1.Global, regional and national burden and trends of congenital musculoskeletal and limb deformities among under-5 children from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021.
Qinglin YANG ; Zhuanmei JIN ; Yongping WANG
Frontiers of Medicine 2025;19(5):807-819
Congenital musculoskeletal and limb deformities (CMLD) seriously affect the physical and mental health of patients, and pose great challenges to healthcare systems worldwide. We explored the specific situation and changes of incidence, prevalence, disability-adjusted life years rates, and mortality of CMLD in under-5 children from 1990 to 2021 in different groups, including different regions, periods, genders and socio-demographic indices (SDI), through corresponding analytical models. Overall, the global disease burden of CMLD in under-5 children has decreased from 1990 to 2021. The disease burden of CMLD in under-5 children varied significantly among different regions and countries, and there was a strong correlation between the corresponding burden of disease and the level of SDI. In addition, cross-country inequality analysis showed that while absolute inequalities in the disease burden of CMLD in under-5 children have improved, relative inequalities have worsened. It is essential to reduce the global health impact of CMLD by implementing targeted interventions to improve health care in underdeveloped areas.
Humans
;
Global Burden of Disease/trends*
;
Child, Preschool
;
Global Health/statistics & numerical data*
;
Infant
;
Male
;
Prevalence
;
Limb Deformities, Congenital/mortality*
;
Musculoskeletal Abnormalities/mortality*
;
Female
;
Disability-Adjusted Life Years
;
Incidence
;
Infant, Newborn
;
Cost of Illness
;
Socioeconomic Factors
2.The Disease Burden of Asthma in China, 1990 to 2021 and Projections to 2050: Based on the Global Burden of Disease 2021.
Rui Yi ZHANG ; Miao Miao ZHANG ; Yu Chang ZHOU ; Jia Huan GUO ; Xuan Kai WANG ; Mai Geng ZHOU
Biomedical and Environmental Sciences 2025;38(5):529-538
OBJECTIVE:
Asthma imposes a significant global health burden. This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.
METHODS:
Using data from the Global Burden of Disease 2021 study, we analyzed asthma incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled. Temporal trends in age-standardized incidence, prevalence, mortality, and DALY rates were explored using Annual Percent Change.
RESULTS:
In 2021, the age-standardized rates for asthma incidence, prevalence, mortality, and DALYs in China were 364.17 per 100,000 (95% uncertainty interval [ UI]: 283.22-494.10), 1,956.49 per 100,000 (95% UI: 1,566.68-2,491.87), 1.47 per 100,000 (95% UI: 1.15-1.79), and 103.76 per 100,000 (95% UI: 72.50-145.46), respectively. A higher disease burden was observed among Chinese men and individuals aged 70 years or older. Compared to the current trend, a combined scenario involving improvements in environmental factors, behavioral and metabolic health, child nutrition, and vaccination resulted in a greater reduction in the disease burden caused by asthma.
CONCLUSION
Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.
Humans
;
Asthma/mortality*
;
China/epidemiology*
;
Male
;
Female
;
Adult
;
Middle Aged
;
Aged
;
Child
;
Adolescent
;
Global Burden of Disease/trends*
;
Child, Preschool
;
Young Adult
;
Infant
;
Cost of Illness
;
Disability-Adjusted Life Years
;
Prevalence
;
Incidence
;
Infant, Newborn
;
Aged, 80 and over
;
Risk Factors
3.Forecast of the Burden of Lower Respiratory Infections in the Elderly Aged 70 and above in China from 1990 to 2050, GBD2021.
Miao Miao ZHANG ; Rui Yi ZHANG ; Yu Chang ZHOU ; Mai Geng ZHOU
Biomedical and Environmental Sciences 2025;38(5):539-546
OBJECTIVE:
This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.
METHODS:
This study utilized Global Burden of Disease (GBD) 1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year (DALY) rates for lower respiratory infections in the elderly population (aged 70 and above) in China from 1990 to 2050. It also discusses future trends in the burden of lower respiratory infections (LRI) in China under different scenarios.
RESULTS:
According to GBD predictions, the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average. The burden has been decreasing from 1990 to 2020, but is projected to increase from 2020 to 2050. Scenario-based predictions suggest that, under scenarios involving improvements in nutrition and vaccination, the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.
CONCLUSION
This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen. The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.
Humans
;
China/epidemiology*
;
Aged
;
Respiratory Tract Infections/mortality*
;
Aged, 80 and over
;
Male
;
Female
;
Forecasting
;
Disability-Adjusted Life Years
;
Global Burden of Disease
;
Cost of Illness
4.Burden of Headache Disorders in China and its Provinces, 1990-2021.
Zhe LIU ; Xue Hua HU ; Lin YANG ; Jin Lei QI ; Jiang Mei LIU ; Li Jun WANG ; Mai Geng ZHOU ; Peng YIN
Biomedical and Environmental Sciences 2025;38(5):547-556
OBJECTIVE:
To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.
METHODS:
Using data from the Global Burden of Disease Study (GBD) 2021, the number of prevalent cases, prevalence rate, disability-adjusted life years (DALYs), and age-standardized DALY rates were analyzed by sex, age group, and province for headache disorders and their subtypes (migraine and tension-type headache [TTH]) between 1990 and 2021. Percentage changes during this period were also estimated.
RESULTS:
In 2021, approximately 426 million individuals in China were affected by headache disorders, with an age-standardized prevalence rate of 27,582.61/100,000. The age-standardized DALY rate for all headache disorders was 487.15/100,000. Between 1990 and 2021, the number of prevalent cases increased by 37.78%, while the prevalence of all headache disorders, migraine, and TTH increased by 6.92%, 7.57%, and 7.86%, respectively. The highest prevalence was observed in the 30-34 age group (39,520.60/100,000). Migraine accounted for a larger proportion of DALYs attributable to headache disorders, whereas TTH has a greater impact on its prevalence. In 2021, the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang (617.85/100,000) and Shanghai (542.86/100,000).
CONCLUSION
The prevalence of headache disorders is increasing in China. Effective health education, improve diagnosis and treatment are essential, particularly for middle-aged working populations and women of childbearing age.
Humans
;
China/epidemiology*
;
Female
;
Male
;
Adult
;
Middle Aged
;
Prevalence
;
Young Adult
;
Adolescent
;
Aged
;
Child
;
Headache Disorders/epidemiology*
;
Disability-Adjusted Life Years
;
Child, Preschool
;
Cost of Illness
;
Infant
;
Aged, 80 and over
5.Disease Burden and Trends of COPD in the Asia-Pacific Region (1990-2019) and Predictions to 2034.
Biomedical and Environmental Sciences 2025;38(5):557-570
OBJECTIVE:
The Asia-Pacific region has a high chronic obstructive pulmonary disease (COPD) burden, but studies on its trends are limited. Using the Global Burden of Disease (GBD) 2019 data, we analyzed COPD trends in 36 countries and territories from 1990 to 2019 and predicted future incidence trends through 2034.
METHODS:
COPD data by age and sex from the GBD 2019 database were analyzed for incidence, prevalence, mortality, and disability-adjusted life years (DALY) rates from 1990 to 2019. Joinpoint regression identified significant annual trends, and age-standardized incidence rates were predicted through 2034 using age-period-cohort models.
RESULTS:
The incidence, prevalence, mortality, and disease burden of COPD have been decreasing, and the incidence rates will continue to decrease or remain stable until 2034 in most selected countries and territories, except for a few Southeastern Asian countries. The Lao People's Democratic Republic and Vietnam are projected to experience an increase in COPD incidence from 165.3 per 100,000 in 2019 to 177 per 100,000 in 2034 and from 179.9 per 100,000 in 2019 to 192.5 per 100,000 in 2034, respectively. Older males had a higher incidence than any other sex or age group. The sex gap in incidence rates continues to widen, though it is smaller and less significant in the younger age group than in those in the older one.
CONCLUSION
COPD rates are expected to decline until 2034 but remain a health risk, especially in countries with rising rates. Urgent action on tobacco control, air pollution, and public education is needed.
Humans
;
Pulmonary Disease, Chronic Obstructive/mortality*
;
Male
;
Female
;
Middle Aged
;
Aged
;
Incidence
;
Asia/epidemiology*
;
Adult
;
Prevalence
;
Cost of Illness
;
Aged, 80 and over
;
Disability-Adjusted Life Years
;
Young Adult
;
Global Burden of Disease
;
Adolescent
6.A Multi-site Analysis for the Economic Burden of Mortality Attributable to Cold Spells of Different Intensities in China, 2014-2019.
Cheng ZHAO ; Yu WANG ; Rui ZHANG ; Shi Lu TONG ; Jiang HE ; Yong Hong LI ; Xiao Yuan YAO
Biomedical and Environmental Sciences 2025;38(10):1205-1216
OBJECTIVE:
The role of cold spells of different intensities in the economic burden of death is crucial for health adaptation to climate change, especially in a multi-site setting. The objective of the study was to explore the economic burden of mortality attributable to cold spells.
METHODS:
We performed a two-stage time-series analysis using the Value of Statistical Life (VSL) approach to evaluate the economic impact of mortality related to cold spells of varying lengths and intensities. This analysis employed a case-crossover design, with a distributed lag nonlinear model (DLNM) used for analysis. Analysis was stratified according to age, sex, and region of origin. The results of the assessment show that cold spells have an enormous impact on the economic losses of mortality due to climate change and aging.
RESULTS:
Totally, 8.3% (95% CI: 0.0%, 16.0%) to 13.8% (95% CI: 1.0%, 24.8%) of VSL were ascribed to cold spells, accounting for economic losses of 4.71 (95% CI: 0.34, 8.47) to 11.45 (95% CI: 0.00, 21.00) billion CNY, in the cold season. The population aged over 65 y and females are particularly vulnerable. Economic impacts in warmer regions, such as the southern and subtropical zones, are more extensive than those in the northern and temperate zones.
CONCLUSION
Customizing cold spell prevention measures for vulnerable populations or regions is vital to alleviating the socioeconomic burden.
China/epidemiology*
;
Humans
;
Female
;
Male
;
Cold Temperature/adverse effects*
;
Aged
;
Middle Aged
;
Adult
;
Mortality
;
Infant
;
Child
;
Adolescent
;
Child, Preschool
;
Young Adult
;
Climate Change
;
Aged, 80 and over
;
Cost of Illness
;
Infant, Newborn
7.Disease burden of spinal fractures in China from 1990 to 2021 and temporal trends: A comparative analysis based on the Global Burden of Disease Study 2021.
Hao WANG ; Hua LIU ; Tianyun SHI ; Huaixi FAN ; Songkai LI
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):762-768
OBJECTIVE:
To analyze the current status and temporal trends of the disease burden of spinal fractures in China from 1990 to 2021 based on data from the Global Burden of Disease Study 2021 (GBD 2021), aiming to provide evidence for developing prevention and treatment strategies.
METHODS:
Epidemiological data on spinal fractures in China, the United States of America (USA), and globally were extracted from the GBD 2021 database. Joinpoint regression models were applied to analyze temporal trends. Age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rates were calculated, with comparisons of gender- and age-group disparities.
RESULTS:
In 2021, the number of incident cases, prevalent cases, and DALYs of spinal fractures in China increased by 52.28%, 113.68%, and 106.98%, respectively, compared to 1990. The age-standardized incidence, prevalence, and DALYs rates rose by 11.80%, 16.11%, and 14.79%, respectively. The disease burden escalated significantly with age, peaking in individuals aged ≥75 years. Males exhibited higher age-standardized incidence and DALYs rates than females. Comparative analysis revealed that the age-standardized DALYs rate in China (4.19/100 000) was lower than that in globally (6.62/100 000) and USA (15.92/100 000). However, China showed an upward trend [annual average percentage change (AAPC)=0.19%], contrasting with a declining trend in the USA (AAPC=-0.08%).
CONCLUSION
The escalating disease burden of spinal fractures in China is closely linked to population aging, gender disparities, and insufficient targeted prevention policies. Future strategies should integrate age- and gender-specific interventions, including strengthened osteoporosis prevention, trauma risk control, and big data-driven precision measures, to mitigate this burden.
Humans
;
China/epidemiology*
;
Global Burden of Disease/trends*
;
Male
;
Female
;
Spinal Fractures/epidemiology*
;
Middle Aged
;
Aged
;
Disability-Adjusted Life Years
;
Prevalence
;
Incidence
;
Adult
;
Young Adult
;
Adolescent
;
Aged, 80 and over
;
United States/epidemiology*
;
Cost of Illness
;
Quality-Adjusted Life Years
;
Child
8.Attributable disease burden of low bone mineral density related fractures in people over 50 years old from 1990 to 2023 in China.
Zepeng LAI ; Yunxiao WU ; Juxi JIANG ; Xiang SHU ; Ziqian ZENG ; Weizhong CHEN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(11):1363-1370
OBJECTIVE:
To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures (fragility fractures) among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation.
METHODS:
Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression.
RESULTS:
From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=-0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a "W-shaped" manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=-0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115).
CONCLUSION
Since 1990, the LBMD attributable fracture burden in China's older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
Humans
;
China/epidemiology*
;
Middle Aged
;
Female
;
Male
;
Bone Density
;
Aged
;
Incidence
;
Osteoporotic Fractures/epidemiology*
;
Aged, 80 and over
;
Accidental Falls/statistics & numerical data*
;
Cost of Illness
;
Global Burden of Disease
;
Osteoporosis/complications*
;
Disability-Adjusted Life Years
;
Fractures, Bone/epidemiology*
9.Trends in burden of pelvic fractures from 1990 to 2023 and long short-term memory-based insights into future projections.
Wenbin FAN ; Yueheng YIN ; Chuwei TIAN ; Jun ZHOU ; Tian XIE ; Liu SHI ; Guodong LIU ; Yunfeng RUI
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(11):1371-1380
OBJECTIVE:
To analyze the disease burden of pelvic fractures at the global, regional, and national levels from 1990 to 2023 using data from the 2023 Global Burden of Disease Study (GBD), and to predict the disease burden through 2050.
METHODS:
Leveraging data from the GBD 2023, this study investigated the disease burden of pelvic fractures across 204 countries and regions. Assessment indicators included incidence rate, prevalence rate, and years lived with disability (YLDs). The Joinpoint regression model was employed to analyze trends in pelvic fracture burden from 1990 to 2023, while the average annual percentage change (AAPC) was used to quantify this temporal trend. The relationship between the socio-demographic index and pelvic fracture burden was evaluated. Furthermore, the long short-term memory (LSTM) model was applied to predict trends in pelvic fracture burden through 2050.
RESULTS:
In 2023, the estimated number of new pelvic fracture cases globally was 7 479 884 [95% uncertainty interval ( UI): 5 293 401-10 611 876], representing a 42.74% increase from 1990. In the same year, the number of prevalent pelvic fracture cases and YLDs were 23 007 508 (95% UI: 21 021 518-25 327 165) and 3 909 228 person-years (95% UI: 2 725 498-5 194 385), respectively. Additionally, age-standardized rates exhibited an opposing downward trend. Significant disparities in the disease burden of pelvic fractures were identified across different age groups, genders, and social contexts. According to predictions from the LSTM model, the global age-standardized incidence rate (ASIR) of pelvic fractures will be approximately 88.44 per 100 000 persons by 2050, while the total number of incident cases will rise to 8 547 095.
CONCLUSION
Although the overall incidence rate, prevalence rate, and YLDs of pelvic fractures have exhibited an upward trend over the past three decades, the ASIR, age-standardized prevalence rate (ASPR), and age-standardized years of life lost rate (ASYR) have shown a downward trend. It is predicted that over the upcoming 26-year period, the age-standardized rate of disease burden due to pelvic fractures will further decrease, while the number of incident cases and prevalent cases will continue to exhibit an upward trend. Formulating more targeted disease prevention strategies is critical to addressing disparities across genders, regions, and other dimensions, and to mitigating the burden of pelvic fractures.
Humans
;
Fractures, Bone/epidemiology*
;
Pelvic Bones/injuries*
;
Male
;
Female
;
Middle Aged
;
Adult
;
Incidence
;
Prevalence
;
Aged
;
Global Burden of Disease/trends*
;
Global Health
;
Adolescent
;
Cost of Illness
;
Young Adult
;
Forecasting
;
Disability-Adjusted Life Years
;
Memory, Short-Term
10.Analysis of current status and trends of disease burden of knee osteoarthritis in China, 1990-2023.
Jie LIAO ; Qiongyao WU ; Gonghua WU ; Bing GUO ; Juying ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(11):1381-1387
OBJECTIVE:
To analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of KOA in China.
METHODS:
Based on the 2023 Global Burden of Disease Study (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI.
RESULTS:
The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in females than in males, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95% CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences.
CONCLUSION
The continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.
Humans
;
Osteoarthritis, Knee/epidemiology*
;
China/epidemiology*
;
Male
;
Female
;
Middle Aged
;
Incidence
;
Aged
;
Adult
;
Prevalence
;
Body Mass Index
;
Disability-Adjusted Life Years
;
Cost of Illness
;
Aged, 80 and over
;
Sex Factors
;
Global Burden of Disease
;
Age Factors
;
Young Adult
;
Quality-Adjusted Life Years

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