Data Sheet 1_Global, regional, and national burden of acute glomerulonephritis in children and adolescents: 1990–2021 analysis and future projections.docx

BackgroundAcute glomerulonephritis (AGN) remains a significant issue in global health, yet its burden among children and adolescents has not been sufficiently characterized. This study aims to systematically estimate the global, regional, and national burden of AGN, as well as its temporal trends from 1990 to 2021.
MethodsThis study utilized data from the Global Burden of Disease (GBD) 2021 study, focusing on incidence rates, disability-adjusted life years (DALYs), and mortality among individuals under 20 years of age. Estimated annual percentage changes (EAPCs) were employed to assess temporal trends, and statistical analyses were conducted to examine correlations with the Socio-Demographic Index (SDI). Additionally, we performed decomposition and inequality analyses, along with Bayesian Age-Period-Cohort (BAPC) analyses, to evaluate trends and distributions related to the burden of AGN.
ResultsFrom 1990 to 2021, the global burden of AGN among children and adolescents remained significantly high. In 2021, there were approximately 170,584 new cases, representing a decrease compared to earlier years, with an age-standardized incidence rate (ASIR) of 6.47 per 100,000 (95% UI: 4.79–8.45). The EAPC for incidence showed a declining trend of −1.03% (95% CI: −1.15, −0.92). The total number of DALYs associated with AGN was 59,588.50 (95% UI: 32,925.73–79,649.94), with an age-standardized DALY rate of 2.26 per 100,000 (95% UI: 1.25–3.02), demonstrating a significant decline represented by an EAPC of −4.33% (95% CI: −4.46, −4.21). Gender differences were minimal; however, disparities across SDI regions were pronounced, with middle SDI regions exhibiting the highest incidence rate at 8.87 per 100,000, and increasing incidence rates observed in lower-middle and low SDI regions. Notably, China reported the highest number of cases, followed by Brazil and India. Furthermore, absolute inequality among SDI countries improved from 1990 to 2021, while relative inequality intensified during the same period.
ConclusionThis study underscores the substantial and evolving burden of AGN among children and adolescents, highlighting the urgent need for targeted public health strategies and interventions to address disparities in disease burden and improve health outcomes in vulnerable populations.

背景：急性肾小球肾炎（Acute glomerulonephritis, AGN）仍是全球卫生领域的重大公共卫生问题，但目前针对儿童和青少年群体的疾病负担尚未得到充分阐明。本研究旨在系统评估1990年至2021年间急性肾小球肾炎的全球、区域及国家层面疾病负担，并分析其时间变化趋势。
方法：本研究使用全球疾病负担（Global Burden of Disease, GBD）2021研究的数据，重点关注20岁以下人群的发病率、伤残调整寿命年（Disability-adjusted life years, DALYs）及死亡率。研究采用估计年度百分比变化（Estimated annual percentage changes, EAPCs）评估时间趋势，通过统计学分析探讨其与社会人口指数（Socio-Demographic Index, SDI）的相关性。此外，本研究还开展了分解分析、不平等性分析以及贝叶斯年龄-时期-队列（Bayesian Age-Period-Cohort, BAPC）分析，以评估急性肾小球肾炎疾病负担的变化趋势与分布特征。
结果：1990年至2021年间，全球儿童及青少年急性肾小球肾炎疾病负担始终处于较高水平。2021年全球新增病例约170584例，较早年有所下降，年龄标化发病率（age-standardized incidence rate, ASIR）为每10万人6.47例（95%不确定区间：4.79~8.45）。发病率的估计年度百分比变化为-1.03%（95%置信区间：-1.15~-0.92），呈下降趋势。急性肾小球肾炎相关伤残调整寿命年总数为59588.50（95%不确定区间：32925.73~79649.94），年龄标化伤残调整寿命年率为每10万人2.26例（95%不确定区间：1.25~3.02），其估计年度百分比变化为-4.33%（95%置信区间：-4.46~-4.21），降幅显著。性别差异极小，但不同社会人口指数区域间的不平等性较为显著：中等社会人口指数区域的发病率最高，达每10万人8.87例，而中低、低社会人口指数区域的发病率呈上升趋势。值得注意的是，中国的新增病例数最多，其次为巴西和印度。此外，1990年至2021年间，不同社会人口指数国家间的绝对不平等性有所改善，但相对不平等性则有所加剧。
结论：本研究强调了儿童及青少年急性肾小球肾炎疾病负担的严重性与动态变化，指出亟需制定针对性的公共卫生策略与干预措施，以应对疾病负担的不平等性，改善脆弱人群的健康结局。