Global, regional, and national burden of endocrine, metabolic, blood, and immune disorders from 1990 to 2021, and projections to 2050: a systematic analysis of the global burden of disease study

Abstract

Background: Endocrine, metabolic, blood, and immune disorders (EMBID) are a leading cause of morbidity and mortality worldwide, with substantial regional disparities. Despite advancements in diagnosis and treatment, the burden of EMBID continues to rise. This study aimed to comprehensively assess the global, regional, and national burden of EMBID from 1990 to 2021, with projections to 2050.

Methods: We conducted a systematic analysis using data from the GBD 2021, covering 204 countries and territories, 21 GBD regions, and five Socio-demographic Index (SDI) groups. Age-standardized rates of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for EMBID were estimated using the GBD analytical framework. Temporal trends were assessed using estimated annual percentage change (EAPC) derived from log-linear regression. Bayesian age-period-cohort (BAPC) models were applied for projections to 2050. Decomposition analysis attributed changes in disease burden to population growth, aging, and epidemiological shifts.

Results: In 2021, the global incidence of EMBID was 79.47 million (95% UI 63.34-98.63 million), with an age-standardized rate of 957.58 (95% UI 766.99-1,183.95) per 100,000, showing a slight decline (EAPC: -0.24% [95% CI -0.35 - -0.12]). Prevalence reached 475.78 million (95% UI 381.23-591.19 million), while deaths rose to 175,902 (95% UI 154,306-190,755; EAPC: 0.75% [95% CI 0.67-0.83]). DALYs totaled 12.86 million (95% UI 9.94-16.98 million), with an age-standardized rate of 157.66 (95% UI 122.38-206.92) per 100,000 (EAPC: -0.09% [95% CI -0.16 - -0.02]). Females had higher incidence and prevalence, while males showed higher mortality. Older adults (≥70 years) experienced the highest burden. Decomposition analysis attributed rising DALYs to population aging (26.02%) and growth (85.83%). Regionally, high-SDI regions showed declining incidence, while low-SDI regions had limited progress. Projections to 2050 indicate declining incidence and prevalence but rising mortality among older adults.

Conclusion: The global burden of EMBID has demonstrated substantial geographical and temporal variability, with lower-SDI regions bearing the highest burden. Addressing these disparities requires enhanced preventive measures, improved healthcare access, and targeted interventions, particularly in low- and middle-income countries.

Keywords: age-specific trends; decomposition analysis; endocrine metabolic blood and immune disorders; future projections; global burden of disease; socio-demographic index.

Figure 1

Global and regional trends in age-standardized rates of incidence, prevalence, deaths, and DALYs of EMBID (1990–2021).

Figure 2

Global distribution of age-standardized rates per 100,000 population for (A) incidence, (B) prevalence, (C) deaths, and (D) DALYs of EMBID in 2021.

Figure 3

Global distribution of the EAPC for age-standardized rates of (A) incidence, (B) prevalence, (C) deaths, and (D) DALYs of EMBID from 1990 to 2021.

Figure 4

Age-specific number and age-standardized rates per 100,000 population of (A) incidence, (B) prevalence, (C) deaths, and (D) DALYs of EMBID by sex in 2021. Data are shown with 95% uncertainty intervals (UIs).

Figure 5

Association between the SDI and age-standardized rates per 100,000 population of (A) incidence, (B) prevalence, (C) deaths, and (D) DALYs across the 21 Global Burden of Disease regions.

Figure 6

Association between the SDI and age-standardized rates per 100,000 population of (A) incidence, (B) prevalence, (C) deaths, and (D) DALYs across 204 countries and territories in 2021.

Figure 7

Age–Period–Cohort analysis of age-standardized rates for DALYs of EMBID. Panels show (A) cohort-specific rates by age group, (B) age-specific rates by period, (C) net drift and local drifts, (D) age effects, (E) period effects, and (F) cohort effects.

Figure 8

Decomposition analysis of the change in (A) incidence, (B) prevalence, (C) deaths, and (D) DALYs of EMBID from 1990 to 2021, showing contributions from population growth, population aging, and epidemiological changes, stratified by sex and SDI levels.

Figure 9

BAPC model projections of age-standardized rates per 100,000 population for (A) incidence, (B) prevalence, (C) deaths, and (D) DALYs of EMBID from 1990 to 2050.