Yang Qinghua, Jin Li, Luo Mingwei, Xie Shiwei
Department of Endocrinology, Panzhihua Central Hospital, Panzhihua, China.
Department of Medical Records Statistics, Panzhihua Central Hospital, Panzhihua, China.
Front Endocrinol (Lausanne). 2025 Mar 17;16:1559363. doi: 10.3389/fendo.2025.1559363. eCollection 2025.
This study analyzes the global and China trends in the prevalence, disease burden, and future projections of Type 1 Diabetic Nephropathy (T1DN) over the past three decades, providing data to inform public health policies and clinical interventions.
Data from the Global Burden of Disease (GBD) 2021 database were used to analyze the incidence, prevalence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) of T1DN globally and in China from 1990 to 2021. Trend analysis was conducted using R and Joinpoint software, and the ARIMA model was applied to predict future trends in T1DN prevalence for the next 20 years. A significance level of p<0.05 was applied.
Globally, deaths from T1DN increased from 49,300(95% CI: 39,088-61,207) in 1990 to 94,020 (95% CI: 71,456-119,984)in 2021, with the age-standardized mortality rate remaining stable. DALYs rose from 2,227,518(95% CI: 1,835,372-2,679,207) in 1990 to 3,875,628 (95% CI: 3,062,395-4,845,503) in 2021, though the age-standardized rate slightly decreased. In China, the mortality rate declined significantly, and DALYs decreased, with the age-standardized DALYs dropping from 80.915/100,000(95% CI: 65.121-98.391)to 47.953/100,000(95% CI: 36.9-60.734). Globally, both incidence and prevalence increased, with global incidence reaching 95,140(95% CI: 82,236-111,471) cases and prevalence rising to 6,295,711 (95% CI: 5,459,693-7,114,345)cases. In China, incidence showed a declining trend, but prevalence continued to rise. The ARIMA model forecasts global incidence will reach 115,000 cases, with prevalence reaching 7,000,000 by 2041. In China, incidence is expected to stabilize, while prevalence may increase to approximately 2,500,000 cases.
The burden of T1DN is rising globally, especially in terms of prevalence, while China has made progress in reducing mortality and disease burden. However, challenges remain in chronic disease management. Over the next 20 years, global prevalence is projected to continue increasing, while China's prevalence may stabilize. Targeted interventions for different age groups and genders will be essential in reducing the T1DN burden.
本研究分析过去三十年全球及中国1型糖尿病肾病（T1DN）的患病率、疾病负担及未来预测趋势，为公共卫生政策和临床干预提供数据依据。
利用全球疾病负担（GBD）2021数据库的数据，分析1990年至2021年全球及中国T1DN的发病率、患病率、死亡率、伤残调整生命年（YLDs）、生命损失年数（YLLs）和伤残调整生命年（DALYs）。使用R软件和Joinpoint软件进行趋势分析，并应用自回归积分移动平均（ARIMA）模型预测未来20年T1DN患病率的趋势。采用p<0.05的显著性水平。
全球范围内，T1DN死亡人数从1990年的49,300例（95%可信区间：39,088 - 61,207）增至2021年的94,020例（95%可信区间：71,456 - 119,984），年龄标准化死亡率保持稳定。DALYs从1990年的2,227,518例（95%可信区间：1,835,372 - 2,679,207）增至2021年的3,875,628例（95%可信区间：3,062,395 - 4,845,503），尽管年龄标准化率略有下降。在中国，死亡率显著下降，DALYs减少，年龄标准化DALYs从80.915/10万（95%可信区间：65.121 - 98.391）降至47.953/10万（95%可信区间：36.9 - 60.734）。全球范围内，发病率和患病率均上升，全球发病率达95,140例（95%可信区间：82,236 - 111,471），患病率升至6,295,711例（95%可信区间：5,459,693 - 7,114,345）。在中国，发病率呈下降趋势，但患病率持续上升。ARIMA模型预测，到2041年全球发病率将达115,000例左右，患病率将达700万例左右。在中国，发病率预计将趋于稳定，而患病率可能增至约250万例。
全球T1DN负担不断上升，尤其是患病率方面，而中国在降低死亡率和疾病负担方面取得了进展。然而，慢性病管理仍面临挑战。未来20年，预计全球患病率将持续上升，而中国患病率可能趋于稳定。针对不同年龄组和性别的针对性干预对于减轻T1DN负担至关重要。
