Wang Xiaofeng, Yang Song, Zhao Shanzhi, Yang Zhitao, Mao Enqiang, Chen Erzhen, Chen Ying
Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Emergency and Critical Care Medicine, Ruijin Hospital Wuxi Branch, Shanghai Jiao Tong University School of Medicine, Wuxi, China.
Front Glob Womens Health. 2025 Apr 1;6:1529549. doi: 10.3389/fgwh.2025.1529549. eCollection 2025.
Peptic ulcer disease (PUD) constitutes a significant global health concern, particularly in women of childbearing age (WCBA), who face elevated risks of severe pregnancy-associated complications. This investigation aimed to map the temporal dynamics and forecast the future incidence of PUD in this demographic to inform targeted prevention and control initiatives.
This analysis drew on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, extracting data on PUD incidence and mortality across seven age groups (15-49 years) in WCBA. Age-standardized incidence and mortality rates were calculated using the direct method of age standardization. Temporal trends from 1992 to 2021 were analyzed using joinpoint regression. The study further employed age-period-cohort analysis to discriminate the effects of these variables on incidence and mortality, and frontier analysis to evaluate potential reductions in burden by country based on developmental status. Nordpred modeling was used to project epidemiological trends up to 2044.
In 2021, the global age-standardized incidence rates (ASIR) and death rates (ASDR) for PUD among WCBA were 24.18 per 100,000 (95% CI: 14.72-36.38) and 0.54 per 100,000 (95% CI: 0.42-0.66), respectively. The highest incidence rates were observed in Oceania, while the greatest mortality rates were recorded in South Asia. Over the period from 1992 to 2021, global age-standardized mortality rates showed a significant decline. Conversely, after an initial drop, age-standardized incidence rates began to rise, with considerable regional and country-specific variation. This increase was particularly marked in regions with high Socio-demographic Index (SDI). Frontier analyses indicate that countries or regions in the middle SDI quintiles possess significant untapped potential to enhance both access to and quality of healthcare. Despite predictions of declining age-standardized incidence and mortality rates, total case numbers are expected to continue rising modestly through 2044.
The study underscores substantial global disparities in PUD trends in WCBA, with increasing case numbers and regional inequalities. The findings highlight the need for focused attention on high SDI regions and older WCBA cohorts to refine disease management and prevention strategies, aiding in the mitigation of PUD's public health impact.
消化性溃疡病（PUD）是一个重大的全球健康问题，对于育龄期女性（WCBA）而言尤为如此，她们面临着与妊娠相关的严重并发症风险升高的情况。本研究旨在梳理该人群中PUD的时间动态变化，并预测其未来发病率，以为针对性的预防和控制举措提供信息。
本分析借鉴了《2021年全球疾病、伤害及风险因素负担研究》（GBD 2021），提取了WCBA中七个年龄组（15 - 49岁）的PUD发病率和死亡率数据。采用直接年龄标准化方法计算年龄标准化发病率和死亡率。使用连接点回归分析了1992年至2021年的时间趋势。该研究还采用年龄 - 时期 - 队列分析来区分这些变量对发病率和死亡率的影响，并通过前沿分析根据发展状况评估各国负担的潜在降低情况。使用Nordpred模型预测了截至2044年的流行病学趋势。
2021年，WCBA中PUD的全球年龄标准化发病率（ASIR）和死亡率（ASDR）分别为每10万人24.18例（95%CI：14.72 - 36.38）和每10万人0.54例（95%CI：0.42 - 0.66）。大洋洲的发病率最高，而南亚的死亡率最高。在1992年至2021年期间，全球年龄标准化死亡率显著下降。相反，在最初下降之后，年龄标准化发病率开始上升，存在相当大的区域和国家差异。这种上升在社会人口指数（SDI）较高的地区尤为明显。前沿分析表明，处于中等SDI五分位数的国家或地区在改善医疗服务可及性和质量方面具有巨大的未开发潜力。尽管预计年龄标准化发病率和死亡率会下降，但到2044年病例总数预计仍将继续适度上升。
该研究强调了WCBA中PUD趋势在全球存在显著差异，病例数不断增加且存在区域不平等。研究结果凸显了需要重点关注高SDI地区和年龄较大的WCBA队列，以完善疾病管理和预防策略，有助于减轻PUD对公共卫生的影响。
