Objective  To examine the temporal trends in the burden of CIrrhosis among residents of Guangdong province from 1990 to 2019, thereby providing data support and evidence for the development of targeted prevention strategies and effective intervention measures for CIrrhosis.

Methods  Data on the burden of CIrrhosis among residents of Guangdong province from 1990 to 2019 were obtained from the 2019 Global Burden of Disease (GBD 2019) study. The age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), age-standardized disability- adjusted life years (DALY) rate, and estimated annual percentage change (EAPC) were calculated to analyze trends in the burden of CIrrhosis and its five etiologies over the study period. EAPC, a measure of the average annual rate of change, was used to assess trends over time.

Results  The ASPR, ASMR, and age-standardized DALY rate of CIrrhosis (all per 100 000 population) among residents decreased from 28 849.8, 21.7, and 637.5 in 1990 to 23 440.3, 6.2, and 173.9 in 2019, with EAPCs of -0.88% (95%CI confidence interval 95%CI: -1.13% to -0.63%), -4.65% (95%CI: -5.20% to -4.10%), and -4.80% (95%CI: -5.34% to -4.25%), respectively, showing a decreasing trend over the period. The ASPR, ASMR, and age-standardized DALY rate of CIrrhosis attributable to viral hepatitis B and C decreased from 14 094.1 and 2 217.4, 8.2 and 5.4, and 242.4 and 163.6, respectively, in 1990 to 7 450.2 and 1 074.6, 1.7 and 1.9, and 47.6 and 53.8, respectively, in 2019, with EAPCs of -2.39% (95%CI: -2.55% to -2.23%) and -3.39% (95%CI: -4.56% to -2.20%), -5.77% (95%CI: -6.62% to -4.91%) and -3.97% (95%CI: -4.43% to -3.51%), and -5.84% (95%CI: -6.66% to -5.01%) and -4.13% (95%CI: -4.58% to -3.68%), respectively, showing a decreasing trend over the period. For CIrrhosis attributable to nonalcoholic fatty liver disease, the ASPR increased from 12 318.3 in 1990 to 14 709.2 in 2019, with an EAPC of 0.57% (95%CI: 0.20% to 0.95%), while both the ASMR and the age-standardized DALY rate decreased from 1.7 and 42.9 in 1990 to 0.6 and 14.1 in 2019, respectively, with EAPCs of -4.04% (95%CI: -4.44% to -3.63%) and -4.27% (95%CI: -4.67% to -3.89%). For CIrrhosis attributable to alcohol-related liver disease, the ASPR increased slightly from 111.4 in 1990 to 114.9 in 2019, but the difference was not statistically significant, with an EAPC of 0.12% (95%CI: -0.09% to 0.33%); the ASMR and the age-standardized DALY rate decreased from 3.6 and 106.8 in 1990 to 1.2 and 34.7 in 2019, respectively, both showing decreasing trends, with EAPCs of -4.09% (95%CI: -4.53% to -3.65%) and -4.22% (95%CI: -4.65% to -3.79%), respectively. For cirrhosis caused by other causes, The ASPR, ASMR and age-standardized DALY rate among residents decreased from 108.7, 2.8 and 81.7 in 1990 to 91.4, 0.9 and 23.8 in 2019, with EAPCs of -0.74% (95%CI: -0.93 % to -0.55 %), -4.44% ( 95%CI: -4.85 to -4.03), and -4.69% (95%CI: -5.10 to -4.29). The ASPR, ASMR, and age-standardized DALY rate of CIrrhosis for male residents were all higher than those for female residents in both 1990 and 2019. From 1990 to 2019, the ASMR and age-standardized DALY rate of CIrrhosis showed a decreasing trend for both male and female residents. In terms of age group, the prevalence, mortality, and DALY rate of CIrrhosis all increased with age, but the prevalence of CIrrhosis decreased in residents younger than 30 years, while the mortality and DALY rate decreased across all age groups.

Conclusions  The overall burden of CIrrhosis among residents of Guangdong province showed a significant decreasing trend from 1990 to 2019, while the ASPR of CIrrhosis caused by nonalcoholic fatty liver disease exhibited a notable increase. Men and the elderly remained high-risk groups with a disproportionately higher burden of CIrrhosis.