Zhou Jia, Liang Luling, Zhang Hanlin, Liu Mingjuan, Zhu Zhou, Leng Ling, Li Jun
Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China.
Stem Cell and Regenerative Medicine Lab, State Key Laboratory of Complex Severe and Rare Diseases, Institute of Clinical Medicine, Translational Medicine Center, Peking Union Medical College Hospital, Beijing, China.
J Cosmet Dermatol. 2025 Mar;24(3):e70076. doi: 10.1111/jocd.70076.
Alopecia areata (AA) is a chronic autoimmune disorder characterized by non-scarring hair loss, affecting approximately 2% of the global population. Its etiology involves genetic, immunological, and environmental factors, with significant psychological impacts such as anxiety and depression. However, international trends and comorbidity associations remain poorly understood.
This study aims to analyze global trends in the incidence and prevalence of AA and assess its associations with major comorbidities across different demographic and regional groups.
PATIENTS/METHODS: Using data from the Global Burden of Disease Study (GBD) 2021, AA incidence, prevalence, and years lived with disability (YLDs) from 1990 to 2021 were analyzed by age, sex, geographic region, and socioeconomic indices (SDI and HDI). Temporal trends were evaluated with Pearson's correlation and Joinpoint regression, and comorbidities were assessed against 22 conditions.
From 1990 to 2021, global AA incidence increased in absolute terms, though age-standardized incidence rates (ASIR) slightly declined. Incidence was highest in North America, Southeast Asia, and Australia, with females and individuals aged 30-34 most affected. Significant associations were found with atopic dermatitis, iron deficiency, and depressive disorders, with regional variations in comorbidity patterns.
This study highlights rising AA cases with stable ASIRs, reflecting improved awareness and reporting. Findings underscore the complex interplay of socioeconomic factors, healthcare access, and AA burden. Further research should investigate mechanisms underlying comorbidities and guide targeted interventions to mitigate the physical and psychological impacts of AA.
斑秃（AA）是一种慢性自身免疫性疾病，其特征为非瘢痕性脱发，全球约2%的人口受其影响。其病因涉及遗传、免疫和环境因素，会产生焦虑和抑郁等重大心理影响。然而，国际趋势以及共病关联仍知之甚少。
本研究旨在分析斑秃发病率和患病率的全球趋势，并评估其与不同人口统计学和区域群体中主要共病的关联。
患者/方法：利用全球疾病负担研究（GBD）2021的数据，按年龄、性别、地理区域和社会经济指数（SDI和HDI）分析了1990年至2021年的斑秃发病率、患病率和伤残调整生命年（YLDs）。采用Pearson相关性分析和Joinpoint回归评估时间趋势，并针对22种疾病评估共病情况。
从1990年到2021年，全球斑秃发病率绝对值上升，尽管年龄标准化发病率（ASIR）略有下降。北美、东南亚和澳大利亚的发病率最高，女性和30 - 34岁的个体受影响最大。发现斑秃与特应性皮炎、缺铁和抑郁症有显著关联，共病模式存在区域差异。
本研究突出了斑秃病例增加而ASIR稳定的情况，反映出认识和报告水平的提高。研究结果强调了社会经济因素、医疗服务可及性与斑秃负担之间的复杂相互作用。进一步的研究应调查共病的潜在机制，并指导有针对性的干预措施，以减轻斑秃对身体和心理的影响。
