Ye Zhongming, Liu Junping, You Lijiao, Han Yaoguo, Zhang Xiaodan, Lei Ming
Department of Critical Care Medicine, Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Traditional Medicine, Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Nutr. 2025 Aug 26;12:1658507. doi: 10.3389/fnut.2025.1658507. eCollection 2025.
The purpose of this study was to analyze changes in the disease burden caused by vitamin A deficiency (VAD) in China from 1990 to 2021, based on the Global Burden of Disease (GBD) Database, and to predict the disease burden trend in 2035 using the Bayesian age-period-cohort (BAPC) model.
Based on modeled estimates from the GBD 2021 database, this study used Joinpoint regression to calculate annual percentage change (APC) and assess long-term trends (1990-2021) in VAD burden. Disaggregated analysis quantified the contributions of population growth, population aging, and epidemiological changes. The BAPC model was used to predict incidence, prevalence, and DALYs for 2035.
From 1990 to 2021, VAD incidence and prevalence significantly declined across all age groups in China, most notably in children under 5 years (-6.23% average annual change). Disability-adjusted life years (DALYs) improved substantially for children and adolescents. However, DALYs rebounded among those aged 50-74 years. Significant age and sex disparities exist. Children under 5 years bear the heaviest burden. Women have a higher incidence and prevalence than men, while DALY rates are lower in men across all age groups. While overall trends in incidence and prevalence declined, DALYs showed recent increases. Decomposition analysis revealed that favorable epidemiological shifts primarily drove the decline in incidence and prevalence. Conversely, population aging increased the number of cases and DALYs. Projections for 2035 indicate continued declines in incidence, prevalence, and DALYs across all age groups. However, the rate of decrease is projected to be slower in middle-aged and older populations compared to younger groups.
This study reveals the complex dynamics and shifting burden of VAD in China. It affirms past prevention successes while highlighting new challenges, particularly the increasing disease burden driven by population aging. To achieve "Healthy China 2030" goals, future strategies require a more refined, lifecycle approach focusing on vulnerable groups (children, pregnant women, and the elderly), strengthening surveillance and evaluation systems, and promoting research into pathogenesis and technological innovation to meet evolving public health needs.
本研究旨在基于全球疾病负担（GBD）数据库分析1990年至2021年中国维生素A缺乏症（VAD）所致疾病负担的变化，并使用贝叶斯年龄-时期-队列（BAPC）模型预测2035年的疾病负担趋势。
基于GBD 2021数据库的模型估计，本研究使用Joinpoint回归计算年度百分比变化（APC）并评估VAD负担的长期趋势（1990 - 2021年）。分解分析量化了人口增长、人口老龄化和流行病学变化的贡献。使用BAPC模型预测2035年的发病率、患病率和伤残调整生命年（DALYs）。
1990年至2021年，中国所有年龄组的VAD发病率和患病率均显著下降，最明显的是5岁以下儿童（年均变化-6.23%）。儿童和青少年的伤残调整生命年（DALYs）有显著改善。然而，50 - 74岁人群的DALYs出现反弹。存在显著的年龄和性别差异。5岁以下儿童负担最重。女性的发病率和患病率高于男性，而各年龄组男性的DALY率较低。虽然发病率和患病率的总体趋势下降，但DALYs近期有所增加。分解分析表明，有利的流行病学转变主要推动了发病率和患病率的下降。相反，人口老龄化增加了病例数和DALYs。2035年的预测表明，所有年龄组的发病率、患病率和DALYs将持续下降。然而，预计中年和老年人群的下降速度将比年轻人群慢。
本研究揭示了中国VAD的复杂动态和不断变化的负担。它肯定了过去预防工作的成功，同时突出了新的挑战，特别是人口老龄化导致疾病负担增加。为实现“健康中国2030”目标，未来战略需要采用更精细的全生命周期方法，关注弱势群体（儿童、孕妇和老年人），加强监测和评估系统，并促进发病机制研究和技术创新，以满足不断变化的公共卫生需求。
