1990-2046年五种主要上消化道疾病的全球负担、趋势与预测：基于GBD 2021的分析
Global burden, trends, and projections of five major upper gastrointestinal diseases, 1990-2046: an analysis of GBD 2021.
文献信息
| PMID | 42959320 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xiru Liang |
| 作者单位 | Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. |
| 期刊 | Frontiers in public health |
| SCI 分区 | Q1 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 上消化道（GI）疾病，包括胃食管反流病（GERD）、消化性溃疡病（PUD）、胃炎和十二指肠炎（GD）、胃癌和食管癌，构成重大的全球健康与经济挑战。本研究分析其1990年至2046年的趋势、地区差异、危险因素及未来预测。
方法： 利用2021年全球疾病负担数据库，我们分析了204个国家、21个地区及五个社会人口指数（SDI）水平下的发病率、患病率、死亡率和伤残调整生命年（DALYs）。采用估计年度百分比变化和连接点回归评估时间趋势。分解分析评估了人口增长、老龄化和流行病学变化对绝对疾病负担变化的贡献。风险归因分数识别了社会经济和行为因素，贝叶斯模型预测了未来负担。
结果： 1990年至2021年，PUD、GD、胃癌和食管癌的全球负担下降，而GERD上升，尤其是在中等SDI地区。地区和性别差异持续存在，较低SDI地区负担更高。老龄化驱动了中高SDI地区的绝对疾病负担，而人口增长在较低SDI地区占主导。吸烟和饮酒对上消化道癌症有显著贡献。预测表明GERD将持续增加，PUD将出现适度反弹，尤其是在老龄化和资源有限人群中。
结论： 不断演变的上消化道疾病模式凸显了持续存在的健康不平等。有针对性的公共卫生干预对于减轻未来负担和促进全球公平的消化健康结局至关重要。
英文摘要
BACKGROUND: Upper gastrointestinal (GI) diseases, including gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), gastritis and duodenitis (GD), stomach cancer, and esophageal cancer, pose significant global health and economic challenges. This study analyzes their trends, regional disparities, risk factors, and future projections from 1990 to 2046.
METHODS: Using the 2021 Global Burden of Disease database, we analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across 204 countries, 21 regions, and five Socio-demographic Index (SDI) levels. Temporal trends were assessed with estimated annual percentage change and joinpoint regression. Decomposition analysis evaluated the contributions of population growth, aging, and epidemiological changes to changes in absolute disease burden. Risk-attributable fractions identified socioeconomic and behavioral factors, and Bayesian models projected future burdens.
RESULTS: From 1990 to 2021, global burdens of PUD, GD, stomach cancer, and esophageal cancer decreased, while GERD increased, particularly in middle SDI regions. Regional and sex disparities persisted, with higher burdens in lower SDI areas. Aging drove absolute disease burden in high-middle SDI regions, while population growth dominated in lower SDI regions. Smoking and alcohol significantly contributed to upper GI cancers. Projections suggest continued GERD increases and a modest PUD rebound, especially in aging and resource-limited populations.
CONCLUSION: Evolving upper GI disease patterns highlight persistent health inequities. Targeted public health interventions are essential to mitigate future burdens and promote equitable digestive health outcomes globally.