Li Xiangqian, Liu Huixin, Ren Wenhui, Zhu Qijiong, Yin Peng, Wang Lijun, Zhang Jianzhong, Qi Jinlei, Zhou Cheng
Department of Dermatology, Peking University People's Hospital, Beijing 100044, China.
Department of Clinical Epidemiology and Biostatistics, Peking University People's Hospital, Beijing 100044, China.
Chin Med J (Engl). 2025 Feb 5;138(3):318-324. doi: 10.1097/CM9.0000000000003373. Epub 2024 Nov 22.
Research has indicated that the disease burden of alopecia areata (AA) in China exceeds the global average. Therefore, accurate and updated epidemiological information is crucial for policymakers. In this study, we aimed to comprehensively assess the disease burden of AA in China.
The following four key indicators were utilized: the prevalence of cases; disability-adjusted life-years (DALYs); the age-standardized prevalence rate (ASPR); and the age-standardized DALY rate (ASDR) of AA according to the Global Burden of Disease (GBD) study 2021. We analyzed the epidemiological burden of AA in China during 2021, examined changes between 1990 and 2021, and performed a Bayesian age-period-cohort analysis to predict trends over the course of the next decade (2022-2030). Additionally, a Gaussian process regression model was applied to estimate the relationship between the gross domestic product (GDP) and the ASPR and ASDR of AA at the provincial level between 1992 and 2021.
In 2021, the estimated number of patients with AA in China was approximately 3.49 million (95% uncertainty interval [UI], 3.37-3.62 million); of these patients, 1.20 million (95% UI, 1.16-1.25 million) were male and 2.29 million (95% UI, 2.20-2.37 million) were female. This large number of patients with AA resulted in a total of 114,431.25 DALYs (95% UI, 74,780.27-160,318.96 DALYs). Additionally, the ASPR and ASDR were 224.61 per 100,000 population (95% UI, 216.73-232.65 per 100,000 population) and 7.41 per 100,000 population (95% UI, 4.85-10.44 per 100,000 population), respectively; both of these rates were higher than the global averages. The most affected demographic groups were young and female individuals 25-39 years of age. Slight regional disparities were observed, with the northern and central regions of China bearing comparatively higher burdens. Between 1990 and 2021, the health loss and disease burden caused by AA in China remained relatively stable. The ASPR and ASDR of AA increased with the GDP when the annual GDP was less than 2 trillion Chinese yuan; however, a downward trend was observed as the GDP surpassed 2 trillion Chinese yuan. A slight upward trend in the disease burden of AA in China is predicted to occur over the next decade.
AA continues to be a public health concern in China that shows no signs of declining. Targeted efforts for young individuals and females are necessary because they experience a disproportionately high burden of AA.
研究表明，中国斑秃（AA）的疾病负担超过全球平均水平。因此，准确且最新的流行病学信息对政策制定者至关重要。在本研究中，我们旨在全面评估中国AA的疾病负担。
采用以下四个关键指标：病例患病率；伤残调整生命年（DALYs）；年龄标准化患病率（ASPR）；以及根据《2021年全球疾病负担（GBD）研究》得出的AA年龄标准化DALY率（ASDR）。我们分析了2021年中国AA的流行病学负担，研究了1990年至2021年期间的变化，并进行了贝叶斯年龄-时期-队列分析以预测未来十年（2022 - 2030年）的趋势。此外，应用高斯过程回归模型来估计1992年至2021年期间省级国内生产总值（GDP）与AA的ASPR和ASDR之间的关系。
2021年，中国AA患者估计约为349万（95%不确定区间[UI]，337 - 362万）；其中男性患者120万（95% UI，116 - 125万），女性患者229万（95% UI，220 - 237万）。如此众多的AA患者导致总计114,431.25个伤残调整生命年（95% UI，74,780.27 - 160,318.96个伤残调整生命年）。此外，ASPR和ASDR分别为每10万人224.61（95% UI，每10万人216.73 - 232.65）和每10万人7.41（95% UI，每10万人4.85 - 10.44）；这两个率均高于全球平均水平。受影响最严重的人群是25 - 39岁的年轻女性个体。观察到存在轻微的地区差异，中国北部和中部地区负担相对较重。1990年至2021年期间，中国AA导致的健康损失和疾病负担保持相对稳定。当年度GDP低于2万亿元人民币时，AA的ASPR和ASDR随GDP增长而增加；然而，当GDP超过2万亿元人民币时则呈下降趋势。预计未来十年中国AA的疾病负担将呈轻微上升趋势。
AA在中国仍然是一个公共卫生问题，且没有下降的迹象。针对年轻人和女性开展有针对性的工作很有必要，因为他们承受着过高的AA负担。
