Data Sheet 11_Global, regional, and national burden of musculoskeletal disorders, 1990–2021: an analysis of the global burden of disease study 2021 and forecast to 2035.pdf

ObjectivesThis study aimed to assess the global, regional, and national burdens of musculoskeletal disorders (MSDs) since 1990. It also projected trends up to 2035 and explored potential improvements through frontier analysis.
MethodsUsing data from the Global Burden of Disease 2021 study, MSDs in 204 countries and territories were analyzed. Age-standardized rates (ASRs) for prevalence (ASPR), incidence (ASIR), DALYs (ASDR), and mortality (ASMR) were calculated. Trends were evaluated through estimated annual percentage changes (EAPC). The Bayesian age-period-cohort (BAPC) model was employed for projections to 2035, and frontier analysis was used to assess the potential for reducing MSD burdens.
ResultsIn 2021, 1.686 billion MSDs prevalent cases were recorded globally, representing a 95% increase since 1990. Although total cases and DALYs have increased, ASIR and ASMR showed declining trends, with global MSD-related mortality decreasing by 0.265% annually. By 2035, the number of MSD cases is projected to rise to 2.161 billion, along with corresponding increases in DALYs and mortality, although ASRs are expected to continue declining. Frontier analysis revealed significant gaps between current burdens and achievable benchmarks, particularly in high-SDI regions, while some low-SDI regions demonstrated effective management despite limited resources. A U-shaped relationship between SDI and MSDs burdens was observed, with middle-SDI regions generally performing better.
ConclusionThe global burden of MSDs is projected to rise in absolute case numbers, underscoring the necessity for strategically targeted interventions to manage their impact effectively. Frontier analysis illuminates potential improvements, particularly in high-SDI countries, while projections indicate that enhanced access to healthcare and better resource distribution could alleviate the global MSDs burden. Addressing disparities and implementing tailored interventions are crucial for reducing MSDs-related disability and mortality.

研究目标
本研究旨在评估1990年以来肌肉骨骼疾病（musculoskeletal disorders, MSDs）的全球、区域及国家层面疾病负担，同时预测至2035年的疾病流行趋势，并通过前沿分析探索潜在的优化路径。
研究方法
本研究采用《2021年全球疾病负担研究》（Global Burden of Disease 2021 study）的数据，对204个国家及地区的肌肉骨骼疾病负担进行分析。计算了患病率年龄标化率（age-standardized prevalence rate, ASPR）、发病率年龄标化率（age-standardized incidence rate, ASIR）、伤残调整寿命年年龄标化率（age-standardized Disability-Adjusted Life Years rate, ASDR）以及死亡率年龄标化率（age-standardized mortality rate, ASMR）。通过估计年度百分比变化（estimated annual percentage change, EAPC）评估疾病流行趋势，采用贝叶斯年龄-时期-队列（Bayesian age-period-cohort, BAPC）模型开展至2035年的疾病负担预测，并运用前沿分析评估肌肉骨骼疾病负担的潜在缩减空间。
研究结果
2021年，全球肌肉骨骼疾病现患病例共计16.86亿例，较1990年增长95%。尽管总病例数与伤残调整寿命年（Disability-Adjusted Life Years, DALYs）总量均有所上升，但ASIR与ASMR均呈下降趋势，全球因肌肉骨骼疾病导致的死亡率年均下降0.265%。预计至2035年，肌肉骨骼疾病病例数将增至21.61亿例，伤残调整寿命年与死亡率也将相应攀升，不过各类年龄标化率仍将持续走低。前沿分析显示，当前疾病负担与可实现的基准水平之间存在显著差距，尤以社会人口指数（Social Demographic Index, SDI）较高的地区为甚；而部分低社会人口指数地区虽资源有限，却实现了较为有效的疾病管理。研究同时观察到社会人口指数与肌肉骨骼疾病负担之间呈U型关联，中等社会人口指数地区的疾病管理表现普遍更优。
研究结论
全球肌肉骨骼疾病负担的绝对病例数预计将持续增长，这凸显了制定针对性干预策略以有效管控疾病影响的必要性。前沿分析揭示了潜在的优化空间，尤其针对高社会人口指数国家；预测结果同时表明，扩大医疗服务可及性与优化资源分配，或可有效缓解全球肌肉骨骼疾病负担。缩小地区差异并实施个性化干预措施，对于降低肌肉骨骼疾病相关伤残与死亡率至关重要。