中日韩儿童青少年孤独症谱系障碍疾病负担及趋势预测

Disease burden and trend prediction of autism spectrum disorders among children and adolescents in China, Japan and South Korea

摘要

目的 比较1990—2021年中日韩儿童青少年孤独症谱系障碍(ASD)疾病负担差异,预测2022—2035年发展趋势,并探讨其影响因素,为我国儿童青少年ASD治疗及卫生服务提供科学依据。方法 基于2021年全球疾病负担(GBD 2021)数据,运用Joinpoint回归模型分析1990—2021年间3国儿童青少年ASD的患病率及伤残调整生命年(DALYs)率的变化趋势[计算平均年度变化百分比(AAPC)],并使用自回归移动平均模型(ARIMA)对2022—2035年的疾病负担趋势进行预测。结果 1990—2021年,中、日、韩3国儿童青少年ASD患病率(中AAPC=0.19%,日AAPC=0.24%,韩AAPC=0.16%)和DALYs率(中AAPC=0.21%,日AAPC=0.24%,韩AAPC=0.17%)均呈上升趋势(P<0.001)。预测至2035年,中国儿童青少年ASD患病率下降至696.35/10⁵,DALYs率上升至136.42/10⁵。相比之下,日本(1 711.40/10⁵,329.14/10⁵)和韩国(1 618.68/10⁵,315.22/10⁵)均呈持续上升趋势。3国男性患病率均高于女性。2021年,中日韩5岁以下人群的患病率和DALYs率均为各年龄段最高,其中中国分别为713.66/10⁵,139.36/10⁵,远低于日本(1 692.73/10⁵,328.99/10⁵)和韩国(1 599.42/10⁵,311.38/10⁵)。结论 1990—2021年中日韩儿童青少年ASD疾病负担均呈上升趋势,存在显著的性别和年龄差异。未来15年,中国儿童青少年ASD患病率预计趋于平稳或小幅下降,而日韩将持续上升,提示需结合各国人口政策与医疗资源配置制定针对性干预策略。

Abstract

Objective To compare the differences in the disease burden of autism spectrum disorder (ASD) among children and adolescents in China, Japan, and South Korea from 1990 to 2021, and to predict the trends from 2022 to 2035, and to explore influencing factors, so as to provide a scientific basis for ASD treatment and health services in China. Methods Based on data from the Global Burden of Disease Study 2021 (GBD 2021), Joinpoint regression analysis was used to assess the trends in prevalence and disability-adjusted life years (DALYs) rates of ASD among children and adolescents from 1990 to 2021, calculating the average annual percent change (AAPC).The autoregressive integrated moving average (ARIMA) model was employed to predict disease burden trends from 2022 to 2035. Results From 1990 to 2021, both the prevalence rate(China:AAPC=0.19%,Japan:AAPC=0.24%,South Korea:AAPC=0.16%) and DALYs rate (China:AAPC=0.21%,Japan:AAPC=0.24%,South Korea:AAPC=0.17%) of ASD among children and adolescents in the three countries all showed an upward trend(P<0.001).By 2035, the prevalence of ASD in China is predicted to slightly decrease to 696.35/10⁵, while the DALYs rate is projected to rise to 136.42/10⁵.In contrast, Japan (1 711.40/10⁵,329.14/10⁵) and South Korea (1 618.68/10⁵,315.22/10⁵) are predicted to show continuous upward trends.The prevalence was consistently higher in males than in females across all three countries.In 2021, the highest burden was observed in children under 5 years old; the prevalence and DALYs rates in China were 713.66/10⁵ and 139.36/10⁵, respectively, which were lower than those in Japan (1 692.73/10⁵, 328.99/10⁵) and South Korea (1 599.42/10⁵, 311.38/10⁵). Conclusions From 1990 to 2021, the prevalence and DALYs of ASD in children and adolescents in China, Japan, and South Korea all showed upward trends.Males and younger age groups faced higher risks.In the next 15 years, the prevalence in China is expected to stabilize or slightly decline, whereas the burden in Japan and South Korea will likely continue to rise.This highlights the necessity for tailored intervention strategies aligned with respective national pouputation policies and the configuration of medical resources.

关键词

孤独症谱系障碍 / 疾病负担 / 中日韩 / Joinpoint回归模型 / ARIMA模型 / 儿童青少年

Key words

autism spectrum disorder / disease burden / China, Japan, and South Korea / Joinpoint regression model / ARIMA model / children and adolescents

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基金资助

国家自然科学基金项目(82103869);黑龙江博士后启动基金项目(LBH-QY22004)