ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1628726
Impact of high fasting plasma glucose on liver cancer burden in China: a comprehensive analysis of trends from 1990 to 2021
Provisionally accepted
Zhouwei Zhan1,2*
Wei Lin1,2Xintong Yao1,2Shuqi Huang1,2Shuangting Lan1,2Lina Zheng1,2
Zengqing Guo1,2
Bijuan Chen1,2- 1Fujian Medical University, Fuzhou, China
- 2Fujian Cancer Hospital, Fuzhou, China
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Background: High fasting plasma glucose (HFPG), a key metabolic risk factor, has emerged as a major contributor to the global cancer burden, particularly liver cancer. However, little is known about the long-term trends and sex-specific patterns of HFPG-attributable liver cancer in China.: Data were obtained from the Global Burden of Disease Study 2021 to estimate the liver cancer burden attributable to HFPG in China from 1990 to 2021. Metrics analyzed included age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Joinpoint regression and decomposition analyses were conducted to evaluate temporal trends and contributing factors. Results: In 2021, 3,467 deaths and 83,113 DALYs were attributable to HFPG-related liver cancer in China, with males bearing a higher burden than females. Mortality and DALYs peaked in individuals aged 65-69, and age-standardized rates rose with advancing age, especially among men. Between 1990 and 2021, the absolute burden increased, driven by population aging and growth, although age-standardized rates remained relatively stable. Joinpoint regression showed fluctuating trends with recent declines in DALYs and YLLs, especially in females.Compared to global trends, China exhibited more stability in age-standardized rates.Decomposition analysis identified aging as the primary driver of increased deaths, while population growth led the rise in DALYs. Epidemiological changes slightly offset DALYs in women but increased the burden in men.Conclusions: Despite stable age-standardized rates, the absolute burden of HFPG-related liver cancer in China has increased due to demographic shifts, with males and older adults disproportionately affected. Targeted interventions addressing metabolic risk factors in aging populations, particularly men, are urgently needed.
Keywords: liver cancer, High fasting plasma glucose, Joinpoint regression analysis, ageperiod-cohort analysis, Burden, Trends, China
Received: 14 May 2025; Accepted: 22 Aug 2025.
Copyright: © 2025 Zhan, Lin, Yao, Huang, Lan, Zheng, Guo and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhouwei Zhan, Fujian Medical University, Fuzhou, China
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