Evolving Trends and Burden of Inflammatory Bowel Disease in Asia, 1990-2019: A Comprehensive Analysis Based on the Global Burden of Disease Study

Abstract

Background: Asia's inflammatory bowel disease (IBD) burden has rapidly increased recently, but the epidemiological trends in Asia remain unclear. We report IBD's incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALY) in 52 Asian countries from 1990 to 2019.

Methods: Data from the Global Burden of Disease 2019 were analyzed for IBD burden across 52 countries, using metrics like incidence, prevalence, mortality rates, and DALY. The epidemiological trend of IBD from 1990 to 2019 was assessed with the Joinpoint and APC methods. Decomposition and frontier analyses examined factors behind IBD case and death changes. The NORPRED forecasted Asia's morbidity and mortality trends from 2019 to 2044.

Results: From 1990 to 2019, The incidence and prevalence of IBD increased in Asia, while mortality and DALY decreased. East Asia had the highest increase in disease burden. IBD incidence was highest among the 30-34 age group, with prevalence peaking in the 45-49 age group. In high-income regions, IBD peak age shifted to younger groups. Decompose analysis showed population growth as the primary factor for the increasing IBD cases in Asia. NORDPRED model predicted a continued IBD burden increase in Asia over the next 25 years.

Conclusions: Between 1990 and 2019, ASIR and ASPR of IBD in Asia increased, while ASMR and ASDR decreased. Due to population growth and aging, the IBD burden is expected to rise over the next 25 years, particularly in East Asia.

Keywords: Comprehensive analysis; Global Burden of Disease; Inflammatory bowel disease.

Fig. 1

Age-specific numbers and age-standardized prevalence, incidence, and mortality rates of IBD in four continents. A Trends of ASIR, ASPR, ASDR, and ASMR of IBD in Asia, America, Africa, and Europe from 1990 to 2019. B Absolute incidence number, prevalence number, DALY number, and deaths number of IBD in Asia, America, Africa, and Europe in 2019. IBD, Inflammatory bowel disease; DALY, disability-adjusted life year; ASIR, Age-standardized incidence rates; ASPR, Age-standardized prevalence rates; ASDR, Age-standardized DALY rates; ASMR, Age-standardized mortality rates

Fig. 2

Age-specific numbers and age-standardized incidence, prevalence, mortality and DALY rates of IBD in Asia. A Trends from 1990 to 2019 in ASIR of IBD in Asia; B Trends from 1990 to 2019 in ASPR of IBD in Asia; C Asia cases of incidence across age groups, 2019; D Asia cases of prevalence across age groups, 2019; E trends from 1990 to 2019 in ASMR of IBD in Asia; F trends from 1990 to 2019 in ASDR of IBD in Asia; G Asia cases of deaths across age groups, 2019; H Asia number of DALY across age groups, 2019. IBD, Inflammatory bowel disease; ASIR, Age-standardized incidence rates. ASPR, Age-standardized prevalence rates; ASMR, Age-standardized mortality rates. DALY, disability-adjusted life year. ASDR: age-standardized DALY rate

Fig. 3

Maps of age-standardized prevalence and DALY rates of IBD in Asian countries and regions. A ASPR, B DALY of IBD burden in Asian countries and regions. IBD, Inflammatory bowel disease; ASPR, Age-standardized prevalence rates; DALY, disability-adjusted life year; ASDR, Age-standardized DALY rates

Fig. 4

Age-period-cohort effects of prevalence from 1990 to 2019 in Asia and High-income regions in Asia. A Age effects are rep-resented by the fitted longitudinal age curves of prevalence (per 100,000 person-years) adjusted for period deviations. B Period effects are represented by the relative risk of prevalence (prevalence rate ratio) and computed as the ratio of age-specific rates in each period compared to the referent 2000–2004 period. C Cohort effects are represented by the relative risk of prevalence (prevalence rate ratio) and computed as the ratio of age-specific rates in each cohort compared to referent 1955 cohort. D Local drifts indicate the annual percentage change of prevalence (% per year) across five-year age groups (from 0 to 4 to 95 plus years). The shaded areas indicate the corresponding 95% CIs of each point estimate

Fig. 5

Changes in IBD A incidence, B deaths according to population-level determinants of population growth, aging, and epidemiological change from 1990 to 2019 across location. The black dot represents the overall value of change contributed by all three components. For each component, the magnitude of a positive value indicates a corresponding increase attributed to the component; the magnitude of a negative value indicates a corresponding decrease attributed to the related component