【摘要】 目的:分析中国人群1990—2021年下腰痛(LBP)疾病负担的变化趋势和归因危险因素,预测2035年LBP的相关疾病负担。方法:基于2021全球疾病负担研究(GBD 2021)数据库,描述统计中国人群1990—2021年LBP的发病率、患病率、伤残损失寿命年(YLDs)和归因危险因素的特点及变化趋势,通过基于贝叶斯方法的年龄-时期-队列(BAPC)模型预测2035年疾病负担。结果:从1990—2021年,中国人群LBP的发病例数、患病例数、YLDs分别从2 984.4万例、6 828.1万例、777.3万年增加到4 337.5万例、10 009.4万例、1 129.8万年;发病率、患病率、YLDs率从2 536.77/10万、5 803.95/10万、660.71/10万上升到3 048.68/10万、7 035.25/10万、794.08/10万。然而,年龄标准化发病率、患病率、YLDs率从2 859.38/10万、6 635.49/10万、749.03/10万下降至2 342.46/10万、5 342.10/10万、603.03/10万。LBP疾病负担呈现明显的年龄和性别特征,女性高于男性,LBP发病率和患病率随着年龄增加逐渐升高,高峰为50～59岁。归因分析显示,吸烟、职业因素和高身体质量指数(BMI)是导致YLDs的主要因素。1990—2021年,吸烟、职业因素和高BMI导致的男性YLDs从107.11万年、137.56万年、9.04万年上升到155.86万年、139.78万年、35.87万年,女性YLDs从22.52万年、179.26万年、15.48万年上升到29.45万年、191.63万年、70.33万年。根据BAPC模型预估2021—2035年LBP的年龄标准化发病率、患病率和YLDs率从2021年将逐年下降,预计2035年将下降到2 165.91/10万、4 930.11/10万、557.05/10万。结论:本研究显示,1990—2021年中国人群的LBP负担逐年加重,吸烟、职业因素和高BMI是主要危险因素,针对这些可控风险因素的干预对减轻疾病负担至关重要。预计到2035年,LBP的疾病负担将有所下降。更多还原

【Abstract】 Objective:To analyze the trends in the burden of low back pain(LBP) and its attributable risk factors among the Chinese population from 1990 to 2021,and to forecast the related disease burden for LBP in2035.Methods:Based on the Global Burden of Disease 2021(GBD 2021) database,we described and statistically analyzed the characteristics and trends of incidence,prevalence,years lived with disability(YLDs),and attributable risk factors for LBP among the Chinese population from 1990 to 2021.We predicted the disease burden for 2035 using a Bayesian age-period-cohort(BAPC) model.Results:From 1990to 2021,the number of incident cases,prevalent cases,and YLDs for LBP in the Chinese population increased from 29.844 million,68.281 million,and 7.773 million years to 43.375 million,100.094 million,and11.298 million years,respectively.The rates of incidence,prevalence,and YLDs increased from 2 536.77/100 000,5 803.95/100 000,and 660.71/100 000 to 3 048.68/100 000,7 035.25/100 000,and 794.08/100 000,respectively.However,age-standardized incidence,prevalence,and YLDs rates decreased from2 859.38/100 000,6 635.49/100 000,and 749.03/100 000 to 2 342.46/100 000,5 342.10/100 000,and603.03/100 000,respectively.The burden of LBP showed distinct age and gender characteristics,with higher rates in females than in males,and incidence and prevalence rates gradually increased with age,peaking at50—59 years.Attributable analysis indicated that smoking,occupational factors,and high body mass index(BMI) were the main factors contributing to YLDs.From 1990 to 2021,YLDs in males attributable to smoking,occupational factors,and high BMI increased from 1.071 1 million years,1.375 6 million years,and 90 400 years to 1.558 6 million years,1.397 8 million years,and 358 700 years, respectively.While in females,they increased from 225 200 years,1.792 6 million years,and 154 800 years to 294 500 years,1.916 3 million years,and 703 300 years, respectively.According to the BAPC model,the age-standardized incidence rate,prevalence rate,and YLDs rate for LBP will decrease year by year.It is expected that by2035,these rates will drop to 2 165.91/100 000,4 930.11/100 000,and 557.05/100 000,respectively.Conclusion:This study shows that the burden of LBP among the Chinese population has increased year by year from 1990 to 2021,with smoking,occupational factors,and high BMI being the main risk factors.Interventions targeting these modifiable risk factors are crucial for alleviating the disease burden.It is projected that by 2035,the burden of LBP will have decreased.更多还原