中国颈痛疾病负担的趋势分析及预测

Trend Analysis and Prediction of the Disease Burden of Neck Pain in China

摘要:

目的：基于全球疾病负担研究(Global Burden of Disease,GBD)数据库,系统分析1990～2023年中国颈痛(neck pain,NP)的疾病负担变化趋势,并预测其未来发展态势,为制定针对性的防控策略和卫生政策提供科学依据。方法：研究数据来源于GBD数据库,提取1990～2023年中国颈痛的患病人数、伤残调整生命年(disability-adjusted life years,DALYs)及其年龄标准化率(age-standardized rate,ASR)。采用Joinpoint回归模型分析中国总体及不同性别人群颈痛疾病负担的长期变化趋势,计算年度变化百分比(annual percent change,APC)及年度平均变化百分比(average annual percentage change,AAPC)。在此基础上,构建贝叶斯年龄–时期–队列(Bayesian age-period-cohort,BAPC)模型,对未来中国颈痛疾病负担进行预测。最后,通过分解分析评估人口规模变化、人口老龄化及流行病学变化对颈痛疾病负担变化的相对贡献。结果：Joinpoint回归分析显示,1990～2023年中国颈痛年龄标准化DALYs率与患病率整体呈现平台化伴轻度波动的变化趋势。总体人群颈痛年龄标准化DALYs率AAPC约为0.04%,女性略高于男性(女性AAPC≈0.07%,男性AAPC≈?0.02%)。在分段趋势上,2005～2009年期间颈痛疾病负担出现显著上升,2009～2021年进入高位平台期,而2021年后短期内呈现下降趋势。BAPC模型预测结果显示,未来中国颈痛的绝对患病人数和DALYs数仍将持续增加,但年龄标准化率总体保持稳定或缓慢上升。分解分析结果表明,人口规模增长和人口老龄化是驱动中国颈痛疾病负担增加的主要因素,而年龄标准化率的变化对总体负担增长起到一定抵消作用。结论：尽管中国颈痛年龄标准化率未出现持续显著上升,但在人口增长和老龄化背景下,其绝对疾病负担仍将不断加重。未来应重点关注中老年人群及女性群体,通过改善生活方式、优化职业健康防护和加强早期干预,以减轻颈痛带来的长期公共卫生负担。

Abstract:

Objective：To systematically analyze the trends in the disease burden of neck pain in China from 1990 to 2023 based on data from the Global Burden of Disease (GBD) study, and to project future trends, thereby providing scientific evidence for targeted prevention strategies and health policy formulation. Methods：Data were obtained from the GBD database. The number of prevalent cases, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of neck pain in China from 1990 to 2023 were extracted. Joinpoint regression analysis was used to assess long-term trends in the disease burden of neck pain in the overall population and by sex, and to estimate the annual percent change (APC) and average annual percent change (AAPC). Subsequently, a Bayesian age–period–cohort (BAPC) model was constructed to predict future trends in the disease burden of neck pain in China. Finally, decomposition analysis was performed to evaluate the relative contributions of population growth, population ageing, and epidemiological changes to variations in the disease burden of neck pain. Results：Joinpoint regression analysis indicated that the age-standardized DALYs rate and prevalence rate of neck pain in China from 1990 to 2023 generally exhibited a plateaued trend with mild fluctuations. The AAPC of the age-standardized DALYs rate in the overall population was approximately 0.04%, with a slightly higher value in females than in males (female AAPC ≈ 0.07%; male AAPC ≈ ?0.02%). In terms of segmented trends, the disease burden of neck pain increased significantly during 2005–2009, entered a high-level plateau during 2009–2021, and showed a short-term decline after 2021. Predictions from the BAPC model suggested that the absolute number of prevalent cases and DALYs attributable to neck pain in China will continue to increase in the future, whereas age-standardized rates are expected to remain stable or increase slowly. Decomposition analysis revealed that population growth and population ageing were the primary drivers of the increasing disease burden of neck pain, while changes in age-standardized rates partially offset the overall growth in burden. Conclusion：Although age-standardized rates of neck pain in China have not shown a sustained and marked increase, the absolute disease burden is expected to continue to rise under the combined effects of population growth and ageing. Future efforts should prioritize middle-aged and older adults as well as female populations, with an emphasis on improving lifestyle factors, optimizing occupational health protection, and strengthening early intervention, in order to reduce the long-term public health burden associated with neck pain.