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.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
4.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
5.Burden and Changing Trends of Non-Alcoholic Fatty Liver Disease in China From 1990 to 2021.
Jun TANG ; Nan ZHENG ; Yu-Xin YAN ; Nan ZHANG ; Xiao-Mei REN
Acta Academiae Medicinae Sinicae 2025;47(4):575-581
Objective To analyze the changing trends of the burden of non-alcoholic fatty liver disease(NAFLD)in China from 1990 to 2021 and provide a basis for formulating prevention and treatment strategies.Methods The standardized incidence rate,prevalence,mortality,and disability-adjusted life year(DALY)rate of NAFLD in China from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021.The average annual percentage change of rate data was calculated by Joinpoint 4.2 and the age,period,and birth cohort effects of the prevalence and DALY rate were analyzed by the age-period-cohort model.Results Compared to 1990,the incidence rate and prevalence of NAFLD have been on the rise,while the mortality and DALY rate have been declining.The age effect curves of prevalence and DALY rate showed an upward trend followed by a downward trend for both males and females.With the period from 1992 to 1996 as the reference group,the period effect curve of prevalence showed a downward trend followed by an upward trend,being the lowest in the period from 2002 to 2006(RR=0.93).The period effect curve of DALY rate showed a downward trend from 1992 to 2011 and then tended to flatten out.With the period from 1972 to 1981 as the reference group,the birth cohort effect curve of prevalence showed a steady upward trend in the general population and both male and female populations.The birth cohort effect curve of DALY rate showed an overall upward trend followed by a downward trend,with the peak occurring in the birth cohort group between 1922 and 1931.The DALY rate of NAFLD caused by smoking and high fasting blood glucose has shown a downward trend since 2014,and fasting blood glucose gradually became the dominant factor as age increased.Conclusions From 1990 to 2021,NAFLD in China has shown a rising prevalence but a significantly declining DALY rate.This suggests that current prevention and control strategies are effective,and further efforts should be made to raise residents' health awareness in controlling the occurrence and development of NAFLD.
Humans
;
Non-alcoholic Fatty Liver Disease/epidemiology*
;
China/epidemiology*
;
Prevalence
;
Female
;
Male
;
Incidence
;
Disability-Adjusted Life Years
;
Middle Aged
;
Adult
6.Burden of alopecia areata in China, 1990-2021: Global Burden of Disease Study 2021.
Xiangqian LI ; Huixin LIU ; Wenhui REN ; Qijiong ZHU ; Peng YIN ; Lijun WANG ; Jianzhong ZHANG ; Jinlei QI ; Cheng ZHOU
Chinese Medical Journal 2025;138(3):318-324
BACKGROUND:
Research has indicated that the disease burden of alopecia areata (AA) in China exceeds the global average. Therefore, accurate and updated epidemiological information is crucial for policymakers. In this study, we aimed to comprehensively assess the disease burden of AA in China.
METHODS:
The following four key indicators were utilized: the prevalence of cases; disability-adjusted life-years (DALYs); the age-standardized prevalence rate (ASPR); and the age-standardized DALY rate (ASDR) of AA according to the Global Burden of Disease (GBD) study 2021. We analyzed the epidemiological burden of AA in China during 2021, examined changes between 1990 and 2021, and performed a Bayesian age-period-cohort analysis to predict trends over the course of the next decade (2022-2030). Additionally, a Gaussian process regression model was applied to estimate the relationship between the gross domestic product (GDP) and the ASPR and ASDR of AA at the provincial level between 1992 and 2021.
RESULTS:
In 2021, the estimated number of patients with AA in China was approximately 3.49 million (95% uncertainty interval [UI], 3.37-3.62 million); of these patients, 1.20 million (95% UI, 1.16-1.25 million) were male and 2.29 million (95% UI, 2.20-2.37 million) were female. This large number of patients with AA resulted in a total of 114,431.25 DALYs (95% UI, 74,780.27-160,318.96 DALYs). Additionally, the ASPR and ASDR were 224.61 per 100,000 population (95% UI, 216.73-232.65 per 100,000 population) and 7.41 per 100,000 population (95% UI, 4.85-10.44 per 100,000 population), respectively; both of these rates were higher than the global averages. The most affected demographic groups were young and female individuals 25-39 years of age. Slight regional disparities were observed, with the northern and central regions of China bearing comparatively higher burdens. Between 1990 and 2021, the health loss and disease burden caused by AA in China remained relatively stable. The ASPR and ASDR of AA increased with the GDP when the annual GDP was less than 2 trillion Chinese yuan; however, a downward trend was observed as the GDP surpassed 2 trillion Chinese yuan. A slight upward trend in the disease burden of AA in China is predicted to occur over the next decade.
CONCLUSIONS
AA continues to be a public health concern in China that shows no signs of declining. Targeted efforts for young individuals and females are necessary because they experience a disproportionately high burden of AA.
Humans
;
China/epidemiology*
;
Alopecia Areata/epidemiology*
;
Global Burden of Disease
;
Female
;
Male
;
Adult
;
Disability-Adjusted Life Years
;
Middle Aged
;
Prevalence
;
Adolescent
;
Young Adult
;
Bayes Theorem
;
Child
;
Quality-Adjusted Life Years
;
Child, Preschool
7.Disability-adjusted life years for colorectal cancer in China, 2017-2030: A prevalence-based analysis focusing on the impact of screening coverage and the application of local weights.
Yujie WU ; Yanjie LI ; Xin WANG ; Xinyi ZHOU ; Xinxin YAN ; Hong WANG ; Juan ZHU ; Wanqing CHEN ; Jufang SHI
Chinese Medical Journal 2025;138(8):962-972
BACKGROUND:
Most studies have evaluated disability-adjusted life years (DALYs) of colorectal cancer (CRC) patients based on a set of generic disability weights (DWs). This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC (CRC-DALYs) in populations in China and consider the influence of local screening coverage of CRC.
METHODS:
A prevalence-based model was constructed using data from various sources. Years lived with disability (YLDs) were estimated mainly via cumulative prevalence data (based on CRC incidence rates, population numbers, and survival rates), stage-specific proportions of CRC, and DWs of the local population. Years of life lost (YLLs) were calculated based on the CRC mortality rates and standard life expectancies. CRC incidence and mortality rates for the years 2020, 2025, and 2030 were estimated by joinpoint regression, and the corresponding DALYs were predicted. The main assumption was made for CRC screening coverage. Sensitivity analyses were used to assess the impact of population, DWs, and coverage.
RESULTS:
In 2017, among the Chinese population, the estimated number of CRC-DALYs was 4,303,314 (11.9% for YLDs). If CRC screening coverage rate in China (2.3%) remains unchanged, the overall DALYs in 2030 are predicted to increase by 37.2% (45.1% of those aged ≥65 years). More optimistically, the DALYs would then decrease by 0.7% in 2030 (from 5,902,454 to 5,860,200) if the coverage could be increased to 25.0%. A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.
CONCLUSIONS
The estimated CRC-DALYs in China using population-specific DWs were considerably lower (with a higher percentage of YLDs) than the global burden of disease (GBD) estimates (5,865,004, of 4.6% for YLDs), suggesting the impact extent of applying local parameters. Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.
Humans
;
Colorectal Neoplasms/diagnosis*
;
China/epidemiology*
;
Disability-Adjusted Life Years
;
Male
;
Prevalence
;
Female
;
Middle Aged
;
Aged
;
Early Detection of Cancer
;
Quality-Adjusted Life Years
;
Adult
;
Incidence
8.Incidence, prevalence, and burden of type 2 diabetes in China: Trend and projection from 1990 to 2050.
Haojie ZHANG ; Qingyi JIA ; Peige SONG ; Yongze LI ; Lihua JIANG ; Xianghui FU ; Sheyu LI
Chinese Medical Journal 2025;138(12):1447-1455
BACKGROUND:
The epidemiological pattern and disease burden of type 2 diabetes have been shifting in China over the past decades. This analysis described the epidemiological transition of type 2 diabetes in the past three decades and projected the trend in the future three decades in China.
METHODS:
Age-, sex-, and year-specific incidence, prevalence, death, and disability-adjusted life years (DALYs) for people with 15 years or older and diabetes or high fasting glucose in China and related countries from 1990 to 2021 were obtained from the Global Burden of Disease. We obtained the trends of age-, sex-, and year-specific rates and absolute numbers of incidence, prevalence, deaths, and DALYs attributable to type 2 diabetes in China from 1990 to 2021. Using the Lee-Carter model, we projected the incidence, prevalence, death, and DALYs attributable to type 2 diabetes to 2050 stratified by age and sex.
RESULTS:
The age-standardized incidence of type 2 diabetes was 341.5 per 100,000 persons (1.6 times in 1990) and the age-standardized prevalence was 9.96% (9960.0 per 100,000 persons, 2.5 times in 1990) in China 2021. In 2021, there were 0.9 million deaths and 26.8 million DALYs due to type 2 diabetes or hyperglycemia, as 2.9 and 2.7 times the data in 1990, respectively. The age-standardized rates of type 2 diabetes and hyperglycemia were projected to raise to 449.5 per 100,000 persons for incidence, 18.17% for prevalence, 244.6 per 100,000 persons for death, and 4720.2 per 100,000 persons for DALYs by 2050. The incidence of type 2 diabetes kept growing among individuals under the age of 20 years in the past three decades (128.7 per 100,000 persons in 1990 and 439.9 per 100,000 persons in 2021) and estimating 1870.8 per 100,000 in 2050.
CONCLUSIONS
The incidence, prevalence, and disease burden of type 2 diabetes grew rapidly in China in the past three decades. The prevention of type 2 diabetes in young people and the care for elder adults will be the greatest challenge for the country.
Humans
;
Diabetes Mellitus, Type 2/mortality*
;
China/epidemiology*
;
Prevalence
;
Female
;
Male
;
Incidence
;
Middle Aged
;
Adult
;
Aged
;
Adolescent
;
Young Adult
;
Disability-Adjusted Life Years
;
Aged, 80 and over
9.Global and Chinese burden of non-alcoholic fatty liver disease in chronic liver disease: Findings from the Global Burden of Disease Study 2021.
Xinyu ZHAO ; Dong XU ; Wei JI ; Zhengzhao LU ; Cheng HUANG ; Jingjie ZHAO ; Tingting XIAO ; Dongxu WANG ; Yuanyuan KONG ; Jidong JIA ; Hong YOU
Chinese Medical Journal 2025;138(14):1741-1751
BACKGROUND:
Chronic liver disease (CLD), mainly non-alcoholic fatty liver disease (NAFLD), is a significant public health concern worldwide. This study aims to quantify the burden of NAFLD in CLD globally and within China, using data from the Global Burden of Disease (GBD) Study 2021, providing crucial insights for global and local health policies.
METHODS:
The study used comprehensive data from the GBD study 2021. It included estimates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Age-standardized rates and average annual percent change (AAPC) from 2011 to 2021 were reported. A meticulous decomposition analysis was conducted.
RESULTS:
In 2021, there were 1582.5 million prevalent cases, 47.6 million incident cases, 1.4 million deaths, and 44.4 million DALYs attributable to CLD, globally. Among these, NAFLD has emerged as the predominant cause, accounting for 78.0% of all prevalent CLD cases (1234.7 million) and 87.2% of incident cases (41.5 million). Correspondingly, NAFLD had the highest age-standardized prevalence (15,017.5 per 100,000 population) and incidence (876.5 per 100,000 population) rates among CLDs. In addition, China's CLD age-standardized prevalence rate was 21,659.5 per 100,000 population, and the age-standardized incidence rate was 752.6 per 100,000 population, higher than the global average. From 2011 to 2021, the global prevalence rate of CLD increased slowly (AAPC = 0.17), consistent with the trend in China (AAPC = 0.23). Furthermore, the prevalence rate of NAFLD rose significantly in China (AAPC = 1.30) compared with the global average (AAPC = 0.91). Decomposition analysis also showed the worldwide increase in deaths and DALYs for NAFLD, which were primarily attributable to population growth and aging.
CONCLUSIONS
The burden of CLD and NAFLD remains substantial globally and within China in terms of high prevalence and incidence. As such, this underscores the need for targeted prevention and treatment strategies. These findings emphasize the importance of continued surveillance and research to mitigate the growing impact of liver diseases on global and Chinese health systems.
Humans
;
Non-alcoholic Fatty Liver Disease/mortality*
;
Global Burden of Disease
;
China/epidemiology*
;
Prevalence
;
Male
;
Disability-Adjusted Life Years
;
Female
;
Incidence
;
Middle Aged
;
Chronic Disease
;
Adult
;
Quality-Adjusted Life Years
;
Liver Diseases/epidemiology*
;
Aged
10.Global burden and trends of gout incidence and prevalence.
Shuai JIN ; Yuhan WANG ; Shuangtong YAN ; Xiaomin FU ; Xiaodong HU ; Zhaohui LYU ; Hongzhou LIU
Chinese Medical Journal 2025;138(23):3153-3162
BACKGROUND:
Gout is a chronic disease primarily caused by elevated urate levels, severely affecting joint health. Its global distribution varies, and updated data for China are lacking. This study aimed to analyze the current burden and trends of gout globally and in China, examining the burden by gender, age, and risk factors while providing future predictions.
METHODS:
This descriptive epidemiological secondary analysis utilized data from the Global Burden of Disease, Injuries, and Risk Factors (GBD) 2021 study. Age-standardized incidence rate (ASIR), prevalence rate (ASPR), and disability-adjusted life years (DALYs) rates (ASDR) were used to assess the gout burden. Trends from 1990 to 2021 were analyzed across global regions, genders, and sociodemographic index (SDI) levels. The burden in China was further examined by gender, age, and associated risk factors. The Bayesian age-period-cohort (BAPC) model was used to predict future trends. Gout burden in China and the United States was compared.
RESULTS:
In 2021, gout affected 57 million people globally, with 9.4 million new cases and 1.75 million DALYs. From 1990 to 2021, the ASIR, ASPR, and ASDR increased by 17.2%, 21.9%, and 21.3%, respectively. Males experienced a significantly higher burden, with greater ASIR, ASPR, and ASDR increasing with higher SDI levels. In China, male ASIR, ASPR, and ASDR were over 2.8 times those of females, and the burden increased with age. In 2021, 31.4% of gout-related DALYs in China were attributed to high body mass index and 7.6% to kidney dysfunction. Between 1990 and 2021, the high body mass index-related burden of gout rose annually for both genders, while the kidney dysfunction-related gout burden remained stable. By 2050, the burden of gout in China is expected to continue increasing, with a slower rise in females and a decline in males after an initial increase. However, the overall burden will remain substantial. In comparison, the gout burden will be higher in the United States than in China.
CONCLUSIONS
Gout is becoming a significant health burden globally and in China, particularly among Chinese males and older individuals. With the aging population and lifestyle changes exacerbating the issue, effective strategies and measures are essential to prevent or reduce gout-related health issues.
Humans
;
Gout/epidemiology*
;
Male
;
Female
;
Incidence
;
Middle Aged
;
Prevalence
;
China/epidemiology*
;
Adult
;
Risk Factors
;
Aged
;
Global Burden of Disease
;
Disability-Adjusted Life Years
;
Young Adult
;
Adolescent
;
Quality-Adjusted Life Years

Result Analysis
Print
Save
E-mail