基于GBD 2021分析中国胃食管反流病疾病负担及预测

Analysis and Prediction of the Burden of Gastroesophageal Reflux Disease in China Based on GBD 2021

摘要: 背景：胃食管反流病(GERD)是一种全球常见慢性疾病，其特征是胃内容物反流到食管，引起烧心、恶心等症状，从而导致患者生活质量严重受损。本研究利用2021年全球疾病负担(GBD)研究的数据，对中国胃食管反流病疾病负担进行全面分析与预测，为胃食管反流病的防控提供理论支持。方法：通过检索GBD 2021数据库内中国胃食管反流病的发病率、患病率和伤残调整生命年(DALYs)，统计描述胃食管反流病疾病负担在不同性别，不同年龄段之间的差异。另外通过联点回归分析，分解分析和贝叶斯模型(Bayesian Model)来确定关键趋势变化年份及影响因素，并预测未来的疾病负担。结果：从1990年到2021年，中国胃食管反流病的发病率、患病率和DALYs率都呈上升趋势。亚组分析显示，中国妇女和中老年个体(30~89岁)承受着不同比例的高疾病负担。联合点回归分析显示，中国胃食管反流病发病率在1994年、2005年、2010年、2015年和2018年出现了显著的转折点，人口增长和老龄化是病例增加的主要驱动因素。贝叶斯模型预测未来十年中国胃食管反流病发病率将持续增加，到2046年，男性群体发病率将增加25.72%，女性将增加27.06%。结论：通过分析GBD 2021数据库，可以了解到中国胃食管反流病负担日益加重，人口老龄化与人口增长是疾病负担加重的主要影响因素，关注女性及中老年群体的疾病趋势，这对我国胃食管反流病公共卫生防控具有重要意义。

Abstract: Background: Gastroesophageal reflux disease (GERD) is a prevalent chronic condition worldwide, characterized by the reflux of gastric contents into the esophagus, causing heartburn, nausea and other symptoms, resulting in serious impairment of patients’ quality of life. This study utilizes data from the 2021 Global Burden of Disease (GBD) study to comprehensively analyze and predict the burden of GERD in China, providing theoretical support for disease prevention and control. Methods：The incidence rate, prevalence rate, and disability-adjusted life years (DALYs) of GERD in China were extracted from the GBD 2021 database to assess disease burden differences across gender and age groups. Additionally, Joinpoint regression analysis, decomposition analysis, and the Bayesian model were employed to identify key years of trend changes, determine influencing factors, and predict future disease burden. Results: From 1990 to 2021, the incidence rate, prevalence rate, and DALYs rate of GERD in China exhibited an upward trend. Subgroup analysis indicated that Chinese women and middle-aged to elderly individuals (30~89 years) bore a disproportionately high disease burden. Joinpoint regression analysis identified significant turning points in GERD incidence in 1994, 2005, 2010, 2015, and 2018, with population growth and aging being the primary drivers of case increases. The Bayesian model projected a continued rise in GERD incidence over the next decade, with incidence rates expected to increase by 25.72% in males and 27.06% in females by 2046. Conclusion: Analysis of the GBD 2021 database reveals a worsening GERD burden in China, with population aging and growth being the primary contributing factors. Attention should be given to the disease trends among women and middle-aged to elderly populations, as this has important implications for public health strategies aimed at GERD prevention and control in China.