1990年至2021年20至54岁成年人中多发性硬化症的新出现的流行趋势及到2035年的预测：2021年全球疾病负担研究的系统分析
Emerging epidemiological trends of multiple sclerosis among adults aged 20-54 years, 1990-2021, with projections to 2035: a systematic analysis for the global burden of disease study 2021.
作者信息
Wang Ling-Yun, Wang Wen-Fu, Hui Shu-Yin, Yang Li, Liu Yue-Xian, Li Hang-Juan
机构信息
Department of Neurology, 920th Hospital of the Joint Logistics Support Force, People's Liberation Army, Kunming, China.
出版信息
Front Neurol. 2025 Jul 10;16:1616245. doi: 10.3389/fneur.2025.1616245. eCollection 2025.
BACKGROUND
Over recent decades, clinical, scientific, and public awareness of multiple sclerosis (MS) has increased significantly. This study aims to analyze global trends in the incidence, mortality, and disability-adjusted life years (DALYs) of MS among adults aged 20-54 years from 1990 to 2021.
METHODS
Using data from the Global Burden of Disease (GBD) database, this study evaluated MS incidence, mortality, and DALYs in adults aged 20-54 years. Data from 204 countries and territories were stratified by age, sex, and geographical location. Annual percentage changes (APC) were calculated using Joinpoint regression, and estimated annual percentage changes (EAPC) were derived through log-linear regression modeling. Bayesian age-period-cohort (BAPC) modeling was employed to forecast future disease burden.
FINDINGS
Globally, in 2021, there were 51,904.12 incident MS cases (95% UI, 44,998.80-59,073.37), 4,738.38 deaths (95% UI, 4,492.03-5,024.11), and 512,985.58 DALYs (95% UI, 428,133.20-610,308.62). Between 1990 and 2021, global incidence increased by 49.48% (95% UI, 44.34-55.15%), mortality rose by 18.21% (95% UI, 11.60-25.45%), and DALYs increased by 43.22% (95% UI, 36.79-48.94%). The High SDI region reported the highest rates of incidence (4.38 per 100,000; 95% UI, 3.93-4.83), mortality (0.41 per 100,000; 95% UI, 0.39-0.42), and DALYs (45.00 per 100,000; 95% UI, 37.22-53.12). Regionally, Western Europe had the highest number of cases (10,964.14; 95% UI, 9,572.30-12,318.88). At the national level, the United States reported the most MS incident cases in 2021 (9,388.21; 95% UI, 8,469.23-10,275.59). Sweden had the highest national incidence rate at 10.12 per 100,000 (95% UI, 8.69-11.66), with an EAPC of 0.24 (95% CI, 0.10-0.38).
INTERPRETATION
The global incidence, mortality, and DALYs associated with MS have shown increasing trends, although substantial variations persist across different SDI regions. A comprehensive understanding of MS epidemiology is essential for improving global disease prevention and control efforts.
背景
在最近几十年里，临床、科学界以及公众对多发性硬化症（MS）的认识显著提高。本研究旨在分析1990年至2021年20至54岁成年人中MS的发病率、死亡率和伤残调整生命年（DALYs）的全球趋势。
方法
利用全球疾病负担（GBD）数据库的数据，本研究评估了20至54岁成年人中的MS发病率、死亡率和DALYs。来自204个国家和地区的数据按年龄、性别和地理位置进行分层。使用Joinpoint回归计算年度百分比变化（APC），并通过对数线性回归模型得出估计年度百分比变化（EAPC）。采用贝叶斯年龄-时期-队列（BAPC）模型预测未来疾病负担。
研究结果
在全球范围内，2021年有51,904.12例MS新发病例（95%不确定区间，44,998.80 - 59,073.37），4,738.38例死亡（95%不确定区间，4,492.03 - 5,024.11），以及512,985.58个伤残调整生命年（95%不确定区间，428,133.20 - 610,308.62）。1990年至2021年期间，全球发病率上升了49.48%（95%不确定区间，44.34 - 55.15%），死亡率上升了18.21%（95%不确定区间，11.60 - 25.45%），伤残调整生命年增加了43.22%（95%不确定区间，36.79 - 48.94%）。高社会人口指数（SDI）地区报告的发病率最高（每10万人4.38例；95%不确定区间，3.93 - 4.83），死亡率（每10万人0.41例；95%不确定区间，0.39 - 0.42）和伤残调整生命年（每10万人45.00例；95%不确定区间，37.22 - 53.12）也最高。在区域层面，西欧的病例数最多（10,964.14例；95%不确定区间，9,572.30 - 12,318.88）。在国家层面，美国在2021年报告的MS新发病例最多（9,388.21例；95%不确定区间，8,469.23 - 10,275.59）。瑞典的全国发病率最高，为每10万人10.12例（95%不确定区间，8.69 - 11.66），估计年度百分比变化为0.24（95%置信区间，0.10 - 0.38）。
解读
与MS相关的全球发病率、死亡率和伤残调整生命年呈上升趋势，尽管不同SDI地区仍存在显著差异。全面了解MS流行病学对于改善全球疾病预防和控制工作至关重要。
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