Si Tianyu, Shi Xiawei, Ma Jiayi, Yang Junchao
Zhejiang Chinese Medical University, Hangzhou, China.
The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Front Med (Lausanne). 2025 Aug 29;12:1620714. doi: 10.3389/fmed.2025.1620714. eCollection 2025.
This study aims to comprehensively evaluate the historical, current, and projected burden of interstitial lung diseases (ILD) across global populations, China, and the Belt and Road Initiative (BRI) countries. Additionally, exploring cross-national inequalities across socio-demographic index (SDI).
From the 2021 Global Burden of Disease (GBD) database, we selected data on interstitial lung diseases (ILD) for global populations, China, and BRI countries. We analyzed the changes in the burden of ILDs according to year, sex, location, age, and SDI, and used the estimated annual percentage change (EAPC) to estimate the trends of the disease burden. Time trends were evaluated using Joinpoint analysis, while health disparities were assessed with the inequality slope index and concentration index. Additionally, the autoregressive integrated moving average (ARIMA) model was employed to forecast the future trends.
From 1990 to 2021, the global age-standardized incidence rate (ASIR) of interstitial lung diseases and sarcoidosis (ILD) increased from 3.77 per 100,000 (95% UI: 3.27, 4.28) to 4.55 per 100,000 (95% UI: 4.06, 5.04), with an EAPC of 0.73 (95% CI: 0.63, 0.82). Both the age-standardized mortality rate (ASMR) and the age-standardized disability-adjusted life year (DALY) rate (ASDR) also showed an increase. In 2021, China's ASIR was 2.32 per 100,000 (95% UI: 2.03, 2.65), ASMR was 0.39 per 100,000 (95% UI: 0.24, 0.53), and ASDR was 10.82 per 100,000 (95% UI: 7.70, 13.97). When it comes to rankings among BRI countries, China ranked 49.36% for ASIR, 17.95% for ASMR, and 17.31% for ASDR, from lowest to highest. Countries with higher SDI along the BRI countries had a faster annual average growth rate in ILD incidence, and the inequality in ILD between high SDI and low SDI countries was gradually increasing, albeit to a smaller extent. Predicting the trend of ASDR by 2031, it showed a global downward trend, while it showed an upward trend in Chinese.
The ILD burden of BRI countries varies by region, gender, and time factors, and the unbalanced development of their regions exacerbates the imbalance of burden. Therefore, it is necessary to pay attention to and strengthen cooperation in the health field of BRI countries and promote the rational allocation of medical resources to help realize the construction of a community of human destiny.
本研究旨在全面评估间质性肺疾病（ILD）在全球人群、中国以及“一带一路”倡议（BRI）国家中的历史、当前和预计负担。此外，探索社会人口指数（SDI）方面的跨国不平等情况。
从2021年全球疾病负担（GBD）数据库中，我们选取了全球人群、中国和“一带一路”倡议国家的间质性肺疾病（ILD）数据。我们根据年份、性别、地点、年龄和SDI分析了ILD负担的变化，并使用估计年变化百分比（EAPC）来估计疾病负担的趋势。使用Joinpoint分析评估时间趋势，同时用不平等斜率指数和集中指数评估健康差异。此外，采用自回归积分移动平均（ARIMA）模型预测未来趋势。
从1990年到2021年，间质性肺疾病和结节病（ILD）的全球年龄标准化发病率（ASIR）从每10万人3.77例（95% UI：3.27，4.28）增至每10万人4.55例（95% UI：4.06，5.04），EAPC为0.73（95% CI：0.63，0.82）。年龄标准化死亡率（ASMR）和年龄标准化伤残调整生命年（DALY）率（ASDR）也均呈上升趋势。2021年，中国的ASIR为每10万人2.32例（95% UI：2.03，2.65），ASMR为每10万人0.39例（95% UI：0.24，0.53），ASDR为每10万人10.82例（95% UI：7.70，13.97）。在“一带一路”倡议国家中，中国的ASIR排名第49.36%，ASMR排名第17.95%，ASDR排名第17.31%，从低到高。沿着“一带一路”倡议国家，SDI较高的国家ILD发病率的年平均增长率更快，高SDI和低SDI国家之间的ILD不平等程度虽在逐渐增加，但幅度较小。预测到2031年ASDR的趋势，全球呈下降趋势，而中国呈上升趋势。
“一带一路”倡议国家的ILD负担因地区、性别和时间因素而异，其地区发展不平衡加剧了负担不平衡。因此，有必要关注并加强“一带一路”倡议国家在卫生领域的合作，促进医疗资源合理分配，助力实现人类命运共同体建设。
