中国与全球溃疡性结肠炎疾病负担及趋势OA

[Objective]To assess changes in the incidence,prevalence,and disability-adjusted life-year(DALY)burden of ulcerative colitis(UC)in China and worldwide from 1990 to 2023 using data from the Global Burden of Disease Study 2023(GBD 2023),and to examine demographic drivers and future trends.[Methods]UC data for China,the world,and 204 countries and territories were extracted from the GBD 2023 Results Tool.Age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized DALY rate(ASDR),with 95％uncertainty interval(UI),were obtained.Joinpoint regression was used to estimate average annual percent change(AAPC)and 95％confidence interval(CI).Spearman rank correlation,inequality and frontier analyses,Das Gupta decomposition,and autoregressive integrated moving average(ARIMA)models were used to assess associations with the sociodemographic index(SDI),cross-country burden disparities,demographic drivers,and trends from 2024 to 2035,respectively.[Results]In 2023,the ASIR,ASPR,and ASDR in China were 0.94,5.95,and 5.94 per 100 000 population,respectively,lower than the corresponding global estimates of 2.87,28.48,and 13.82 per 100 000 population.From 1990 to 2023,China's ASIR and ASPR increased,with AAPCs of 2.720％(95％CI:2.133％-3.309％)and 2.261％(95％CI:1.617％-2.908％),whereas the ASDR decreased(AAPC=-3.056％,95％CI:-3.449％to-2.662％).Globally,ASIR increased slightly,whereas ASPR and ASDR decreased.In China,the crude incidence,prevalence,and DALY rates peaked at ages 50-54 years,60-64 years,and≥95 years,respectively.ASIR and ASPR were positively correlated with SDI(rs=0.5794 and 0.6177,both P<0.001),whereas the correlation between ASDR and SDI was not statistically significant(rs=0.0666,P=0.343).In China,epidemiological change contributed most to increases in incident and prevalent cases,and changes in age-specific rates contributed most to the decline in DALYs;globally,population growth and population aging contributed most to the increase in DALYs.By 2035,China's ASIR,ASPR,and ASDR were projected to be 1.23,6.37,and 2.55 per 100 000 population,respectively.[Conclusions]From 1990 to 2023,the age-standardized incidence and prevalence rates of UC increased in China,whereas the age-standardized DALY rate decreased,and peaks in absolute burden generally shifted toward middle-aged and older age groups.The projected directions may persist.These findings may provide reference for long-term UC management and health-resource planning.