Table 2_Rising global burden of migraine among adolescents and young adults: a 30-year analysis (1990–2021).docx

BackgroundMigraine significantly impacts the physical and mental health of adolescents and young adults (AYA, aged 10–24 years). This study aims to assess global trends in migraine incidence, prevalence, and DALYs in this age group from 1990 to 2021, providing evidence to guide prevention and policy efforts.
Materials and methodsData were obtained from the Global Burden of Disease (GBD) 2021 study, encompassing AYA’s migraine burden across 204 countries and territories over the past 30 years, stratified by sex, age, socio-demographic index (SDI), location and year. The assessment analyzed incidence, prevalence, and disability-adjusted life years (DALYs).
ResultsBetween 1990 and 2021, the global burden of migraine among AYA increased markedly in terms of absolute case numbers. Incident cases rose by 23.50%, prevalent cases by 24.82%, and DALYs by 24.94%. Despite these increases, the overall rates and age-standardized rates (ASRs) remained relatively stable, suggesting that population growth and aging are key drivers. The burden was consistently higher in females and in high-SDI regions; however, the rate of increase was greater in males, gradually narrowing the sex gap. Age-wise, those aged 10–14 had the highest incidence rate (45.9%), while the 20–24 group bore the greatest prevalence (39.8%) and DALY burden (39.9%). Among 21 regions, Western Europe recorded the highest ASIR (2272.50 per 100,000), while Tropical Latin America had the highest ASPR (27542.29 per 100,000) and ASDR (1011.78 per 100,000). Nationally, Belgium had the highest ASIR (2758.02 per 100,000), and Brazil had the highest ASPR (27592.69 per 100,000) and ASDR (1013.43 per 100,000). However, projections indicated that ASIR, ASPR, and ASDR will continue to rise by 2035.
ConclusionGlobal migraine burden surged (1990–2021), with high-SDI regions facing highest DALYs and low-SDI areas underdiagnosed. AYA (10–14, especially females) show peak incidence due to hormonal/social factors. Despite projected ASR decline, cases will rise, demanding precision interventions: healthcare access, sex-specific strategies, and school-based programs. Urgent global efforts are required to promote equitable access to migraine care and prevention, as well as to advance research on emerging risk factors, such as air pollution, prolonged screen exposure, chronic stress, academic pressure, and others.

背景：偏头痛对青少年与青年群体（Adolescents and Young Adults, AYA，年龄区间为10~24岁）的身心健康造成显著影响。本研究旨在评估1990年至2021年间该群体偏头痛的全球流行趋势，包括发病率、患病率及伤残调整生命年（Disability-Adjusted Life Years, DALYs），以期为偏头痛防控与政策制定提供循证依据。

材料与方法：数据来源于2021年全球疾病负担（Global Burden of Disease, GBD）研究，涵盖了过去30年间204个国家和地区的青少年与青年群体偏头痛负担数据，按性别、年龄、社会人口学指数（Socio-demographic Index, SDI）、地区及年份进行分层。本次评估分析了发病率、患病率与伤残调整生命年。

结果：1990至2021年间，全球青少年与青年群体的偏头痛负担绝对病例数显著上升。新发病例增长23.50%，现患病例增长24.82%，伤残调整生命年增长24.94%。尽管上述指标均有所升高，但总率与年龄标准化率（Age-Standardized Rates, ASRs）相对稳定，提示人口增长与人口老龄化是主要驱动因素。女性群体及高社会人口学指数地区的偏头痛负担始终更高；然而男性群体的增长速率更快，性别差距正逐步缩小。按年龄分层来看，10~14岁群体的发病率最高（45.9%），而20~24岁群体的患病率（39.8%）与伤残调整生命年负担（39.9%）均居首位。在21个区域中，西欧的年龄标准化发病率（Age-Standardized Incidence Rate, ASIR）最高，达每10万人2272.50例；热带拉丁美洲的年龄标准化患病率（Age-Standardized Prevalence Rate, ASPR）与年龄标准化伤残调整生命年率（Age-Standardized DALY Rate, ASDR）最高，分别为每10万人27542.29例与1011.78例。国家层面来看，比利时的年龄标准化发病率最高（每10万人2758.02例），巴西的年龄标准化患病率与年龄标准化伤残调整生命年率最高，分别为每10万人27592.69例与1013.43例。不过预测显示，到2035年，年龄标准化发病率、患病率及伤残调整生命年率仍将持续上升。

结论：1990至2021年间，全球青少年与青年群体的偏头痛负担大幅攀升，高社会人口学指数地区的伤残调整生命年负担最重，而低社会人口学指数地区则存在偏头痛诊断不足的问题。10~14岁群体（尤其是女性）的发病率达到峰值，这与激素水平及社会因素相关。尽管预测显示年龄标准化率将有所下降，但病例总数仍将增加，因此需要采取精准干预措施：包括优化医疗可及性、制定性别特异性防控策略以及开展校园健康教育项目。当前亟需全球协同行动，以推动偏头痛诊疗与预防服务的公平可及，并加强对新兴危险因素的研究，例如空气污染、长时间屏幕暴露、慢性应激及学业压力等。