{"title":"Long-term trends in the burden of asthma in China: a joinpoint regression and age-period-cohort analysis based on the GBD 2021.","authors":"Na Li, Yuhan Xu, Xinru Xiao, Ziqi Ding, Chuang Sun, Qian Zhang","doi":"10.1186/s12931-025-03135-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To develop effective strategies for controlling asthma, a thorough assessment of its disease burden is essential. In this study, we examined long-term trends in the asthma burden in China over the past three decades and analyzed its epidemiological features.</p><p><strong>Methods: </strong>We assessed the burden of asthma in China via the global burden of disease (GBD) 2021 database, focusing on prevalence, incidence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Additionally, we employed joinpoint analysis and age-period-cohort (apc) methods to interpret the epidemiological characteristics of asthma. Finally, we analyzed the attributable burden of asthma to gain a comprehensive understanding of its impact.</p><p><strong>Results: </strong>The age-standardized incidence rate (ASIR) and mortality rate (ASMR) for both sexes in China shifted from 524.81 (95% UI: 421.31, 672.76) to 314.17 (95% UI: 283.22, 494.10) and from 5.82 (95% UI: 4.46, 8.50) to 1.47 (95% UI: 1.15, 1.79) per 100,000 population between 1990 and 2021. According to joinpoint analysis, the average annual percentage change (AAPC) in the age-standardized incidence rate was - 1.2 (95% CI: - 1.4, - 1.1), indicating a gradual but fluctuating decline (with significant turning points in 2005 and 2014). The apc fitting results suggest that the prevalence is now lower than it was in the past and that the relative prevalence risk is high among adolescents and middle-aged to elderly individuals, possibly due to different pathophysiological mechanisms. In 2021, the primary asthma-related burdens were metabolic risks, especially obesity.</p><p><strong>Conclusions: </strong>In conclusion, we found that the disease burden of asthma in China has significantly decreased. However, it remains a major concern among adolescents and elderly individuals. Metabolic risk factors, particularly obesity, are the main contributors to the asthma burden. It is essential to address specific risk factors and develop targeted public health strategies for different age groups.</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":"26 1","pages":"56"},"PeriodicalIF":5.8000,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829478/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12931-025-03135-7","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
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Abstract
Background: To develop effective strategies for controlling asthma, a thorough assessment of its disease burden is essential. In this study, we examined long-term trends in the asthma burden in China over the past three decades and analyzed its epidemiological features.
Methods: We assessed the burden of asthma in China via the global burden of disease (GBD) 2021 database, focusing on prevalence, incidence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Additionally, we employed joinpoint analysis and age-period-cohort (apc) methods to interpret the epidemiological characteristics of asthma. Finally, we analyzed the attributable burden of asthma to gain a comprehensive understanding of its impact.
Results: The age-standardized incidence rate (ASIR) and mortality rate (ASMR) for both sexes in China shifted from 524.81 (95% UI: 421.31, 672.76) to 314.17 (95% UI: 283.22, 494.10) and from 5.82 (95% UI: 4.46, 8.50) to 1.47 (95% UI: 1.15, 1.79) per 100,000 population between 1990 and 2021. According to joinpoint analysis, the average annual percentage change (AAPC) in the age-standardized incidence rate was - 1.2 (95% CI: - 1.4, - 1.1), indicating a gradual but fluctuating decline (with significant turning points in 2005 and 2014). The apc fitting results suggest that the prevalence is now lower than it was in the past and that the relative prevalence risk is high among adolescents and middle-aged to elderly individuals, possibly due to different pathophysiological mechanisms. In 2021, the primary asthma-related burdens were metabolic risks, especially obesity.
Conclusions: In conclusion, we found that the disease burden of asthma in China has significantly decreased. However, it remains a major concern among adolescents and elderly individuals. Metabolic risk factors, particularly obesity, are the main contributors to the asthma burden. It is essential to address specific risk factors and develop targeted public health strategies for different age groups.
期刊介绍：
Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases.
As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion.
Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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