1.Research progress on the mechanism of traditional Chinese medicine regulating metabolic reprogramming to improve breast cancer
Zhenyu ZHANG ; Weixia CHEN ; Bo FENG ; Jilei LI ; Sizhe WANG ; Meng ZHU ; Chunzheng MA
China Pharmacy 2026;37(2):250-256
Metabolic reprogramming, as one of the core hallmarks of malignant tumors, plays a key role in the occurrence, development and treatment of breast cancer (BC). Abnormal changes in glucose metabolism, amino acid metabolism, lipid metabolism, as well as the tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OXPHOS) pathways significantly influence the pathogenesis and progression of BC. Studies have shown that various active components of traditional Chinese medicine (TCM) (such as berberine, matrine, quercetin, curcumin, etc.) and their compound formulations (e.g. Xihuang pill, Danzhi xiaoyao powder, Yanghe decoction, etc.) can inhibit the proliferation and migration of BC cells and induce apoptosis by regulating key metabolic pathways such as glycolysis, lipid synthesis, and amino acid metabolism. TCM demonstrates multi-target and holistic regulatory advantages in intervening in BC metabolic reprogramming, showing significant potential in modulating key molecules like hypoxia inducible factor-1α, hexokinase-2, pyruvate kinase M2, lactate dehydrogenase A, glucose transporter-1, fatty acid synthase, and signaling pathways such as AKT/mTOR. However, current researches still focus predominantly on glucose metabolism, with insufficient mechanistic studies on lipid metabolism, amino acid metabolism, the TCA cycle, and OXPHOS. The precise targets, molecular mechanisms, and clinical translation value of these interventions require further validation and clarification through more high-quality experimental studies and clinical trials.
2.Volatile Component Differences in Xihuangwan Prepared with Natural and Artificial Musk Based on Non-targeted and Targeted Metabolomics
Jing WANG ; Fangzhu XU ; Li MENG ; Qizhen ZHU ; Huanjun ZHAO ; Caina YU ; Xuelian CHEN ; Hui GAO ; Zimin YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):194-201
ObjectiveHeadspace solid-phase microextraction-gas chromatography-mass spectrometry(HS-SPME-GC-MS) and GC-triple quadrupole MS(GC-QqQ-MS) in combination with non-targeted and targeted metabolomics were employed to systematically analyze the chemical composition differences of Xihuangwan prepared with natural musk and artificial musk, and establish an identification system for them. MethodsThe volatile components of 9 batches of Xihuangwan samples from 8 manufacturers were analyzed by HS-SPME-GC-MS non-targeted metabolomics, and identified by comparing their MS data with the National Institute of Standards and Technology(NIST) spectral library. Orthogonal partial least squares-discriminant analysis(OPLS-DA) was used to identify differential volatile components of Xihuangwan prepared with natural musk and artificial musk. Additionally, GC-QqQ-MS targeted metabolomics was applied to quantify the levels of α-pinene, β-elemene, muscone, dehydroepiandrosterone, bornyl acetate, and octyl acetate in 27 batches of samples from 9 manufacturers. Cluster analysis, principal component analysis(PCA), and partial least squares-discriminant analysis(PLS-DA) were conducted to further explore the differences in volatile components between Xihuangwan samples prepared with natural musk and artificial musk. ResultsNon-targeted metabolomics identified 291 volatile compounds in Xihuangwan, including alkanes, esters, alkanes, alcohols, ketones, naphthalenes and others. OPLS-DA analysis revealed distinct separation between Xihuangwan samples containing artificial musk(A1, C1, D1, E1, F1, G1, I1) and those containing natural musk(H1, H3). A total of 30 differential metabolites were identified. The relative contents of these 30 differential metabolites were visualized using a radar chart, revealing significant differences in the levels of octanol, borneol acetate and muscone. Cluster analysis and PCA results from targeted metabolomics indicated that Xihuangwan could be classified into two distinct groups:one composed of natural musk(H1, H3) and the other of artificial musk, sample H2. PLS-DA identified muscone, octyl acetate, and dehydroepiandrosterone as key differential volatile components. Although no significant difference was observed in the content of octyl acetate between the two groups, statistically significant differences were found for muscone and dehydroepiandrosterone(P<0.05). ConclusionMuscone and dehydroepiandrosterone can be used for the differentiation of Xihuangwan samples containing natural musk from those containing artificial musk. This study systematically and comprehensively analyzed the differences in the types and contents of major volatile components in Xihuangwan prepared with natural musk and artificial musk, providing a scientific basis for quality evaluation and control of Xihuangwan.
3.Volatile Component Differences in Xihuangwan Prepared with Natural and Artificial Musk Based on Non-targeted and Targeted Metabolomics
Jing WANG ; Fangzhu XU ; Li MENG ; Qizhen ZHU ; Huanjun ZHAO ; Caina YU ; Xuelian CHEN ; Hui GAO ; Zimin YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):194-201
ObjectiveHeadspace solid-phase microextraction-gas chromatography-mass spectrometry(HS-SPME-GC-MS) and GC-triple quadrupole MS(GC-QqQ-MS) in combination with non-targeted and targeted metabolomics were employed to systematically analyze the chemical composition differences of Xihuangwan prepared with natural musk and artificial musk, and establish an identification system for them. MethodsThe volatile components of 9 batches of Xihuangwan samples from 8 manufacturers were analyzed by HS-SPME-GC-MS non-targeted metabolomics, and identified by comparing their MS data with the National Institute of Standards and Technology(NIST) spectral library. Orthogonal partial least squares-discriminant analysis(OPLS-DA) was used to identify differential volatile components of Xihuangwan prepared with natural musk and artificial musk. Additionally, GC-QqQ-MS targeted metabolomics was applied to quantify the levels of α-pinene, β-elemene, muscone, dehydroepiandrosterone, bornyl acetate, and octyl acetate in 27 batches of samples from 9 manufacturers. Cluster analysis, principal component analysis(PCA), and partial least squares-discriminant analysis(PLS-DA) were conducted to further explore the differences in volatile components between Xihuangwan samples prepared with natural musk and artificial musk. ResultsNon-targeted metabolomics identified 291 volatile compounds in Xihuangwan, including alkanes, esters, alkanes, alcohols, ketones, naphthalenes and others. OPLS-DA analysis revealed distinct separation between Xihuangwan samples containing artificial musk(A1, C1, D1, E1, F1, G1, I1) and those containing natural musk(H1, H3). A total of 30 differential metabolites were identified. The relative contents of these 30 differential metabolites were visualized using a radar chart, revealing significant differences in the levels of octanol, borneol acetate and muscone. Cluster analysis and PCA results from targeted metabolomics indicated that Xihuangwan could be classified into two distinct groups:one composed of natural musk(H1, H3) and the other of artificial musk, sample H2. PLS-DA identified muscone, octyl acetate, and dehydroepiandrosterone as key differential volatile components. Although no significant difference was observed in the content of octyl acetate between the two groups, statistically significant differences were found for muscone and dehydroepiandrosterone(P<0.05). ConclusionMuscone and dehydroepiandrosterone can be used for the differentiation of Xihuangwan samples containing natural musk from those containing artificial musk. This study systematically and comprehensively analyzed the differences in the types and contents of major volatile components in Xihuangwan prepared with natural musk and artificial musk, providing a scientific basis for quality evaluation and control of Xihuangwan.
4.Syndrome Patterns Distribution and Risk Factors of Mixed Hemorrhoids in Traditional Chinese Medicine: A Multicenter Real-world Study Using Large Language Models and Latent Class Analysis
Ruyue DENG ; Kang DING ; Yuxin ZHU ; Meng LI ; Huiting ZHU ; Lei DU
Journal of Traditional Chinese Medicine 2026;67(7):755-763
ObjectiveTo develop a standardized classification model for traditional Chinese medicine (TCM) syndrome patterns of mixed hemorrhoids using multi-center real-world data, and unveil their distribution patterns and core risk factors, thereby providing evidence-based support for standardizing TCM syndrome differentiation and implementing precision interventions. MethodsA multi-center cross-sectional study was conducted, enrolling 13 283 mixed hemorrhoid patients from eight hospitals in Jiangsu Province between September 1st, 2023 and December 31st, 2024. DeepSeek-R1-Distill-Qwen-7B and LLaMA-3.3 large language models (LLM) were integrated with latent class analysis (LCA) to perform unsupervised learning and latent class modeling of TCM symptomatology. Potential risk factors were screened via univariate analysis, followed by logistic regression to identify independent risk factors for each syndrome pattern. ResultsThe model's performance indicators were stable and reliable across different clinical data types,i.e. in the outpatient records, past medical history (F1=99.7%), current medical history (F1=94.9%), and specialist examination (F1=90.7%); in inpatient records, past medical history (F1=98.2%), current medical history (F1=91.2%), specialist examination (F1=90.3%), and discharge status (F1=90.6%). Latent class mode-ling identified four core TCM syndrome patterns including spleen deficiency and qi sinking syndrome (915 cases, 6.89%), damp-heat pouring downward syndrome (10 820 cases, 81.46%), qi stagnation and blood stasis syndrome (1252 cases, 9.43%), and wind injuring intestinal collaterals syndrome (296 cases, 2.22%), with respective latent class probabilities of 0.069, 0.815, 0.094, and 0.022. Logistic regression demonstrated that gender, age, disease duration, hypertension, diabetes, hyperlipidemia, constipation, smoking history, and alcohol consumption were independent risk factors for pattern differentiation (P<0.05). The efficacy validation evaluation revealed that the cure rates for patients with spleen deficiency and qi sinking syndrome and qi stagnation and blood stasis syndrome were higher than those for patients with damp-heat pouring downward syndrome (adjusted P<0.05), with no statistically significant differences among other syndrome patterns. ConclusionDamp-heat pouring downward syndrome is the predominant syndrome in mixed hemorrhoids. Gender, age, disease duration, hypertension, diabetes, hyperlipi-demia, constipation, smoking history, and alcohol consumption are independent risk factors for the differentiation of syndrome types.
5.Strategic Optimization of CHO Cell Expression Platforms for Biopharmaceutical Manufacturing
Rui-Ming ZHANG ; Meng-Lin LI ; Hong-Wei ZHU ; Xing-Xiao ZHANG
Progress in Biochemistry and Biophysics 2026;53(2):327-341
Chinese hamster ovary (CHO) cells are the most established and versatile mammalian expression system for the large-scale production of recombinant therapeutic proteins, owing to their genetic stability, adaptability to serum-free suspension culture, and ability to perform human-like post-translational modifications. More than 70% of biologics approved by the U.S. Food and Drug Administration rely on CHO-based production platforms, underscoring their central role in modern biopharmaceutical manufacturing. Despite these advantages, CHO systems continue to face three persistent bottlenecks that limit their potential for high-yield, reproducible, and cost-efficient production: excessive metabolic burden during high-density culture, heterogeneity of glycosylation patterns, and progressive loss of long-term expression stability. This review provides an integrated analysis of recent advances addressing these challenges and proposes a forward-looking framework for constructing intelligent and sustainable CHO cell factories. In terms of metabolic regulation, excessive lactate and ammonia accumulation disrupts energy balance and reduces recombinant protein synthesis efficiency. Optimization of culture parameters such as temperature, pH, dissolved oxygen, osmolarity, and glucose feeding can effectively alleviate metabolic stress, while supplementation with modulators including sodium butyrate, baicalein, and S-adenosylmethionine promotes specific productivity (qP) by modulating apoptosis and chromatin structure. Furthermore, genetic engineering strategies—such as overexpression of MPC1/2, HSP27, and SIRT6 or knockout of Bax, Apaf1, and IGF-1R—have demonstrated significant improvements in cell viability and product yield. The combination of multi-omics metabolic modeling with artificial intelligence (AI)-based prediction offers new opportunities for building self-regulating CHO systems capable of dynamic adaptation to environmental stress. Regarding glycosylation uniformity, which determines therapeutic efficacy and immunogenicity, gene editing-based glycoengineering (e.g., FUT8 knockdown or ST6Gal1 overexpression) has enabled the humanization of CHO glycan profiles, minimizing non-human sugar residues and enhancing drug stability. Process-level strategies such as galactose or manganese co-feeding and fine control of temperature or osmolarity further allow rational regulation of glycosyltransferase activity. Additionally, in vitro chemoenzymatic remodeling provides a complementary route to construct human-type glycans with defined structures, though industrial applications remain constrained by cost and scalability. The integration of model-driven process design and AI feedback control is expected to enable real-time prediction and correction of glycosylation deviations, ensuring batch-to-batch consistency in continuous biomanufacturing. Long-term expression stability, another critical challenge, is often impaired by promoter silencing, chromatin condensation, and random genomic integration. Molecular optimization—such as the use of improved promoters (CMV, EF-1α, or CHO endogenous promoters), Kozak and signal peptide refinement, and incorporation of chromatin-opening elements (UCOE, MAR, STAR)—helps maintain durable transcriptional activity, while site-specific integration systems including Cre/loxP, Flp/FRT, φC31, and CRISPR/Cas9 can enable single-copy, position-independent gene insertion at genomic safe-harbor loci, ensuring stable, predictable expression. Collectively, this review highlights a paradigm shift in CHO system optimization driven by the convergence of genome editing, synthetic biology, and artificial intelligence. The transition from empirical optimization to rational, data-driven design will facilitate the development of programmable CHO platforms capable of autonomous regulation of metabolic flux, glycosylation fidelity, and transcriptional activity. Such intelligent cell factories are expected to accelerate the transformation from laboratory-scale research to industrial-scale, high-consistency, and economically sustainable biopharmaceutical manufacturing, thereby supporting the next generation of efficient and customizable biologics manufacturing.
6.Strategic Optimization of CHO Cell Expression Platforms for Biopharmaceutical Manufacturing
Rui-Ming ZHANG ; Meng-Lin LI ; Hong-Wei ZHU ; Xing-Xiao ZHANG
Progress in Biochemistry and Biophysics 2026;53(2):327-341
Chinese hamster ovary (CHO) cells are the most established and versatile mammalian expression system for the large-scale production of recombinant therapeutic proteins, owing to their genetic stability, adaptability to serum-free suspension culture, and ability to perform human-like post-translational modifications. More than 70% of biologics approved by the U.S. Food and Drug Administration rely on CHO-based production platforms, underscoring their central role in modern biopharmaceutical manufacturing. Despite these advantages, CHO systems continue to face three persistent bottlenecks that limit their potential for high-yield, reproducible, and cost-efficient production: excessive metabolic burden during high-density culture, heterogeneity of glycosylation patterns, and progressive loss of long-term expression stability. This review provides an integrated analysis of recent advances addressing these challenges and proposes a forward-looking framework for constructing intelligent and sustainable CHO cell factories. In terms of metabolic regulation, excessive lactate and ammonia accumulation disrupts energy balance and reduces recombinant protein synthesis efficiency. Optimization of culture parameters such as temperature, pH, dissolved oxygen, osmolarity, and glucose feeding can effectively alleviate metabolic stress, while supplementation with modulators including sodium butyrate, baicalein, and S-adenosylmethionine promotes specific productivity (qP) by modulating apoptosis and chromatin structure. Furthermore, genetic engineering strategies—such as overexpression of MPC1/2, HSP27, and SIRT6 or knockout of Bax, Apaf1, and IGF-1R—have demonstrated significant improvements in cell viability and product yield. The combination of multi-omics metabolic modeling with artificial intelligence (AI)-based prediction offers new opportunities for building self-regulating CHO systems capable of dynamic adaptation to environmental stress. Regarding glycosylation uniformity, which determines therapeutic efficacy and immunogenicity, gene editing-based glycoengineering (e.g., FUT8 knockdown or ST6Gal1 overexpression) has enabled the humanization of CHO glycan profiles, minimizing non-human sugar residues and enhancing drug stability. Process-level strategies such as galactose or manganese co-feeding and fine control of temperature or osmolarity further allow rational regulation of glycosyltransferase activity. Additionally, in vitro chemoenzymatic remodeling provides a complementary route to construct human-type glycans with defined structures, though industrial applications remain constrained by cost and scalability. The integration of model-driven process design and AI feedback control is expected to enable real-time prediction and correction of glycosylation deviations, ensuring batch-to-batch consistency in continuous biomanufacturing. Long-term expression stability, another critical challenge, is often impaired by promoter silencing, chromatin condensation, and random genomic integration. Molecular optimization—such as the use of improved promoters (CMV, EF-1α, or CHO endogenous promoters), Kozak and signal peptide refinement, and incorporation of chromatin-opening elements (UCOE, MAR, STAR)—helps maintain durable transcriptional activity, while site-specific integration systems including Cre/loxP, Flp/FRT, φC31, and CRISPR/Cas9 can enable single-copy, position-independent gene insertion at genomic safe-harbor loci, ensuring stable, predictable expression. Collectively, this review highlights a paradigm shift in CHO system optimization driven by the convergence of genome editing, synthetic biology, and artificial intelligence. The transition from empirical optimization to rational, data-driven design will facilitate the development of programmable CHO platforms capable of autonomous regulation of metabolic flux, glycosylation fidelity, and transcriptional activity. Such intelligent cell factories are expected to accelerate the transformation from laboratory-scale research to industrial-scale, high-consistency, and economically sustainable biopharmaceutical manufacturing, thereby supporting the next generation of efficient and customizable biologics manufacturing.
7.TAZ WW Domain-Mediated Regulation of Gluconeogenesis and Tumorigenesis in Hepatocellular Carcinoma through Interaction with the Glucocorticoid Receptor
Hongxiang HUANG ; Jinhong CHEN ; Xingyu TAO ; Peiyuan ZHONG ; Yanqiu MENG ; Sujuan PENG ; Wanying LUO ; Zhiyong HE ; Shuai LUO ; Xie ZHU ; Zhihui LU ; Li CHEN ; Yangyang LIU
Endocrinology and Metabolism 2026;41(2):267-287
Background:
Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, characterized by poor prognosis due to its high proliferative and invasive potential. Tumor metabolic reprogramming, particularly involving glucose metabolism, is essential for tumor survival. This study investigates the role of the Hippo pathway effector transcriptional co-activator with PDZ-binding motif (TAZ) in regulating gluconeogenesis and promoting tumorigenesis in HCC.
Methods:
TAZ expression in HCC was analyzed using The Cancer Genome Atlas data and validated in clinical samples and cell lines. TAZ was overexpressed or silenced in HCC cell lines to evaluate its effects on cell proliferation, apoptosis, migration, and invasion. The expression and prognostic relevance of the gluconeogenesis-related genes phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase (G6PC) were examined, along with their correlation with TAZ expression. Tumor growth was assessed in nude mice. Interactions between TAZ and the glucocorticoid receptor (GR) were investigated using co-immunoprecipitation, immunofluorescence, and chromatin immunoprecipitation assays.
Results:
TAZ was significantly upregulated in HCC tissues and cell lines. TAZ overexpression enhanced proliferation, reduced apoptosis, and promoted migration and invasion. In contrast, PCK1 and G6PC were downregulated in HCC and showed a negative correlation with TAZ expression.
Conclusion
TAZ modulates gluconeogenesis and accelerates tumor growth, whereas its knockdown attenuates tumor progression. TAZ interacts with GR, suppressing its transcriptional activity on gluconeogenic gene promoters.
8.Prevalence and influencing factors of metabolic syndrome in the population aged 35-75 years in Hubei Province
Peijun ZHANG ; Meng LEI ; Shuzhen ZHU ; Junfeng QI ; Shenghong HAN ; Junlin LI
Journal of Public Health and Preventive Medicine 2026;37(3):80-84
Objective To analyze the prevalence characteristics and influencing factors of metabolic syndrome (MS) in people aged 35-75 years in Hubei Province. Methods The follow-up data from 2016 to 2022 in the early screening and comprehensive intervention project for high-risk cardiovascular population in Hubei Province were collected. SAS 9.4 software was used to conduct 2-test and multivariate logistic regression to analyze the prevalence of MS and its influencing factors. Results Among the 89 199 subjects, 24 757 were affected by MS, with a prevalence rate of 27.75% and a standardized rate of 23.55%. Among the various components of MS, the prevalence of abnormal blood pressure was the highest, at 70.88%, and the standardized rate was 59.32%. Secondly, abnormal blood glucose was 36.26%, and the standardized rate was 30.04%. Central obesity was 33.12%, and the standardized rate was 30.28%. Hypertriglyceridemia was 32.90%, and the standardized prevalence rate was 32.70%. The rate of low HDL-C syndrome was 10.25%, and the standardized rate was 11.67%. The results of multivariate logistic regression analysis showed that the risk of MS increased with age, and the risk of MS in urban residents was lower than that in rural residents (OR=0.835, 95%CI: 0.77-0.886). Administrative and professional workers had a higher risk of MS than farmers (OR=1.313, 95%CI:1.194-1.445). Overweight, obesity, central obesity, history of self-reported hypertension, history of self-reported diabetes, and history of self-reported dyslipidemia were associated with a higher risk of MS, and the differences were statistically significant (P < 0.001). Conclusion The prevalence of MS is high in people aged 35-75 years in Hubei Province. On the basis of comprehensive intervention, focus monitoring should be strengthened to control the risk factors of MS and reduce the risk of cardiovascular and cerebrovascular diseases.
9.Role of IL-17A in acute inhalational pneumonia caused by highly virulent and multidrug-resistant Staphylococcus aureus
Qi KUANG ; Xiaoyu ZHU ; Lu LI ; Xueyan WANG ; Peijie YAN ; Lili ZHANG ; Meng LÜ ; Lingfei HU ; Dongsheng ZHOU ; Wenhui YANG
Acta Universitatis Medicinalis Anhui 2026;61(4):599-605
ObjectiveTo investigate the role of interleukin (IL)-17A in acute inhalational pneumonia induced by the highly drug-resistant and hypervirulent Staphylococcus aureus strain USA300-R in mice. MethodsAn acute inhalational pneumonia model was established in mice using an aerosolized pulmonary delivery technique. RNA sequencing (RNA-seq) and enzyme-linked immunosorbent assay (ELISA) were employed to examine the expression dynamics of Il17a mRNA and IL-17A protein, respectively, in the lungs of infected mice. Il17a knockout (Il17a-/-) mice were generated using CRISPR/Cas9 gene editing technology. The survival rate, body weight, bacterial load in lung tissue, and histopathological changes were compared between Il17a-/- and wild-type (WT) mice following inhalational infection with USA300-R. Results12 hours after USA300-R infection, compared to pre-infection, the expression level of Il17a mRNA in lung tissue and the level of IL-17A protein in bronchoalveolar lavage fluid (BALF) increased by approximately 50-fold (P<0.01) and 6-fold (P<0.001), respectively. Compared to WT mice, Il17a-/- mice exhibited approximately 10-fold higher bacterial loads in lung tissue at both 12 and 24 hours post-infection (P<0.001, P<0.05). However, they showed significantly attenuated lung histopathological injury, reduced alveolar wall thickening, markedly decreased neutrophil infiltration, and an approximately 50% improvement in survival rate (P<0.05). ConclusionIn acute Staphylococcus aureus USA300-R inhalational pneumonia, IL-17A contributes to bacterial clearance by recruiting neutrophils; however, excessive neutrophil infiltration exacerbates pulmonary inflammation and injury, reduces survival rates, and represents a potential therapeutic target.
10.Changing trend of non-alcoholic fatty liver disease among young people aged 20—44 years in East Asian countries in 1990—2023
Fei SU ; Chunzhi SU ; Xianxin MENG ; Jingyao LI ; Xiaodi ZHU ; Jinli ZHANG
Journal of Clinical Hepatology 2026;42(5):1048-1055
ObjectiveTo investigate the disease burden of non-alcoholic fatty liver disease (NAFLD) among young people in East Asian countries (including China, North Korea, Japan, Mongolia, and South Korea) in 1990—2023, and to provide a basis for formulating and adjusting the prevention and treatment strategies for NAFLD. MethodsRelated disease burden data of NAFLD among the young people in these five East Asian countries were collected from the Global Burden of Disease 2023 (GBD 2023) database, including incidence rate, prevalence rate, and disability-adjusted life years (DALY), and the young people were divided into groups based on country, sex, and age. Estimated annual percentage change (EAPC) was used to comprehensively evaluate the changing trend of the disease burden of NAFLD among young people from 1990 to 2023, and the Autoregressive Integrated Moving Average model was used to predict the disease burden of NAFLD among the young people in China. ResultsIn 2023, the standardized incidence rates of NAFLD among the young people in China, North Korea, Japan, Mongolia, and South Korea were 926.57/100 000, 805.83/100 000, 412.66/100 000, 747.66/100 000, and 534.08/100 000, respectively; the standardized prevalence rates of NAFLD among the young people in China, North Korea, Japan, Mongolia, and South Korea were 16 817.94/100 000, 14 500.98/100 000, 8 534.40/100 000, 13 705.28/100 000, and 11 587.93/100 000, respectively; the standardized DALY rates of NAFLD among the young people in China, North Korea, Japan, Mongolia, and South Korea were 6.34/100 000, 10.18/100 000, 5.23/100 000, 47.93/100 000, and 6.76/100 000, respectively. From 1990 to 2023, there was a tendency of increase in the standardized incidence rate of NAFLD among the young people in China, North Korea, Japan, Mongolia, and South Korea, with an EAPC of 0.87%, 0.52%, 0.26%, 0.48%, and 0.87%, respectively; there was also a tendency of increase in the standardized prevalence rate of NAFLD among the young people in China, North Korea, Japan, Mongolia, and South Korea, with an EAPC of 0.99%, 0.49%, 0.24%, 0.59%, and 0.93%, respectively; conversely, there was a tendency of reduction in the standardized DALY rate of NAFLD among the young people in China, Japan, Mongolia, and South Korea, with an EAPC of -2.21%, -2.01%, -0.37%, and -4.62%, respectively, while the standardized DALY rate of NAFLD among the young people in North Korea remained relatively stable, with an EAPC of -0.01%. The subgroup analysis based on sex showed that there was a significant difference in the disease burden of NAFLD between the young people with different sexes in the five East Asian countries, and the subgroup analysis based on age showed that the incidence rate of NAFLD in young people decreased with the increase in age, while the prevalence rate and DALY rate of NAFLD increased with age. In addition, the standardized incidence rate and standardized prevalence rate of NAFLD among Chinese young people would further increase in the future, while there would be a reduction in standardized DALY rate in the future. ConclusionThere is a significant difference in the disease burden of NAFLD in young people across different countries, sexes, and age groups. In the future, targeted prevention and treatment measures should be developed based on the distribution characteristics of the disease burden of NAFLD, in order to effectively reduce the disease burden of NAFLD among young people.


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