1990～2021年中国脊柱骨折疾病负担分析及2035年趋势预测

Analysis of the burden of vertebral column fracture in china from 1990 to 2021 and trend forecast to 2035

中文关键词:  脊柱骨折  全球疾病负担数据库  可视化分析

英文关键词:Vertebral column fracture  Global Burden of Disease database  Visualized analysis

中文摘要:

  【摘要】 目的：为中国脊柱骨折的流行特征提供新视角，并为制定针对性的公共卫生策略提供指导。方法：使用2021全球疾病负担数据库分析中国1990～2021年脊柱骨折的流行病学趋势，并进一步探究年龄、性别和相关病因的疾病负担特点，利用Joinpoint回归模型计算平均年度变化百分比（average annual percent change，AAPC）来分析标准化率的时间变化趋势，通过贝叶斯-年龄-时期-队列（Bayesian age-period-cohort，BAPC）模型来预测2035年的标准化率。结果：2021年中国脊柱骨折的发病数和患病数分别为1194465例[95%不确定性区间（uncertainty interval，UI）：888994～1594120]和717078例（95%UI：619114～835347），比1990年分别增加了52.28%和113.66%。从1990～2021年，中国年龄标准化发病率（age-standardized incidence rate，ASIR）上升趋势不明显，AAPC值为0.45%[95%置信区间（confidence interval，CI）：-0.29%～1.20%，P>0.05]；而年龄标准化患病率（age-standardized prevalence rate，ASPR）上升趋势明显，AAPC值为0.53%（95%CI：0.24%～0.83%，P<0.05），2022～2035年的贝叶斯年龄-时期-队列模型（Bayesian age-period-cohort，BAPC）预测结果显示ASIR和ASPR均呈下降趋势。年龄组分析发现，发病数和患病数的峰值年龄组均有所增长，粗发病率（crude incidence rate，CIR）和粗患病率（crude prevalence rate，CPR）随年龄增长而增加，呈现出老龄化趋势。性别分析发现，中年男性和老年女性的疾病负担较为突出。病因分析发现，跌倒位于中国脊柱骨折病因的首位，其次为道路伤害。结论：1990~2021年，中国脊柱骨折疾病负担显著增加，并呈现出老龄化趋势，尽管2035年的疾病负担预测结果呈下降趋势，但仍不能松懈，中年男性和老年女性是重点关注群体，并注重预防跌倒和道路伤害。

英文摘要:

  【Abstract】 Objectives: To provide a new perspective on the epidemiological characteristics of vertebral column fracture in China and to guide the formulation of targeted public health strategies. Methods: The Global Burden of Disease 2021 database was utilized to analyze the epidemiological trends of vertebral column fracture in China from 1990 to 2021. The study further explored the disease burden characteristics related to age, sex, and etiology. The Joinpoint regression model was employed to calculate the average annual percent change(AAPC) to analyze the temporal trends of age-standardized rates. The Bayesian age-period-cohort(BAPC) model was used to forecast the age-standardized rates for 2035. Results: In 2021, the incidence and prevalence of vertebral column fracture in China were 1194465[95% uncertainty interval(UI): 888994-1594120] and 717078(95%UI: 619114-835347), respectively, representing increases of 52.28% and 113.66% compared to 1990. From 1990 to 2021, the age-standardized incidence rate(ASIR) in China showed no significant upward trend, with an AAPC of 0.45%[95% confidence interval(CI): -0.29% to 1.20%, P>0.05], while the age-standardized prevalence rate(ASPR) showed a significant upward trend, with an AAPC of 0.53%(95%CI: 0.24% to 0.83%, P<0.05). The BAPC prediction results for 2022-2035 indicated a downward trend for both ASIR and ASPR. Analysis by age group revealed that the peak age groups for incidence and prevalence have increased, with the crude incidence rate(CIR) and crude prevalence rate(CPR) increasing with age, reflecting an aging trend. Gender analysis found that the disease burden was more prominent among middle-aged men and elderly women. Etiological analysis revealed that falls were the leading cause of spinal fractures in China, followed by road injuries. Conclusions: From 1990 to 2021, the disease burden of spinal fractures in China has significantly increased and shown an aging trend. Although the predicted disease burden for 2035 is expected to decline, it is still necessary to remain vigilant. Middle-aged men and elderly women are the key populations of concern, and emphasis should be placed on preventing falls and road injuries.