains a global health concern despite tremendous progress being made. The disease burden in China improved significantly, while the burden in the United States was deteriorating, with new infections increasing recently, suggesting more targeted interventions to be established to realize the 2030 elimination goals.

Obesity is a serious ongoing health problem that significantly increases the incidence of nonalcoholic fatty liver disease (NAFLD). During obesity, adipose tissue dysfunction is obvious and characterized by increased fat deposition (adiposity) and chronic low-grade inflammation. The latter has been implicated to critically promote the development and progression of NAFLD, whose advanced form non-alcoholic steatohepatitis (NASH) is considered one of the most common causes of terminal liver diseases. This review summarizes the current knowledge on obesity-related adipose dysfunction and its roles in the pathogenesis of hepatic steatosis and inflammation, as well as liver fibrosis. A better understanding of the crosstalk between adipose tissue and liver under obesity is essential for the development of new and improved preventive and/or therapeutic approaches for managing NAFLD.

Hepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China. In this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D. Nine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = − 0.134; 2000–4999 RMB, β = − 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = − 0.090), disease profile (cirrhosis, β = − 0.114), hyperlipidemia (β = − 0.065) and depression (β = − 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = − 0.129; 2000–4999 RMB, β = − 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = − 0.091), disease profile and depression (β = − 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D. In this cross-sectional assessment of HCV patients in China, we indicated HRQoL of Chinese HCV patients. Significant negative associations between HRQoL and sociodemographic and clinical factors such as moderate or severe symptoms of discomfort, disease profile and depression emerged. We have to focus on optimally managing care of HCV patients and improving their HRQoL. ClinicalTrials.gov identifier NCT01293279. Date of registration: February 10, 2011.

Background: Health Related Quality of Life (HRQL) is a multi-dimensional construct that can comprehensively evaluate the patient’s health status, including physical, emotional, mental and social well-being. In this study, we aimed to evaluate the impact of non-alcoholic fatty liver disease (NAFLD) on HRQL in a Chinese population. Methods: In this national multicenter cross-sectional survey, patients with NAFLD were enrolled. Chronic Liver Disease Questionnaire (CLDQ)-NAFLD was used to qualify HRQL. Univariate and multivariate analysis were used to identify independent risk factors of HRQL. Results: A total of 5181 patients with NAFLD from 90 centers were enrolled in this study (mean age, 43.8 ± 13.3 years; male, 65.8%). The overall CLDQ score was 5.66 ± 0.89. Multivariate logistic regression analysis showed that body mass index (BMI: HR, 1.642; 95% CI, 1.330–2.026), alanine transaminase (ALT: HR, 1.006; 95% CI, 1.001–1.011), triglyceride (HR, 1.184; 95% CI, 1.074–1.305), disease severity (HR, 3.203; 95% CI, 1.418–7.232) and cardiovascular disease (HR, 4.305; 95% CI, 2.074–8.939) were independent risk factors for overall CLDQ score. In the logistic analyses of individual domain, BMI and triglyceride were independent risk factors of all domains. ALT, disease severity, diabetes, depression and cardiovascular disease were influencing factors for the CLDQ score of several domains. Conclusions: This national multicenter cross-sectional survey in China indicated that the HRQL in patients with NAFLD was impaired. HRQL was found to be significantly associated with sociodemographic and clinical factors. Attention should be paid to the optimally managing care of patients with NAFLD to improve their HRQL.

Background. This study is aimed at investigating the systemic risk factors of diabetic retinopathy and further establishing a risk prediction model for DR development in T2DM patients. Methods. This is a retrospective cohort study including 330 type 2 diabetes mellitus (T2DM) patients who were followed up from December 2012 to November 2020. Multivariable cox regression analysis identifying factors associated with the hazard of developing diabetic retinopathy (DR) was used to construct the DR risk prediction model in the form of nomogram. Results. 50.6% of participants (mean age: ) were female, and mean duration of diabetes was . After multivariate cox regression, the risk factors for developing DR were age (HR 1.068, 95%Cl 1.021-1.118, ), diabetes duration (HR 1.094, 95%Cl 1.018-1.177, ), HbA1c (HR 1.411, 95%Cl 1.113-1.788, ), albuminuria (HR 6.908, 95%Cl 1.794-26.599, ), and triglyceride (HR 1.554, 95%Cl 1.037-2.330, ). The AUC values of the nomogram for predicting developing DR at 3-, 4-, and 5-year were 0.854, 0.845, and 0.798. Conclusion. Combining age, diabetes duration, HbA1c, albuminuria, and triglyceride, the nomogram model is effective for early recognition and intervention of individuals at high risk of DR development.

Background and Aim In China, chronic hepatitis C virus (HCV) infection represents a considerable healthcare burden. Although interferon‐based therapy has been the standard‐of‐care for many years, few long‐term, real‐life studies have assessed interferon‐based treatment in China. The objective of CCgenos follow‐up study was to analyze long‐term treatment patterns and outcomes in a cohort of treatment‐naïve, Han ethnic, patients with chronic HCV infection. Methods Patients who had participated in the CCgenos cross‐sectional study were invited to enter this 5‐year follow up. Clinical information and centralized HCV‐RNA measures were collected at scheduled study visits every 6 months for untreated patients and every 3 months for treated patients. Results Among 512 patients enrolled, 334 (65.2%) received interferon‐based treatment and 178 (34.8%) remained untreated over a median of 4.1 (1.2–4.3) years. A total of 82.8% (424/512) of patients had an IL28B CC genotype (GT); 60.7% (311/512) had HCV GT1b infection, including 121 (38.9%) untreated. Most patients with baseline cirrhosis were untreated (26/46, 56.5%). Among patients who completed treatment and 24 weeks of post‐treatment follow up, the duration of interferon‐based therapy was frequently longer than recommended (52.9% [92/174] of GT1b‐infected were treated for > 1 year). Rates of sustained virologic response (SVR24) were 71.1% (226/318) overall; 62.4% (111/178) among patients with HCV GT1b infection; and 42.9% (15/35) among patients with cirrhosis. Conclusions There remains a high unmet need for effective HCV treatment in China, evidenced by a high proportion of patients remaining untreated by the current standard‐of‐care and relatively low SVR24 rates for patients with both GT1b infection and cirrhosis.