Objective To analyze the spatiotemporal trends in hepatitis B-related mortality and disability-adjusted life years (DALYs) attributable to high body mass index (BMI) at the global, regional, and national levels. Methods We extracted data on hepatitis B-related mortality numbers, DALYs, age-standardised mortality rates (ASMR), and age-standardised DALY rates (ASDR) attributed to high BMI from the GBD 2021 database for the period 1990-2021, stratified by gender, age, country, and social demographic index (SDI). Time trends were assessed using estimated annual percentage change (EAPC), and decomposition analysis and frontier analysis were employed to identify the drivers of burden changes and leading countries. Inequality indicators (inequality slope index SII and concentration index CI) were used to measure health disparities across SDI levels, and the Bayesian age period cohort model (BAPC) was applied to predict disease trends up to 2050. Results The global burden of hepatitis B disease attributable to high BMI continues to rise. In 2021, the number of DALYs reached 499 900 (four times that of 1990), and the number of deaths was five times that of 1990. The burden and rate of increase were most pronounced in Asia: in 2021, East Asia recorded 7 919.70 deaths (95%UI 2 984.05 to 14 386.39) and 257 954.31 DALYs (95%UI 97 807.17 to 482 232.54), ranked highest among the 21 GBD regions; From 1990 to 2021, South Asia recorded the fastest increase in ASMR (EAPC=4.99, 95%CI 4.83 to 5.16) and the highest growth rate in ASDR (EAPC=4.92, 95%CI 4.74 to 5.10); at the national level, China and the United States had the heaviest burden. Countries with medium SDI had the highest burden, peaking at an SDI of 0.65. Global and regional decomposition analyses indicated that epidemiological changes were the primary drivers of the increased burden. The CI and SII values derived from inequality analyses of ASDR and ASMR had both increased, indicating worsening health inequalities. Frontier analysis further confirmed that certain countries, such as Tonga and Mongolia, bear a significantly higher burden than expected for their developmental level, demonstrating marked disparities in disease burden across nations. The BAPC model predicts that the burden attributable to high BMI will continue to rise in the absence of interventions. Conclusion High BMI has become an important risk factor for hepatitis B-related diseases globally, with the burden particularly pronounced in Asian regions and middle-income countries. Health inequalities must not be overlooked. Precise interventions should be implemented based on regional, gender, and age differences.
Objective To explore the long-term trends and epidemiological characteristics of the disease burden of tetanus in China over the past 30 years and to predict its disease burden in 2050, in order to comprehensively assess the overall disease burden of tetanus in China. Methods Leveraging the methods and findings of the Global Burden of Disease Study 2021, we provided a detailed description of the disease burden of tetanus in China based on key indicators such as prevalence, incidence, mortality, disability-adjusted life years, years lived with disability, and years of life lost due to premature mortality. Joinpoint regression analysis, age-period-cohort analysis, decomposition analysis, and Bayesian age-period-cohort models were employed to further elucidate the epidemiological characteristics of tetanus and predict its disease burden in China by 2050. Results From 1990 to 2021, the overall disease burden of tetanus in China exhibited a significant year-by-year decline. The primary demographic group bearing the burden of tetanus in China had gradually shifted from newborns to middle-aged and elderly individuals, with males being more affected than females. Decomposition analysis indicated that epidemiological change was a significant factor contributing to tetanus in China, while the impacts of population and aging were relatively minor. According to predictions from the Bayesian age-period-cohort model, by 2050, only the prevalence rate was expected to slightly increase, while all other indicators were projected to decline and remain at low levels. Conclusion The disease burden of tetanus in China decreased from 1990 to 2021. In subsequent prevention efforts, newborns and middle-aged and elderly individuals should be prioritized as targets for prevention and control to maintain the disease burden of tetanus at a low level.
ObjectiveTo analyze trends in the burden of neck pain (NP) in China and worldwide from 1990 to 2023 and to forecast future incidence. MethodsData for China and the globe were obtained from the Global Burden of Disease (GBD) database (1990-2023), including incident cases, prevalent cases, disability-adjusted life years (DALY), and age-standardized incidence, prevalence, and DALY rates (ASIR, ASPR, ASDR). Trends were visualized and assessed using R 4.3.1 and Joinpoint 5.1. A Bayesian age-period-cohort (BAPC) model was used to forecast sex-specific ASIRs for 2024-2036. ResultsIncident cases, prevalent cases, and DALY increased markedly in both China and globally. Globally, ASIR, ASPR, and ASDR declined slightly. In China, ASIR decreased slightly, whereas ASPR and ASDR increased slightly. In 2023, the burden in China peaked at ages 55-59, and women bore a higher burden than men. Joinpoint analysis showed slow declines in ASIR, ASPR, and ASDR during 1990-2005, a rapid rise in 2005-2010, and a slow decline in 2010-2023. Based on BAPC model projections up to 2036, the ASIR, ASPR, and ASDR for males are expected to rise to 512.59, 2 224.55, and 221.60 per 100 000, respectively; whereas for females, these rates are projected to decrease to 629.27, 2 867.17, and 286.67 per 100 000, respectively. ConclusionAlthough absolute NP burden increased substantially in China and globally, age-standardized rates changed only modestly—slightly down or up depending on indicator and setting. NP burden shows clear sex and age differences, with women and those aged 55-59 being priority groups for prevention and control. Forecasts suggest that sex disparities in incidence will persist.
ObjectiveTo systematically analyze the temporal trends in the burden of gallbladder and biliary tract cancer (GBTC) in Yunnan Province, China, from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021), and to project the disease burden through 2030 to inform regional prevention and control strategies. MethodsData on crude prevalence, mortality, and disability-adjusted life year (DALY) rates for GBTC in Yunnan Province, China, from 1990 to 2021 were extracted from GBD 2021. Temporal trends in the age-standardized prevalence, mortality, and DALY rates (ASPR, ASMR, and ASDR) were analyzed using Joinpoint regression models, and the average annual percent change (AAPC) was calculated. Furthermore, the Bayesian age-period-cohort (BAPC) model was employed to project the disease burden from 2022 to 2030. ResultsFrom 1990 to 2021, the crude prevalence, mortality, and DALY rates of GBTC in Yunnan Province increased from 1.01/100 000, 1.00/100 000, and 27.50/100 000 in 1990 to 3.00/100 000, 1.78/100 000, and 43.29/100 000 in 2021, respectively. After age standardization, the ASPR showed an upward trend (AAPC=1.29%), whereas the ASMR (AAPC=–0.58%) and ASDR (AAPC=–0.70%) exhibited downward trends. Regarding sex disparities, the increase in ASPR was more pronounced in males than in females (AAPC: 1.88% vs. 0.67%), while the declines in ASMR and ASDR were less steep in males than in females (ASMR AAPC: –0.20% vs. –0.92%; ASDR AAPC: –0.29% vs. –1.06%). Age-stratified analysis revealed that the ASPR increase was most prominent in the 30–34-year age group (AAPC=2.63%), and the reductions in ASMR and ASDR were most substantial in the 50–59-year age group (AAPC: –1.20% and –1.18%, respectively). Projections based on the BAPC model indicate that by 2030, the ASPR will continue to rise to 3.17/100 000, whereas the ASMR and ASDR are projected to decline gradually to 1.44/100 000 and 34.86/100 000, respectively. ConclusionsThe absolute disease burden of GBTC in Yunnan Province keeps rising. While the ASMR and ASDR have shown a declining trend, the steady growth in the ASPR points to a substantial accumulation of prevalent cases. Future public-health programmes should prioritise targeted early-detection and treatment strategies for the young- and middle-aged population.
