Gender differences in the burden of multiple sclerosis in China from 1990 to 2019 and its 25-year projection: An analysis of the Global Burden of Diseases Study

Abstract

Background and aims: Multiple sclerosis (MS) is a crippling, chronic, gender-related disease that causes burdens to individuals and society. China has a considerable and increasing population of MS. We aim to analyze the gender disparities in the burden of MS in China and predict the trends.

Methods: The study was conducted based on the Global Burden of Disease Study 2019. Data on incidence, prevalence, deaths, and disability-adjusted life years (DALYs) of MS in China from 1990 to 2019 was descriptively analyzed by year, gender, and age group. The Nordpred package in R (version 4.2.2) was used for age-period-cohort analysis to predict the all-ages numbers and age-standardized rates of incidence, prevalence, deaths, and DALYs in China from 2020 to 2044.

Results: The number of prevalent cases of MS in 2019 reached 18,143.56 (95% uncertainty intervals [UI]: 13,997.71-22,658.60) in males and 24,427.11 (95% UI: 18,906.02-30,530.21) in females in China. The peak age of prevalence was shifted from 40-44 years in 1990 to 45-49 years in 2019 in females but remained unchanged in males. In contrast to the increased age-standardized prevalence rate, the age-standardized death rate (ASDR) and age-standardized DALYs rate showed downward trends, which were more significant in females. Different from the global, Chinese males showed lower prevalence but higher deaths and DALYs than females for age-standardized rates and numbers. In the next 25 years, the patient population will remain large and peak around 44,599.78 in 2025-2029. The ASDR, age-standardized DALYs rate, and DALYs number were expected to decrease. The improvements in deaths and DALYs will be more significant in females.

Conclusion: Males with MS had a lower prevalence but higher deaths and DALYs than females in China. The ASDR and age-standardized DALYs rate have reduced over the past 30 years and were expected to continue decreasing, especially in females. The burden of MS will remain notable in the next 25 years.

Keywords: disability‐adjusted life years; disease burden; gender; multiple sclerosis; prediction.

Figure 1

Age trends of (A) prevalence, (B) deaths, and (C) disability‐adjusted life years (DALYs) rates of multiple sclerosis (MS) in China in 1990, 2000, 2010, and 2019.

Figure 2

Rates and numbers of (A, B) prevalence, (C, D) deaths, and (E, F) disability‐adjusted life years (DALYs) by age group and sex in 1990 and 2019.

Figure 3

Time trends of all‐ages numbers and age‐standardized rates of multiple sclerosis (MS) in China by sex from 1990 to 2019, and predicted burden from 1990 to 2044: (A, B) incidence, (C, D) prevalence, (E, F) deaths, and (G, H) disability‐adjusted life years (DALYs).

Figure 3

Time trends of all‐ages numbers and age‐standardized rates of multiple sclerosis (MS) in China by sex from 1990 to 2019, and predicted burden from 1990 to 2044: (A, B) incidence, (C, D) prevalence, (E, F) deaths, and (G, H) disability‐adjusted life years (DALYs).

Figure 4

The female‐to‐male ratios of (A) age‐standardized incidence rate (ASIR), (B) age‐standardized prevalence rate (ASPR), (C) age‐standardized death rate (ASDR), and (D) age‐standardized disability‐adjusted life years (DALYs) rate from 1990 to 2019 in global and China.