Wei X M, Zhang J, Li W J, Zhang Z Y
Department of Rheumatology, the First Affiliated Hospital of Harbin Medical University, Harbin150001, China.
Zhonghua Nei Ke Za Zhi. 2025 Feb 1;64(2):142-147. doi: 10.3760/cma.j.cn112138-20240328-00200.
Using the Global Burden of Disease Study 2019 (GBD 2019) database, the Joinpoint regression model was used to analyze the trend of rheumatoid arthritis (RA) incidence and the standardized disability-adjusted life years (DALY) rate in China. The age, period, and cohort effects were discussed based on the age-period-cohort model. The grey prediction model GM (1, 1) was used to fit the trend of incidence and the standardized DALY rate of RA and predict the incidence and standardized DALY rate of RA in China from 2020 to 2034. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA showed a gradual upward trend, with an average annual increase of 1.41% (95% 1.32%-1.44%, <0.001); 0.10% (95% 0.01%-0.14%, <0.001); and 1.91% (95% 1.82%-2.12%, <0.001). The results of the age-period-cohort model showed that the longitudinal age curve of the incidence of RA from 1990 to 2019 showed a trend of increasing first and then decreasing, reaching a peak in the 60-64 years age group. The longitudinal age curve of the standardized DALY rate showed a gradual upward trend, reaching the peak in the 85-89 years age group. The results of period effect showed that the risk of RA increased first and then decreased from 1990 to 2019, with the highest risk from 2010 to 2014, and the risk of incidence was =1.03 (95% 1.00-1.06). The risk of DALY showed a fluctuating change, with a trend of decreasing first, then increasing, and then decreasing again. The highest risk of DALY in 2005-2009 period was =1.03 (95% 1.02-1.05). The results of the cohort effect showed that the later the birth, the higher the risk of morbidity and DALY. From 2020 to 2034, the projected incidence and standardized DALY rate of RA in China showed an upward trend. RA remains a major public health challenge. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA in China showed an increasing trend, which were affected by age, period effect, and cohort effect to varying degrees. Although the burden of RA in China is lower than the global average, it is still essential to take active preventive measures to reduce the burden of RA and identify and treat RA early.
利用全球疾病负担研究2019（GBD 2019）数据库，采用Joinpoint回归模型分析中国类风湿关节炎（RA）发病率及标准化残疾调整生命年（DALY）率的变化趋势。基于年龄-时期-队列模型探讨年龄、时期和队列效应。采用灰色预测模型GM（1,1）拟合RA发病率及标准化DALY率的变化趋势，并预测2020年至2034年中国RA的发病率及标准化DALY率。1990年至2019年，RA的发病率、标准化发病率及标准化DALY率呈逐渐上升趋势，年均增长率分别为1.41%（95% 1.32%-1.44%，<0.001）；0.10%（95% 0.01%-0.14%，<0.001）；1.91%（95% 1.82%-2.12%，<0.001）。年龄-时期-队列模型结果显示，1990年至2019年RA发病率的纵向年龄曲线呈先上升后下降趋势，在60-64岁年龄组达到峰值。标准化DALY率的纵向年龄曲线呈逐渐上升趋势，在85-89岁年龄组达到峰值。时期效应结果显示，1990年至2019年RA发病风险先上升后下降，2010年至2014年风险最高，发病风险比=1.03（95% 1.00-1.06）。DALY风险呈波动变化，先下降，后上升，再下降。2005-2009年DALY风险最高，风险比=1.03（95% 1.02-1.05）。队列效应结果显示，出生越晚，发病及DALY风险越高。2020年至2034年，中国RA的预测发病率及标准化DALY率呈上升趋势。RA仍然是一项重大的公共卫生挑战。1990年至2019年，中国RA的发病率、标准化发病率及标准化DALY率呈上升趋势，不同程度受年龄、时期效应和队列效应影响。尽管中国RA负担低于全球平均水平，但仍有必要采取积极预防措施以减轻RA负担，并尽早识别和治疗RA。
