Analysis on the Incidence and mortality of asthma in China based on the age-period-cohort model
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目的 分析1990-2019年中国哮喘的发病和死亡情况,并探讨年龄、时期和队列对哮喘发病和死亡的影响.方法 利用全球疾病负担(Global Burden of Disease,GBD)2019数据库,分析1990至2019年中国哮喘发病和死亡情况,应用Joinpoint软件分析标化发病率和标化死亡率的时间变化趋势,计算平均年度变化百分比.构建年龄-时期-队列模型,分析年龄、时期和出生队列对哮喘发病及死亡趋势变化的影响.结果 2019年,中国哮喘发病率为264.44/10万,死亡率为1.74/10万,其中男性发病率(300.94/10万)和死亡率(1.99/10万)均高于女性(226.51/10万和1.49/10万).1990-2019年,中国哮喘标化发病率有下降趋势,但是趋势无统计学意义(P＞0.05),标化死亡率有降低趋势,平均每年下降4.90％,趋势有统计学意义(P＜0.05).年龄效应结果显示,中国哮喘的发病率呈降低趋势,死亡率先呈降低趋势,然后在55-59岁年龄组有所升高.时期效应结果显示,哮喘发病风险呈下降趋势,然后在2015-2019年呈升高趋势,哮喘死亡风险趋势呈下降趋势.队列效应结果显示,出生越晚的人,哮喘的发病和死亡风险越低.哮喘死亡归因于行为风险、高体重指数和烟草有升高趋势,职业风险有降低趋势.结论 1990-2019年,中国哮喘的发病率和死亡率有降低趋势,男性的发病率和死亡率高于女性,哮喘死亡归因于行为风险、高体重指数和烟草的危险因素仍呈升高趋势,应采取相应措施针对重点人群进行早期筛查、早期发现和早期治疗.
Objective To analyze the incidence and mortality of asthma in China from 1990 to 2019,and to explore the influence of age,period and cohort on the incidence and mortality of asthma.Methods Using the Global Burden of Disease(GBD)2019 database,the incidence and mortality of asthma in China from 1990 to 2019 were analyzed,and the time variation trend of age-standardized incidence and mortality was analyzed by using Joinpoint software,and the average annual variation percentage was calculated.The age-period-cohort model was constructed to analyze the influence of age,period and birth cohort on the incidence and mortality trend of asthma.Results In 2019,the incidence of asthma in China was 264.44/100 000,and the mortality rate was 1.74/100 000.The incidence rate of asthma in males(300.94/100 000)and mortality rate(1.99/100 000)were higher than those in females(226.51/100 000 and 1.49/100 000).From 1990 to 2019,the age-standardized incidence of asthma in China showed a downward trend,but the trend was not statistically significant(P＞0.05),and the age-standardized mortality showed a downward trend,with an average annual decrease of 4.90％,with a statistically significant trend(P＜0.05).The results of age effect showed that the incidence of asthma in China showed a downward trend,and the death first showed a downward trend,and then increased in the age group of 55-59.The results of period effect show that the risk of asthma is decreasing,and then it is increasing from 2015 to 2019,and the risk of asthma mortality is decreasing.The results of cohort effect show that the later people are born,the lower the risk of asthma onset and death.The death of asthma is attributed to behavioral risk,high body mass index and tobacco,and the occupational risk tends to decrease.Conclusions From 1990 to 2019,the incidence and mortality of asthma in China showed a decreasing trend,and the incidence and mortality of men were higher than that of women.The risk factors of behavioral risk,high body mass index and tobacco were still on the rise,so corresponding measures should be taken to carry out early screening,early detection,and early treatment for key populations.
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