Xu Ran, Wang Xin-Jun, Lin Qing-Cheng, Zhuang Yan-Ting, Zhou Qing-Ying, Xu Nai-Fen, Zheng Ding-Qin
Department of Urology, Pingyang Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Urology, Zhongshan Hospital Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Front Reprod Health. 2024 Dec 16;6:1501675. doi: 10.3389/frph.2024.1501675. eCollection 2024.
Currently, male infertility represents a serious disease burden worldwide, and China is one of the most affected countries. The aim of this study was to examine the evolution of the disease burden of male infertility in China during the period 1990-2021 and to project the trend for 2022-2036.
By screening and processing data from the Global Burden of Disease 2021, this study obtained data on the prevalence, disability-adjusted life years and corresponding rates and age-standardised rates of male infertility between 1990 and 2021. To assess the trend in the burden of male infertility over the past 30 years, the annual percentage change and the average annual percentage change were calculated from the above data using Joinpoint regression models. In addition, age-period-cohort models were used to estimate the independent effects of age, period and cohort factors on male infertility, and Bayesian projection models were used to predict the trend in the disease over the next 15 years.
In both 1990 and 2021, the burden of male infertility tended to increase and then decrease with age, with the heaviest burden in the 35-39 age group. Meanwhile, the Joinpoint model found statistically significant average annual percentage changes in age-standardised prevalence and age-standardised disability-adjusted life years of 0.14% and 0.19%, respectively. In addition, the trend for both was a gradual increase over time until 1994 and a gradual decrease over time after 1994. In the age-period-cohort analysis model, age, period and cohort effects indicated that 35-39 years, 1997-2001 and 1945-1949 were the years with the highest risk of male infertility. Finally, the Bayesian projection model suggested that the disease burden of male infertility in China would show a decreasing trend over the next 15 years.
From 1990 to 2021, the disease burden of male infertility in China generally increased. However, thanks to a number of factors, including China's proactive health policies and effective management, the burden of disease has continued to decrease in the last decade and is projected to continue declining from 2022 to 2036. To sustain this positive trend, it remains essential for China to maintain and strengthen effective management and control of male infertility.
目前，男性不育在全球范围内构成了严重的疾病负担，中国是受影响最严重的国家之一。本研究的目的是考察1990 - 2021年期间中国男性不育疾病负担的演变情况，并预测2022 - 2036年的趋势。
通过筛选和处理《2021年全球疾病负担》的数据，本研究获得了1990年至2021年期间男性不育的患病率、伤残调整生命年以及相应的率和年龄标准化率的数据。为评估过去30年男性不育负担的趋势，使用Joinpoint回归模型从上述数据中计算年度百分比变化和平均年度百分比变化。此外，使用年龄 - 时期 - 队列模型来估计年龄、时期和队列因素对男性不育的独立影响，并使用贝叶斯预测模型来预测未来15年该疾病的趋势。
在1990年和2021年，男性不育的负担均随年龄增长先增加后减少，35 - 39岁年龄组的负担最重。同时，Joinpoint模型发现年龄标准化患病率和年龄标准化伤残调整生命年的平均年度百分比变化分别具有统计学意义，为0.14%和0.19%。此外，两者的趋势都是在1994年之前随时间逐渐增加，在1994年之后随时间逐渐减少。在年龄 - 时期 - 队列分析模型中，年龄、时期和队列效应表明35 - 39岁、1997 - 2001年以及1945 - 1949年是男性不育风险最高的年份。最后，贝叶斯预测模型表明，未来15年中国男性不育的疾病负担将呈下降趋势。
1990年至2021年，中国男性不育的疾病负担总体呈上升趋势。然而，由于包括中国积极的卫生政策和有效管理在内的诸多因素，过去十年疾病负担持续下降，预计2022年至2036年将继续下降。为维持这一积极趋势，中国继续保持并加强对男性不育的有效管理和控制至关重要。
