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. 2021 Dec;6(4):615-623.
doi: 10.1136/svn-2021-000909. Epub 2021 May 3.

Incidence and prevalence of moyamoya disease in urban China: a nationwide retrospective cohort study

Yixin Sun #  1 , Guoyu Zhou #  2 , Jingnan Feng  1 , Lu Chen  3 , Guozhen Liu  4 , Jinxi Wang  5 , Qingliang Wang  6 , Junyou Yu  1 , Xiwang Yang  1 , Zheng Yang  1 , Pei Gao  1 , Shengfeng Wang  7 , Siyan Zhan  7
Affiliations

Incidence and prevalence of moyamoya disease in urban China: a nationwide retrospective cohort study

Yixin Sun et al. Stroke Vasc Neurol. 2021 Dec.

Abstract

Background and objective: Moyamoya disease (MMD) is an increasingly recognised cause of stroke, mainly described in East Asia. China is the largest nation in Asia, but few studies reported the epidemiology of MMD, especially at a national level. We aimed to estimate the incidence and prevalence of MMD in China.

Methods: We performed a population-based study using data from the national databases of Urban Basic Medical Insurance between 2013 and 2016, covering approximately 0.50 billion individuals. MMD cases were identified by diagnostic code (International Classification of Diseases, 10th Revision I67.5) or related diagnostic text.

Results: A total of 1987 MMD patients (mean age 44.45±14.30 years, female-to-male ratio 1.12) were identified, representing a national crude incidence of 0.59 (95% CI: 0.49 to 0.68) and a prevalence of 1.01 (95% CI: 0.81 to 1.21) per 100 000 person-years in 2016. Rates were higher in females than in males for the incidence (0.66 vs 0.52) and prevalence (1.05 vs 0.90). And the age-specific rates showed a bimodal distribution, with the highest peak in middle-aged group and the second peak in child group.

Conclusions: Our results confirm that MMD is relatively common in East Asians, but the rates in China were lower than those in other East Asian countries such as Japan and Korea. The unique epidemiological features, including a relatively weak female predominance and a shift in the highest peak of incidence from children to adults, revealed new sight into MMD. Further research is expected to explore the potential pathogenesis of MMD.

Keywords: incidence; medical insurance database; moyamoya disease; prevalence.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Incidence of moyamoya disease in urban China in 2016 (standardised by 2010 China census data). (A) Crude and standardised incidence by sex. (B) Crude incidence by sex and age.
Figure 2
Figure 2
Prevalence of moyamoya disease in urban China in 2016 (standardised by 2010 China census data). (A) Crude and standardised prevalence by sex. (B) Crude prevalence by sex and age.
See this image and copyright information in PMC

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