1990－2021年中国慢性阻塞性肺疾病发病、患病和死亡趋势分析及未来十年预测研究

BackgroundThe pathogenesis of chronic obstructive pulmonary diseaseCOPDis complex. Analyzing and forecasting its epidemiological status can provide valuable insights for COPD prevention and control. ObjectiveTo examine COPD incidenceprevalenceand mortality in China from 1990 to 2021and predict the incidence and mortality rates for 2022-2032 to inform COPD prevention and treatment efforts. MethodsBased on the 2021 Global Burden of DiseaseGBDdatabasethe incidenceprevalenceand mortality of COPD in China from 1990 to 2021 were collected. The change rate %and estimated annual percentage changeEAPC were used to describe the changing trends of COPD. The autoregressive integrated moving average modelARIMAwas used to predict the incidenceprevalence and mortality of COPD in China from 2022 to 2032. ResultsThe standardized incidence and prevalence of chronic obstructive pulmonary diseaseCOPDin the whole Chinese population from 1990 to 2021 showed an increasing trendEAPC were 2.25% and 2.53%respectivelyt values of 71.35 and 165.91respectivelyP<0.001whereas the standardized mortality rate showed a decreasing trend compared with that in 1990EAPC=-0.31%P<0.05. In 2021the standardized incidence rate of COPD in Chinese men was 308.68/100 000 and the prevalence rate was 3358.06/100 000both the incidence and prevalence rates of COPD in men showed an increasing trend compared with 1990EAPC were 2.32%2.48%t values of 64.23 and 39.67respectivelyP<0.001whereas the standardized mortality rate in men increased from 97.13/100 000 to 101.05/100 000but was not statistically significant in terms of trendEAPC=0.05%t=0.62P=0.54. In 2021the standardized incidence rate of chronic obstructive pulmonary diseaseCOPDin Chinese women was 320.70/100 000and the standardized prevalence rate was 3 829.79/100 000compared with 1990the standardized incidence and prevalence rates of COPD in women showed an increasing trendEAPC were -2.19% and 2.59%t values of -25.29 and 33.19respectivelyP<0.001the standardized mortality rate in women showed a decreasing trendEAPC=-0.77%t=-3.36P<0.01from 91.43/100 000 in 1990 to 74.18/100 000. In 2021the standardized incidence and prevalence of COPD in Chinese females were 1.04 and 1.14 times higher than that of malesrespectivelyand the standardized mortality rate of COPD in males was 1.36 times higher than that of females. In the age-stratified analysisthere was a weak but statistically significant increasing trend in the age group of 25-29 yearsEAPC=0.05% P0.05. The standardized prevalence of the population over 50 years of age showed an increasing trend and the increase was further widened with agewith the highest rise in the 80 years age groupEAPC=4.46%t=89.92P<0.001. The age-stratified trend of COPD prevalence showed significant differentiationa significant decline in prevalence was observed in the 25-34 year olds25-29 year oldsEAPC=-1.52%P1%P<0.001.COPD mortality showed a significant increasing trend in the 80 years age group EAPC=0.95%P<0.001COPD mortality continued to decrease in the under-80 years age groupall EAPC<-0.5%P<0.001. The results of ARIMA model showed that the incidence and prevalence of chronic obstructive pulmonary disease COPDin China from 2022 to 2032 showed an upward trendand the overall mortality rate declinedbut the male mortality rate showed an upward trendand the female mortality rate fluctuated but generally declined.The incidence rate of COPD in 2032 was estimated to be up to 409.39/100 000and the prevalence rate was estimated to be up to 4 675.48/100 000. In 2032the incidence rate of chronic lung disease is expected to reach 409.39/100 000and the prevalence rate is expected to reach 475.48/100 000.The ARIMA model forecast indicates that the incidence and prevalence of COPD in China will show an upward trend from 2022 to 2032. By 2032the COPD incidence is expected to reach 409.39/100 000and the prevalence is expected to reach 4 675.48/100 000. The overall mortality rate is projected to reach 71.39/100 000with the male mortality rate expected to reach 112.10/100 000and the female mortality rate expected to reach 77.32/100 000. ConclusionFrom 1990 to 2021the standardized incidence and prevalence of chronic obstructive pulmonary diseaseCOPDin the whole populationmale and female populations in China showed an overall increasing trend. In the elderly populationthe standardized incidence and prevalence of COPD showed a growing trendand the mortality rate of the population aged 80 years or older showed an increasing trendwhereas the mortality rate of COPD for people under 80 years of age showed a decreasing trend. Incidence and prevalenceof chronic obstructive pulmonary disease in China from 2022 to 2032 show an increasing trendand the overall mortality rate is decreasingbut the mortality rate of males shows an increasing trendand the mortality rate of females fluctuatesbut the overall trend is decreasing.