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中国自身免疫性疾病的年龄标准化发病率、患病率、死亡率及未来预测:基于全球疾病负担研究(GBD)2021的系统分析

Age-standardized incidence, prevalence, mortality rates and future projections of autoimmune diseases in China: a systematic analysis based on GBD 2021.

作者信息

Xiao Yanhua, Hong Xuezhi, Neelagar Ranjana, Mo Hanyou

机构信息

Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Hiller Research Unit, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany.

出版信息

Immunol Res. 2025 Jan 6;73(1):26. doi: 10.1007/s12026-024-09591-5.

Abstract

This study assessed trends in age-standardized incidence (ASIR), prevalence (ASPR), and mortality rates (ASMR) per 100,000 population for asthma, Type 1 Diabetes Mellitus (T1DM), Inflammatory Bowel Disease (IBD), Multiple Sclerosis (MS), Psoriasis, and Rheumatoid Arthritis (RA) in China from 1990 to 2021 and projected ASIR trends through 2046. Data were obtained from the Global Burden of Disease (GBD) 2021 study. Trends in ASIR, ASPR, and ASMR were analyzed using Joinpoint regression to calculate annual percentage change (APC) and average APC (AAPC). Bayesian age-period-cohort (BAPC) modeling was applied to project future ASIR trends. In 2021, asthma had the highest ASIR (364.17/100,000), followed by psoriasis (59.70/100,000) and RA (13.70/100,000), while MS (0.16/100,000) and IBD (1.40/100,000) were the least common. Asthma exhibited significant declines in ASIR (-1.23% AAPC), ASPR (-1.49%), and ASMR (-4.4%). Conversely, T1DM showed rising ASIR (+ 1.16%) and ASPR (+ 1.15%) alongside declining ASMR (-2.62%). Psoriasis (+ 0.74%) and IBD (+ 2.09%) also showed rising ASIR. Gender differences were notable, with greater T1DM ASIR increases in males and more significant asthma improvements in females. By 2046, the ASIR of T1DM, psoriasis, and RA is projected to reach 5.8, 80.9, and 15.54 per 100,000, respectively, while asthma is expected to decline to 330.98 per 100,000. The rising ASIR and ASPR for most autoimmune diseases in China contrast with declining ASMR, highlighting the dual challenge of managing increasing disease burdens while sustaining reductions in mortality. Targeted prevention and management strategies are essential to address these evolving public health needs.

摘要

本研究评估了1990年至2021年中国每10万人中哮喘、1型糖尿病(T1DM)、炎症性肠病(IBD)、多发性硬化症(MS)、银屑病和类风湿关节炎(RA)的年龄标准化发病率(ASIR)、患病率(ASPR)和死亡率(ASMR)趋势,并预测了到2046年的ASIR趋势。数据来自《2021年全球疾病负担(GBD)研究》。使用Joinpoint回归分析ASIR、ASPR和ASMR趋势,以计算年度百分比变化(APC)和平均APC(AAPC)。应用贝叶斯年龄-时期-队列(BAPC)模型预测未来ASIR趋势。2021年,哮喘的ASIR最高(364.17/10万),其次是银屑病(59.70/10万)和类风湿关节炎(13.70/10万),而MS(0.16/10万)和IBD(1.40/10万)最为少见。哮喘的ASIR(AAPC为-1.23%)、ASPR(-1.49%)和ASMR(-4.4%)均显著下降。相反,T1DM的ASIR(+1.16%)和ASPR(+1.15%)呈上升趋势,而ASMR下降(-2.62%)。银屑病(+0.74%)和IBD(+2.09%)的ASIR也呈上升趋势。性别差异显著,男性T1DM的ASIR升高幅度更大,女性哮喘的改善更为显著。到2046年,预计T1DM、银屑病和类风湿关节炎的ASIR将分别达到每10万人5.8、80.9和15.54,而哮喘预计将降至每10万人330.98。中国大多数自身免疫性疾病ASIR和ASPR的上升与ASMR的下降形成对比,凸显了在维持死亡率下降的同时应对不断增加的疾病负担的双重挑战。针对性的预防和管理策略对于满足这些不断变化的公共卫生需求至关重要。

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