Table 1_The burden of low back pain and predictions in Asia–Pacific region, 1990–2021: a comparative analysis of China, Japan, Thailand, and Pakistan.docx

ObjectiveLow back pain (LBP) is a leading cause of disease burden, imposing substantial societal costs. However, compared to infectious diseases, it receives insufficient attention in the Asia-Pacific region, with limited research and resource allocation. This study examines the characteristics of LBP disease burden in representative Asia-Pacific countries—China, Japan, Thailand, and Pakistan—from 1990 to 2021, and projects trends to 2050, aiming to inform evidence-based health policies.
MethodsUtilizing Global Burden of Disease (GBD) 2021 data, we analyzed LBP incidence, prevalence, and years lived with disability (YLDs). Country comparisons employed age-standardized rates (ASRs), stratified by age groups. Joinpoint regression assessed trends during 1990–2021 and compared cross-national variations. The BAPC model was used to predict future LBP disease burdens from 2022 to 2050. Decomposition analysis quantified contributions from population aging, population growth, and epidemiological changes.
ResultsIn 2021, Japan exhibited the highest ASRs, followed by China, Thailand, and Pakistan. Case counts peaked in the working-age population, while ASR peaks concentrated in middle-aged and older adult groups. Females consistently bore a higher burden than males. From 1990 to 2021, China and Japan showed declining ASR trends, whereas Thailand and Pakistan demonstrated upward ASR trends; all countries saw rising case counts. BAPC projections indicated increasing ASR burdens for Chinese males and Japanese females by 2050, with declines in other groups. Decomposition analysis revealed divergent drivers across countries.
ConclusionLBP remains a major public health challenge in these representative Asia-Pacific countries, with age, gender, and national heterogeneity shaping burden dynamics. Tailored policies addressing country-specific, gender-specific, and age-specific disparities are urgently needed to mitigate the disease burden of LBP.

**研究背景**：腰痛（Low back pain, LBP）是导致疾病负担的首要病因之一，带来了巨额的社会成本。然而，与传染病相比，亚太地区对腰痛的关注不足，相关研究与资源配置均十分有限。本研究针对中国、日本、泰国、巴基斯坦这四个亚太典型国家，分析1990年至2021年腰痛疾病负担的特征，并预测至2050年的变化趋势，以期为循证卫生政策制定提供依据。
**研究方法**：本研究采用全球疾病负担（Global Burden of Disease, GBD）2021数据库数据，分析腰痛的发病率、患病率以及因伤残损失的健康寿命年（Years Lived with Disability, YLDs）。国家间比较采用按年龄组分层的年龄标化率（Age-Standardized Rates, ASRs）。通过连接点回归分析评估1990年至2021年的变化趋势，并比较各国间的差异。采用贝叶斯年龄-时期-队列（Bayesian Age-Period-Cohort, BAPC）模型预测2022年至2050年的腰痛疾病负担。通过分解分析量化人口老龄化、人口增长以及流行病学变化对疾病负担的贡献。
**研究结果**：2021年，日本的年龄标化率最高，其次为中国、泰国与巴基斯坦。腰痛病例数在劳动年龄人口中达到峰值，而年龄标化率的峰值则集中于中老年人群。女性的疾病负担始终高于男性。1990年至2021年期间，中国与日本的年龄标化率呈下降趋势，而泰国与巴基斯坦则呈上升趋势；所有国家的腰痛病例数均有所增加。贝叶斯年龄-时期-队列模型预测显示，至2050年，中国男性与日本女性的年龄标化疾病负担将进一步升高，其余群体则呈下降趋势。分解分析结果显示，各国疾病负担的驱动因素存在差异。
**研究结论**：在上述亚太典型国家中，腰痛仍是一项重大公共卫生挑战，年龄、性别以及国家间的异质性共同塑造了疾病负担的变化态势。亟需制定针对不同国家、性别与年龄群体差异的个性化政策，以减轻腰痛带来的疾病负担。