Disease Burden and Variation Tendency of Inflammatory Bowel Disease in China from 1990 to 2019

doi:10.12114/j.issn.1007-9572.2023.0220

Abstract

Abstract:

Background

Inflammatory bowel disease (IBD) has become highly prevalent in recent years characterized by a prolonged disease course and high disease burden. However, there is a lack of data to understand the burden of IBD in China, which may hinder health care planning and resource allocation for the disease.

Objective

To investigate the burden of IBD and its variation tendency in China from 1990 to 2019, and analyze the influence of age, gender and period on IBD.

Methods

The incidence, mortality and disability adjusted life year (DALY) rate of IBD in China from 1990 to 2019 were collected using the Global Burden of Disease Database 2019. Joinpoint software was used to analyze the variation tendency and characteristics of standardized incidence, standardized mortality and standardized DALY rate of IBD, and Excel 2019 software was used for data processing.

Results

From 1990 to 2019, the standardized incidence increased from 1.47/100 000 to 3.01/100 000 with avevage annual percent change (AAPC) of 2.50%〔95%CI (2.4%, 2.6%) 〕, the standardized mortality decreased from 0.86/100 000 to 0.35/100 000 with AAPC of -1.6%〔95%CI (-3.8%, -3.4%) 〕, the standardized DALY rate decreased from 24.47/100 000 to 16.31/100 000, with AAPC of -2.2%〔95%CI (-2.3%, -2.0%) 〕, the changes of trends were all statistically significant (P<0.05) . The standardized incidence and mortalityof of males were higher than females in each year, while the standardized DALY rate of females was higher than males before 1995, basically the same in males and females from 1995 to 2001, and higher in males than females after 2001. There was overall stable uptrend in the AAPC of the standardized incidence of IBD in all age groups by year (P<0.05) and overall downtrend in the AAPC of standardized mortality rate in all age groups, while the downtrend became slower with increasing age (P<0.05) .

Conclusion

From 1990 to 2019, the standardized mortality rate and DALY rate of IBD showed a downtrend, while the standardized incidence showed an uptrend. The standardized incidence and mortality of males were higher than females by year. The burden of IBD in elderly population deserves priority attention and will be a major public health challenge in China due to large population base and aging population.

Key words: Inflammatory bowel diseases, Burden of disease, Cost of illness, Variation tendency, Joinpoint model

摘要：

背景

炎症性肠病近年来发病率高，具有病程迁延、疾病负担重等特点，但目前缺乏中国炎症性肠病疾病负担的数据，这可能会阻碍此疾病的医疗保健规划和资源分配。

目的

调查1990—2019年我国炎症性肠病疾病负担及变化趋势，分析年龄、性别和时期对炎症性肠病的影响。

方法

利用2019年全球疾病负担数据库，收集1990—2019年中国炎症性肠病发病率、死亡率和伤残调整寿命年（DALY）率数据；采用Joinpoint软件分析炎症性肠病的标化发病率、标化死亡率、标化DALY率变化趋势及特征，利用Excel 2019软件进行数据整理。

结果

1990—2019年我国炎症性肠病标化发病率从1.47/10万上升到3.01/10万，平均年度变化百分比（AAPC）为2.5%〔95%CI（2.4%，2.6%）〕，标化死亡率从0.86/10万下降到0.35/10万，AAPC为-1.6%〔95%CI（-3.8%，-3.4%）〕，标化DALY率从24.47/10万下降到16.31/10万，AAPC为-2.2%〔95%CI（-2.3%，-2.0%）〕，趋势变化均有统计学意义（P<0.05）。各年度男性标化发病率、死亡率高于女性，而标化DALY率在1995年之前女性高于男性，1995—2001年男性与女性基本一致，2001年之后男性高于女性。各年度各年龄段炎症性肠病标化发病率AAPC呈整体平稳上升趋势（P<0.05）；各年龄段标化死亡率AAPC呈整体下降趋势，但是随着年龄的增大下降趋势变缓（P<0.05）。

结论

1990—2019年，我国炎症性肠病标化死亡率和标化DALY率呈下降趋势，标化发病率呈上升趋势。各年度男性标化发病率、死亡率均高于女性。高龄人群炎症性肠病疾病负担问题值得重点关注，鉴于中国庞大的人口基数和人口老龄化，炎症性肠病在中国的负担将是一个重大的公共卫生挑战。

关键词: 炎性肠疾病, 疾病负担, 患病代价, 变化趋势, Joinpoint模型

BAO Yunli,WANG Zhe,TANG Hairu, et al. Disease Burden and Variation Tendency of Inflammatory Bowel Disease in China from 1990 to 2019[J]. Chinese General Practice, 2023, 26(36): 4581-4586. DOI: 10.12114/j.issn.1007-9572.2023.0220.
包云丽,汪哲,唐海茹等. 1990—2019年中国炎症性肠病疾病负担及变化趋势分析[J]. 中国全科医学, 2023, 26(36): 4581-4586. DOI: 10.12114/j.issn.1007-9572.2023.0220.

Figures/Tables 10

References 20

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性别	年份	发病率		死亡率		DALY率
性别	年份	粗率	标化率	粗率	标化率	粗率	标化率
男性	1990年	1.71	1.72	0.42	0.94	18.21	24.06
	2019年	3.99	3.35	0.35	0.47	17.71	18.45
	变化率（%）	133.33	94.76	-16.67	-50.00	-2.75	-23.32
女性	1990年	1.19	1.21	0.52	0.84	21.47	25.50
	2019年	3.24	2.66	0.31	0.30	14.92	14.78
	变化率（%）	172.27	119.83	-40.38	-64.29	-30.51	-42.04
总人群	1990年	1.45	1.47	0.47	0.86	19.79	24.47
	2019年	3.62	3.01	0.33	0.35	16.34	16.31
	变化率（%）	149.66	104.76	-29.79	-59.30	-17.43	-33.35

性别	年份	发病率		死亡率		DALY率
性别	年份	粗率	标化率	粗率	标化率	粗率	标化率
男性	1990年	1.71	1.72	0.42	0.94	18.21	24.06
	2019年	3.99	3.35	0.35	0.47	17.71	18.45
	变化率（%）	133.33	94.76	-16.67	-50.00	-2.75	-23.32
女性	1990年	1.19	1.21	0.52	0.84	21.47	25.50
	2019年	3.24	2.66	0.31	0.30	14.92	14.78
	变化率（%）	172.27	119.83	-40.38	-64.29	-30.51	-42.04
总人群	1990年	1.45	1.47	0.47	0.86	19.79	24.47
	2019年	3.62	3.01	0.33	0.35	16.34	16.31
	变化率（%）	149.66	104.76	-29.79	-59.30	-17.43	-33.35

分类	区间段（年）	APC（%）	t值	P值
男性	1990—1996	1.86	77.1	<0.001
	1996—1999	5.66	42.7	<0.001
	1999—2006	1.56	73.6	<0.001
	2006—2009	2.77	22.0	<0.001
	2009—2015	1.74	63.1	<0.001
	2015—2019	2.52	62.9	<0.001
女性	1990—1995	1.63	6.8	<0.001
	1995—1999	7.19	13.9	<0.001
	1999—2019	2.16	82.7	<0.001
总体	1990—1995	1.68	27.8	<0.001
	1995—2000	5.26	66.1	<0.001
	2000—2005	1.31	17.5	<0.001
	2005—2010	2.54	33.9	<0.001
	2010—2015	1.73	23.2	<0.001
	2015—2019	2.55	33.4	<0.001

分类	区间段（年）	APC（%）	t值	P值
男性	1990—1996	1.86	77.1	<0.001
	1996—1999	5.66	42.7	<0.001
	1999—2006	1.56	73.6	<0.001
	2006—2009	2.77	22.0	<0.001
	2009—2015	1.74	63.1	<0.001
	2015—2019	2.52	62.9	<0.001
女性	1990—1995	1.63	6.8	<0.001
	1995—1999	7.19	13.9	<0.001
	1999—2019	2.16	82.7	<0.001
总体	1990—1995	1.68	27.8	<0.001
	1995—2000	5.26	66.1	<0.001
	2000—2005	1.31	17.5	<0.001
	2005—2010	2.54	33.9	<0.001
	2010—2015	1.73	23.2	<0.001
	2015—2019	2.55	33.4	<0.001

分类	区间段（年）	APC（%）	t值	P值
男性	1990—2004	-1.95	-30.2	<0.001
	2004—2008	-5.74	-14.1	<0.001
	2008—2016	-4.14	-47.1	<0.001
	2016—2019	-2.14	-5.4	<0.001
女性	1990—2004	-1.83	-26.5	<0.001
	2004—2008	-8.98	-16.8	<0.001
	2008—2013	-7.87	-33.2	<0.001
	2013—2016	-6.23	-8.6	<0.001
	2016—2019	-0.41	-0.9	<0.001
总体	1990—2004	-1.72	-32.6	<0.001
	2004—2007	-7.82	-9.5	<0.001
	2007—2013	-6.36	-47.2	<0.001
	2013—2016	-5.04	-9.4	<0.001
	2016—2019	-1.13	-3.5	<0.001