He Kun, Ye Shicai, Kou Yanqi, Du Shenshen, Yuan Weinan, Ge Lei, Tian Yuan, Luo Botao, Ha Yanping, Zhan Liping, Ye Ruyin, Huang Yujie, Li Bingbing, Nie Biao, Yang Yuping
Department of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Zhanjiang, China.
Department of Gastroenterology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China.
Front Public Health. 2025 Jul 18;13:1511050. doi: 10.3389/fpubh.2025.1511050. eCollection 2025.
By analyzing past disease trends and comparing two time series statistical models, we can predict the global burden of gastrointestinal ulcers in specific populations of adolescents and young adults aged 10-24. This prediction can provide important references for optimizing prevention and control strategies in healthcare systems.
We collected data on prevalence, incidence, disability-adjusted life years (DALYs), and mortality for specific age groups between 10 and 24 years from 1990 to 2019. The data were then stratified by age, gender, and economic development level. We applied decomposition analysis and frontier analysis, and compared the performance of two statistical prediction models. We used the best-performing model to predict changes in each indicator.
In 2019, there were 958,842 (95% uncertainty interval [UI]: 639,698-1,371,106) prevalent cases, 407,850 (95% UI: 260,513-577,751) incident cases, 363,862 (95% UI: 309,793-422,230) DALY cases, and 4,404 (95% UI: 3,826-5,042) deaths globally, all showing an increasing trend compared to 1990. However, the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized DALY rate (ASDR), and age-standardized death rate (ASDER) all decreased from 1990 to 2019, with reductions of 6.6, 3.8, 50.86, and 53.8%, respectively. The estimated annual percentage change (EAPC) for these metrics was -0.59 (95% confidence interval [CI]: -0.73 to -0.46), -0.41 (95% CI: -0.51 to -0.31), -2.81 (95% CI: -2.96 to -2.66), and -3.1 (95% CI: -3.28 to -2.92), respectively. The ARIMA model, identified as the most accurate prediction model, suggests that by 2050, the burden of gastrointestinal ulcers in this age group will significantly decrease compared to 2019. Over the next 30 years, the global number of incident cases will initially rise before stabilizing, prevalent cases will fluctuate, and both DALYs and deaths will decline. ASPR, ASIR, ASDR, and ASDER will continue to decrease, with the most notable reductions in ASDR and ASDER.
In 2019, the global burden of gastrointestinal ulcers showed significant increases in prevalent and incident cases, DALYs, and deaths compared to 1990. However, when adjusted for age, the prevalence rate (ASPR), incidence rate (ASIR), DALY rate (ASDR), and death rate (ASDER) all demonstrated substantial reductions, indicating improvements in management and prevention. The ARIMA model, identified as the most accurate, projects a significant decline in the burden of gastrointestinal ulcers for this age group by 2050, compared to 2019. While the raw numbers of cases and mortality have risen, age-standardized rates have decreased, reflecting advancements in healthcare strategies. These findings emphasize the need for continued focus on preventive measures and healthcare optimization to further reduce the global burden of gastrointestinal ulcers. The projected decline highlights the potential effectiveness of current strategies and offers a positive outlook for future management.
通过分析过去的疾病趋势并比较两个时间序列统计模型，我们可以预测10至24岁青少年和青年特定人群中胃肠道溃疡的全球负担。这一预测可为优化医疗系统中的预防和控制策略提供重要参考。
我们收集了1990年至2019年10至24岁特定年龄组的患病率、发病率、伤残调整生命年（DALYs）和死亡率数据。然后按年龄、性别和经济发展水平对数据进行分层。我们应用了分解分析和前沿分析，并比较了两个统计预测模型的性能。我们使用性能最佳的模型来预测每个指标的变化。
2019年，全球有958,842例（95%不确定区间[UI]：639,698 - 1,371,106）现患病例、407,850例（95% UI：260,513 - 577,751）新发病例、363,862例（95% UI：309,793 - 422,230）DALY病例和4,404例（95% UI：3,826 - 5,042）死亡病例，与1990年相比均呈上升趋势。然而，年龄标准化患病率（ASPR）、年龄标准化发病率（ASIR）、年龄标准化DALY率（ASDR）和年龄标准化死亡率（ASDER）在1990年至2019年间均有所下降，分别下降了6.6%、3.8%、50.86%和53.8%。这些指标的估计年变化百分比（EAPC）分别为-0.59（95%置信区间[CI]：-0.73至-0.46）、-0.41（95% CI：-0.51至-0.31）、-2.81（95% CI：-2.96至-2.66）和-3.1（95% CI：-3.28至-2.92）。被确定为最准确预测模型的ARIMA模型表明，到2050年，该年龄组胃肠道溃疡的负担与2019年相比将显著下降。在接下来的30年里，全球新发病例数最初将上升，然后趋于稳定，现患病例数将波动，而DALYs和死亡病例数将下降。ASPR、ASIR、ASDR和ASDER将继续下降（ASDR和ASDER下降最为显著）。
2019年，与1990年相比，全球胃肠道溃疡负担在现患和新发病例、DALYs和死亡病例方面显著增加。然而，在进行年龄调整后，患病率（ASPR）、发病率（ASIR）、DALY率（ASDR）和死亡率（ASDER）均大幅下降，表明管理和预防方面有所改善。被确定为最准确的ARIMA模型预测，到2050年，该年龄组胃肠道溃疡的负担与2019年相比将显著下降。虽然病例数和死亡率的原始数字有所上升，但年龄标准化率却有所下降，这反映了医疗保健策略的进步。这些发现强调需要继续关注预防措施和医疗保健优化，以进一步降低全球胃肠道溃疡负担。预测的下降突出了当前策略的潜在有效性，并为未来管理提供了积极的前景。
