目的 描述1990－2021年中国人群营养缺乏病的疾病负担趋势及流行病学特征，并预测2022至2040年发病率变化。方法 通过联结点回归模型分析全球健康数据库中1990－2021年中国营养缺乏病疾病负担变化趋势，计算年度变化百分比和平均年度变化百分比，并使用贝叶斯-年龄-时期-队列模型预测2022－2040年的发病情况。结果 1990－2021年营养缺乏病全人群的发病率总体呈现连续下降趋势，其平均年度变化百分比为－4.25%；年龄标化发病率总体也呈现连续下降的趋势，平均年度变化百分比为－3.96%；死亡率呈现先下降后上升的趋势，总体为下降趋势，平均年度变化百分比为－3.45%。年龄标化死亡率总体呈下降趋势，平均年度变化百分比为－4.97%；伤残调整寿命年率总体呈下降趋势，平均年度变化百分比为－3.78%，年龄标化伤残调整寿命年总体呈下降趋势，平均年度变化百分比为－4.07%，2021年女性伤残调整寿命年率为男性的三倍，年龄标化伤残调整寿命年率女性为男性的2.5倍；年龄别疾病负担在0~4岁下降最快，其发病率、死亡率、伤残调整寿命年率的平均年度变化百分比分别为－5.66%、－10.80%、－7.89%；贝叶斯-年龄-时期-队列预测模型结果显示，在2022－2040年间，中国营养缺乏病的年龄标化发病率将从2022年的3205.11/10万下降到2040年的2331.78/10万，下降幅度为27.22%。结论 1990－2021年中国全人群营养缺乏病的疾病负担呈下降趋势；2022－2040年中国全人群、女性、男性标化发病率继续呈下降趋势。
Abstract
Objective To describe the trends and epidemiological characteristics of the disease burden of nutritional deficiencies in China from 1990 to 2021 and to project the incidence from 2022 to 2040. Methods Using data from the Global Burden of Disease Study 2019 on the incidence, mortality, and Disability-Adjusted Life Years (DALY) rates of nutritional deficiencies in China from 1990 to 2021, we analyzed the Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC) via Joinpoint regression models. A Bayesian age-period-cohort model was employed to project incidence rates from 2022 to 2040. Results From 1990 to 2021, the overall incidence rate of nutritional deficiencies in China showed a continuous declining trend, with an AAPC of −4.25%. The age-standardized incidence rate also exhibited a continuous decline, with an AAPC of −3.96%. The mortality rate initially decreased and then increased, but showed an overall downward trend with an AAPC of −3.45%. The age-standardized mortality rate declined overall, with an AAPC of −4.97%. The DALY rate displayed a general downward trend (AAPC = −3.78%), as did the age-standardized DALY rate (AAPC = −4.07%). In 2021, the DALY rate for females was three times that of males, and the age-standardized DALY rate for females was 2.5 times that of males. The disease burden declined most rapidly in the 0-4 age group, with AAPCs for incidence, mortality, and DALY rates of −5.66%, −10.80%, and −7.89%, respectively. Projections from the Bayesian age-period-cohort model indicated that the age-standardized incidence rate in China would decrease from 3205.11 per 100 000 in 2022 to 2331.78 per 100 000 in 2040, representing a reduction of 27.22%. Conclusion The disease burden of nutritional deficiencies in China showed a downward trend from 1990 to 2021. Projections suggest that the age-standardized incidence rates for the overall population, females, and males will continue to decline from 2022 to 2040.
关键词
营养缺乏病 /
中国人平均年度变化百分比 /
联结点回归模型 /
贝叶斯-年龄-时期-队列模型
Key words
Nutritional deficiency disease /
AAPC /
Joinpoint regression model /
Bayesian-age-period-cohort model
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基金
2019年度湖南省芙蓉教学名师专项基金（No.201RFS001）
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