ArticleFrontiers in public health2026
Trends in the global burden of anemia associated with liver cirrhosis: an assessment from 1990 to 2021 and projections to 2045.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: As a major global health challenge, liver cirrhosis is accompanied by anemia that correlates closely with increased mortality. This study comprehensively assesses the burden of anemia associated with liver cirrhosis across global, regional, and demographic dimensions. Methods: Using Global Burden of Disease 2021 data, prevalence and years lived with disability (YLDs) of anemia associated with liver cirrhosis were analyzed globally, across five sociodemographic index (SDI) regions, and 21 geographical areas. Analyses were stratified by age, sex, and SDI. Joinpoint regression estimated average annual percentage changes (AAPC). Decomposition analysis identified drivers of burden trends, and the Nordpred model projected future trends to 2045. Results: In 2021, there were 644,273 (95% UI: 558,176-740,430) global cases of anemia associated with liver cirrhosis, marking a 26.02% rise from 1990. Meanwhile, YLDs reached 21,046 (13,156-30,926), corresponding to an 8.04% increase. However, age-standardized prevalence and YLDs rates declined significantly (AAPC: -0.82% and -1.08%). The greatest increases in absolute burden occurred in low SDI regions. Prevalence peaked in the 90-95 age group for both sexes. Decomposition revealed population growth (171.48%) as the primary driver of increased prevalence, while epidemiological changes (-112.36%) reduced rates. Projections to 2045 indicate continued declines in age-standardized rates but persistently high absolute burden due to population growth. Conclusion: Despite overall declines in age-standardized burden, the absolute prevalence and YLDs of anemia associated with liver cirrhosis are expected to rise. Continued focus on high-risk groups and region-specific prevention strategies is needed.
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