Objective: To analyze the changing trends and attributable risk factors of low back pain disease burden in Chinese population from 1990 to 2023, and to predict the related disease burden of low back pain in 2030.
Methods: Based on the 2023 Global Burden of Disease (GBD) study database, the incidence, prevalence, years lived with disability (YLDs), and characteristics and trends of risk factors among Chinese individuals with low back pain from 1990 to 2023 were analyzed, the age and gender differences in disease burden were assessed, and the disease burden in 2030 was jointly predicted by autoregressive integrated moving average model and age-period-cohort model.
Results: From 1990 to 2023, the number of incident cases, the number of prevalent cases, and YLDs in Chinese low back pain population showed an upward trend, from 29.989 1 million cases, 68.636 3 million cases, and 7.732 4 million person-years to 41.383 6 million cases, 95.324 0 million cases, and 10.635 9 million person-years, respectively. The incidence rate, prevalence rate, and YLDs rate increased from 2 543.31 per 100 000, 5 820.89 per 100 000, and 655.77 per 100 000 to 2 892.65 per 100 000, 6 663.01 per 100 000, and 743.43 per 100 000 respectively. However, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized YLDs rate showed a downward trend, from 2 859.73 per 100 000, 6 636.60 per 100 000, and 740.83 per 100 000 to 2 164.80 per 100 000, 4 929.78 per 100 000, and 551.92 per 100 000, respectively. The burden of low back pain in women was significantly higher than that in men and increased with age (peak at 50 to 59 years old). Attribution analysis showed that smoking, occupational factors, and high body mass index (BMI) were the main factors leading to the increase of YLDs, and there was a gender difference. The tow model showed that the age-standardized incidence rate, the age-standardized prevalence rate, and the age-standardized YLDs rate for low back pain would decrease year by year from 2023 to 2030.
Conclusion: The disease burden of low back pain in China shows that from 1990 to 2023, the burden of low back pain in the Chinese population has been increasing year by year. Smoking, occupational factors, and high BMI are the main risk factors. Interventions targeting these controllable risk factors are crucial for reducing the disease burden. It is expected that by 2030, the disease burden of low back pain is expected to decrease, although the absolute burden will remain high. Greater attention should be paid to the middle-aged and elderly population, especially the female population, who bear a heavier disease burden. Targeted interventions, such as weight control and smoking cessation management, should be actively implemented against these controllable risk factors.
目的: 分析中国1990—2023年下腰痛疾病负担的变化趋势和归因危险因素，预测2030年下腰痛的相关疾病负担。.
方法: 基于2023年全球疾病负担研究（Global Burden of Disease，GBD）数据库，分析中国下腰痛人群1990—2023年的发病率、患病率、伤残损失寿命年（years lived with disability，YLDs）和归因危险因素的特点及变化趋势，评估疾病负担的年龄与性别差异，通过自回归积分滑动平均模型与年龄-时期-队列模型对2030年疾病负担进行双模型联合预测。.
结果: 从1990年至2023年，中国下腰痛发病人数、患病人数、YLDs均呈上升趋势，分别由2 998.91万例、6 863.63万例、773.24万人年上升至 4 138.36万例、9 532.40万例、1 063.59万人年；发病率、患病率、YLDs率亦呈上升趋势，分别从2 543.31/10万、5 820.89/10万、655.77/10万上升至2 892.65/10万、6 663.01/10万、743.43/10万；然而年龄标准化发病率、患病率、YLDs率呈下降趋势，分别从2 859.73/10万、6 636.60/10万、740.83/10万下降至2 164.80/10万、4 929.78/10万、551.92/10万。下腰痛疾病负担呈现出女性明显高于男性且随年龄增加逐渐升高的特征（高峰为50～59岁）。归因分析示，吸烟、职业因素和高身体质量指数（body mass index，BMI）是导致YLDs增加的主要因素且存在性别差异。双模型显示，2023—2030年下腰痛的年龄标准化发病率、患病率和YLDs率将从2023年后呈逐年下降趋势。.
结论: 中国下腰痛疾病负担显示，1990—2023年中国人群的下腰痛负担逐年加重，吸烟、职业因素和高BMI是主要危险因素。预计到2030年，下腰痛的疾病负担将有所下降，但绝对疾病负担仍将维持高位，应关注疾病负担更重的中老年群体尤其是女性群体，并积极针对这些可控风险因素采取体质量控制与控烟管理等针对性措施。.
Keywords: Low back pain; disease burden; population aging; risk factors; years lived with disability.