Gastroesophageal reflux disease (GERD) has a high incidence and a heavy disease burden in recent years, but there is a lack of data to understand the burden of GERD in China. This study describes and analyzes the disease burden of GERD in order to better understand the prevalence of GERD in China.

To analyze the disease burden and prevalence trend of GERD in China from 1990 to 2019, and to provide a reference for the prevention and treatment of GERD in China.

Crude and standardized incidence, prevalence, and DALY rates of GERD in China from 1990 to 2019 were obtained from the Global Burden of Disease Database 2019 (GBD 2019) ; the rate of change was calculated, and Joinpoint regression model was used to analyze the standardized incidence, prevalence, and DALY rates of GERD, and the annual percentage change (APC) was calculated.

In 2019, the crude rate and standardized rate of GERD incidence in China were 2 299.80 per 100 000 and 1 841.66 per 100 000, respectively. Compared with 1 761.59 per 100 000 and 1 849.31 per 100 000 in 1990, the crude rate increased by 30.55%, and the standardized rate decreased by 0.41%. In 2019, the crude rate and standardized rate of GERD prevalence in China were 5 739.55 per 100 000 and 4 509.32 per 100 000, respectively. Compared with 4 252.72 per 100 000 and 4 532.19 per 100 000 in 1990, the crude rate increased by 34.96%, and the standardized rate decreased by 0.51%. In 2019, the crude rate and standardized rate of GERD DALY rate in China were 44.37 per 100 000 and 34.94 per 100 000, respectively. Compared with 33.10 per 100 000 and 35.04 per 100 000 in 1990, the crude rate increased by 34.05%, and the standardized rate decreased by 0.29%. The standardized incidence, prevalence, and DALY rates were lower than crude rates after 1996. The standardized incidence, prevalence, and DALY rates of Chinese women were higher than those of men from 1990 to 2019. The results of Joinpoint regression analysis showed that the standardized incidence of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.0%), a downward trend from 2005 to 2010 (APC=-1.4%), and an upward trend from 2014 to 2017 (APC=3.2%). The standardized prevalence of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.2%), a downward trend from 2005 to 2009 (APC=-1.7%), and an upward trend from 2014 to 2017 (APC=3.7%). The standardized DALY rates of GERD in China showed a downward trend from 1990 to 1994 (APC=-1.1%), a downward trend from 2005 to 2009 (APC=-1.7%), and an upward trend from 2014 to 2017 (APC=3.6%). In 2019, the standardized incidence, prevalence, and DALY rates of GERD in China continued to increase with age, peaking at the age of 70 to 84 years. The number of new cases and cases of GERD in 2019 were respectively about 32.711 3 million and 81.636 5 million, and the populations were mainly concentrated in the age group of 45 to 59 years and 30 to 34 years.

From 1990 to 2019, the disease burden of GERD in China showed an upward trend in terms of crude rate and a slight decline in terms of standardized rate, indicating that aging had a great impact on the incidence, prevalence and DALY rate of GERD in China. In addition, it is important to pay attention to the middle-aged and young population, who account for a larger proportion of the population already suffering from GERD and may be closely related to overweight or obesity, alcohol consumption and dietary habits, etc.

胃食管反流病（GERD）近年来发病率较高，疾病负担较重，但目前缺乏中国GERD负担的研究数据，为了更好地了解GERD的流行情况，本研究描述和分析了中国GERD的疾病负担状况。

分析1990—2019年我国GERD疾病负担状况和流行趋势，为我国GERD的防治提供参考依据。

从2019年全球疾病负担数据库（简称GBD 2019）中获取1990—2019年中国GERD的发病率、患病率、伤残调整寿命年（DALY）率的粗率和标化率；计算变化率，并采用Joinpoint回归模型分析GERD标化发病率、患病率、DALY率，计算年度变化百分比（APC）。

2019年中国GERD发病率的粗率和标化率分别为2 299.80/10万和1 841.66/10万，相较1990年的1 761.59/10万和1 849.31/10万，粗率增长30.55%，标化率降低0.41%。2019年中国GERD患病率的粗率和标化率分别为5 739.55/10万和4 509.32/10万，相较1990年的4 252.72/10万和4 532.19/10万，粗率增长34.96%，标化率降低0.51%。2019年中国GERD DALY率的粗率和标化率分别为44.37/10万和34.94/10万，相较1990年的33.10/10万、35.04/10万，粗率上升34.05%，标化率下降0.29%。1996年之后标化发病率、患病率和DALY率均低于粗率。1990—2019年中国女性标化发病率、患病率、DALY率均高于男性。Joinpoint回归分析结果显示，1990—1994年中国GERD标化发病率呈降低趋势（APC=-1.0%），2005—2010年呈降低趋势（APC=-1.4%），2014—2017年均呈上升趋势（APC=3.2%）。1990—1994年、2005—2009年中国GERD标化患病率均呈降低趋势（APC分别为-1.2%、-1.7%），2014—2017年呈上升趋势（APC=3.7%）。1990—1994年、2005—2009年中国GERD标化DALY率均呈降低趋势（APC分别为-1.1%、-1.7%），2014—2017年呈上升趋势（APC=3.6%）。2019年中国GERD标化发病率、患病率、DALY率随着年龄的增加不断上升，在70~84岁达到峰值。2019年GERD新发病例数和现患病例数分别约为3 271.13万和8 163.65万，人群主要集中在45~59岁和30~34岁。

1990—2019年中国GERD疾病负担粗率呈上升趋势，标化率略有下降，说明老龄化对我国GERD的发病率、患病率和DALY率影响较大。此外要关注青中年人群，在已患GERD人群中占比较重，可能与超重或肥胖、饮酒及饮食习惯等密切相关。