Meng Weijian, Sui Liutao
Molecular Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of GI Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Neurol. 2024 Oct 23;15:1501749. doi: 10.3389/fneur.2024.1501749. eCollection 2024.
Currently, neurological diseases has surpassed cardiovascular diseases as the primary cause of global disease burden. Among these, headache disorders are the most prevalent and have emerged as the main cause of disability in people under 50 years old in recent years. Since the release of GBD 2021, there has been no comprehensive systematic exposition on the burden of headache among individuals under 50 years old and a forecast for future burdens. This study aims to quantify the global, regional, and national burden of headache disorders among people under 50 from 1992 to 2021 and to predict future trends in order to provide policy makers with precise and effective epidemiological evidence.
This study extracted the incidence, prevalence, and DALYs data related to headache disorders in the 5-50 age group from the GBD 2021. After age-standardizing the data, we used joinpoint regression analysis and health inequity analysis to analyze the burden and temporal trend of headache disorders and predicted the future disease burden and changes based on the age-period-cohort model.
By 2021, the case number of global incidence, prevalence and DALYs have increased by 35, 39, and 41%, respectively, over the past 30 years. The incidence and prevalence of tension-type headache (TTH) are significantly higher than those of migraine, but migraine causes greater health burdens. The burden is higher for female than for male. In terms of age, youth aged 25-29 years had the highest incidence in 2021, with an age-standardized rate (ASR) of 13,454.64 (95%CI, 9,546.96-18,361.36) per 100,000 population. Nationally, the highest ASR of incidence and prevalence are found in Norway, and the most damaging to health is found in Belgium. Among the five sociodemographic index (SDI) categories, the middle SDI has the highest number of cases (190 million in 2021). It is worth noting that the forecast shows that by 2046 the three indicators will reach 680 million, 2.33 billion, and 41 million, respectively, indicating that the burden of headache disorders in this age group will continue to persist.
Globally, the burden of headache disorders in people under 50 years of age remains significant and has not improved over the past 30 years, especially in regions with high SDI. Headache problems will continue to pose a serious public health challenge for this age group for some time to come. This study reveals the burden and distribution of headache disorders in this age group, providing important basis for governments and policymakers to accurately and effectively allocate health care resources, strengthen prevention and management strategies, and respond to this global health problem.
目前，神经系统疾病已超过心血管疾病，成为全球疾病负担的主要原因。其中，头痛障碍最为普遍，近年来已成为50岁以下人群残疾的主要原因。自《2021年全球疾病负担研究》发布以来，尚未有关于50岁以下人群头痛负担的全面系统阐述以及未来负担预测。本研究旨在量化1992年至2021年全球、区域和国家50岁以下人群头痛障碍的负担，并预测未来趋势，以便为政策制定者提供准确有效的流行病学证据。
本研究从《2021年全球疾病负担研究》中提取了5 - 50岁年龄组中与头痛障碍相关的发病率、患病率和伤残调整生命年（DALYs）数据。对数据进行年龄标准化后，我们使用Joinpoint回归分析和健康不平等分析来分析头痛障碍的负担和时间趋势，并基于年龄 - 时期 - 队列模型预测未来疾病负担及变化。
到2021年，全球发病率、患病率和伤残调整生命年的病例数在过去30年中分别增加了35%、39%和41%。紧张型头痛（TTH）的发病率和患病率显著高于偏头痛，但偏头痛造成的健康负担更大。女性的负担高于男性。在年龄方面，2021年25 - 29岁的年轻人发病率最高，年龄标准化率（ASR）为每10万人13454.64（95%CI，9546.96 - 18361.36）。在国家层面，挪威的发病率和患病率年龄标准化率最高，而比利时对健康的损害最大。在五个社会人口指数（SDI）类别中，中等SDI类别的病例数最多（2021年为1.9亿）。值得注意的是，预测显示到2046年这三个指标将分别达到6.8亿、23.3亿和4100万，这表明该年龄组头痛障碍的负担将持续存在。
在全球范围内，50岁以下人群头痛障碍的负担仍然很大，在过去30年中没有改善，特别是在高SDI地区。头痛问题在未来一段时间内仍将对该年龄组构成严重的公共卫生挑战。本研究揭示了该年龄组头痛障碍的负担和分布情况，为政府和政策制定者准确有效地分配医疗保健资源、加强预防和管理策略以及应对这一全球健康问题提供了重要依据。
