Analysis on the Incidence and mortality of asthma in China based on the age-period-cohort model_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Chao ¹ , WANG Lize ¹ , YIN Sijia ¹ , ZHENG Xiaotong ¹ ,  SUN Huixin ²

1. Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, P.R.China;
2. Institute of Cancer Prevention and Treatment, Harbin Medical University, Harbin, Heilongjiang 150000, P.R.China;

Corresponding author：

SUN Huixin, Email: sunhx@hrbmu.edu.cn

Keywords：

Aasthma; China; Age-period-queue model; Incidence rate; mortality rate

DOI：

10.7507/1671-6205.202403052

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Objective To analyze the incidence and mortality of asthma in China from 1990 to 2019, and to explore the influence of age, period and cohort on the incidence and mortality of asthma. Methods Using the Global Burden of Disease (GBD) 2019 database, the incidence and mortality of asthma in China from 1990 to 2019 were analyzed, and the time variation trend of age-standardized incidence and mortality was analyzed by using Joinpoint software, and the average annual variation percentage was calculated. The age-period-cohort model was constructed to analyze the influence of age, period and birth cohort on the incidence and mortality trend of asthma. Results In 2019, the incidence of asthma in China was 264.44/100 000, and the mortality rate was 1.74/100 000. The incidence rate of asthma in males (300.94/100 000) and mortality rate (1.99/100 000) were higher than those in females (226.51/100 000 and 1.49/100 000). From 1990 to 2019, the age-standardized incidence of asthma in China showed a downward trend, but the trend was not statistically significant (P>0. 05), and the age-standardized mortality showed a downward trend, with an average annual decrease of 4.90%, with a statistically significant trend (P<0.05). The results of age effect showed that the incidence of asthma in China showed a downward trend, and the death first showed a downward trend, and then increased in the age group of 55-59. The results of period effect show that the risk of asthma is decreasing, and then it is increasing from 2015 to 2019, and the risk of asthma mortality is decreasing. The results of cohort effect show that the later people are born, the lower the risk of asthma onset and death. The death of asthma is attributed to behavioral risk, high body mass index and tobacco, and the occupational risk tends to decrease. Conclusions From 1990 to 2019, the incidence and mortality of asthma in China showed a decreasing trend, and the incidence and mortality of men were higher than that of women. The risk factors of behavioral risk, high body mass index and tobacco were still on the rise, so corresponding measures should be taken to carry out early screening, early detection, and early treatment for key populations.

Citation： ZHANG Chao, WANG Lize, YIN Sijia, ZHENG Xiaotong, SUN Huixin. Analysis on the Incidence and mortality of asthma in China based on the age-period-cohort model. Chinese Journal of Respiratory and Critical Care Medicine, 2024, 23(8): 546-551. doi: 10.7507/1671-6205.202403052 Copy

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14.	Mohamed Hussain S, Ayesha Farhana S, Mohammed Alnasser S. Time trends and regional variation in prevalence of asthma and associated factors in Saudi Arabia: a systematic review and meta-analysis. Biomed Res Int, 2018, 2018: 8102527.
15.	João C, Jácome C, Brito D , et al. Prevalence and characterisation of patients with asthma according to disease severity in Portugal: findings from the EPI-ASTHMA pilot study. J Asthma Allergy, 2022, 15: 1441-1453.
16.	Ryan-Ibarra S, Milet M, Lutzker L, et al. Age, period, and cohort effects in adult lifetime asthma prevalence in California: an application of hierarchical age-period-cohort analysis. Ann Epidemiol, 2016, 26(2): 87-92.
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22.	Leonard SI, Turi ER, Powell JS, Usseglio J, MacDonell KK, Bruzzese JM. Associations of asthma self-management and mental health in adolescents: A scoping review. Respir Med, 2022, 200: 106897.

1. Reddel HK, Bacharier LB, Bateman ED, et al. Global initiative for asthma strategy 2021: executive summary and rationale for key changes. Eur Respir J, 2021, 59(1): 2102730.
2. Reddel HK, Bacharier LB, Bateman ED, et al. Global Initiative for asthma strategy 2021: executive summary and rationale for key changes. Am J Respir Crit Care Med, 2022, 205(1): 17-35.
3. Bissell K, Perrin C, Beran D. Access to essential medicines to treat chronic respiratory disease in low-income countries. Int J Tuberc Lung Dis, 2016, 20(6): 717-728.
4. Singh S, Sharma BB, Sharma SK, et al. Prevalence and severity of asthma among Indian school children aged between 6 and 14 years: associations with parental smoking and traffic pollution. J Asthma, 2016, 53(3): 238-244.
5. Arias SJ, Neffen H, Bossio JC, et al. Prevalence and features of asthma in young adults in urban areas of Argentina. Arch Bronconeumol, 2018, 54(3): 134-139.
6. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1223-1249.
7. Murray CJL. The Global burden of disease study at 30 years. Nat Med, 2022, 28(10): 2019-2026.
8. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1204-1222.
9. Zhang S, Gao Z, Wu L, et al. Global patterns of asthma burden related to environmental risk factors during 1990-2019: an age-period-cohort analysis for global burden of disease study 2019. Environ Health, 2024, 23(1): 20.
10. 华淑名. “年龄-时期-队列”效应模型的应用与发展. 信息系统工程, 2019, 23(9): 73-74.
11. Lou Z, Huang Y, Li S, et al. Global, regional, and national time trends in incidence, prevalence, years lived with disability for uterine fibroids, 1990-2019: an age-period-cohort analysis for the global burden of disease 2019 study. BMC Public Health, 2023, 23(1): 91.
12. Clegg LX, Hankey BF, Tiwari R, et al. Estimating average annual per cent change in trend analysis. Stat Med, 2009, 28(29): 3670-3682.
13. Averell CM, Laliberté F, Germain G, et al. Disease burden and treatment adherence among children and adolescent patients with asthma. J Asthma, 2022, 59(8): 1687-1696.
14. Mohamed Hussain S, Ayesha Farhana S, Mohammed Alnasser S. Time trends and regional variation in prevalence of asthma and associated factors in Saudi Arabia: a systematic review and meta-analysis. Biomed Res Int, 2018, 2018: 8102527.
15. João C, Jácome C, Brito D , et al. Prevalence and characterisation of patients with asthma according to disease severity in Portugal: findings from the EPI-ASTHMA pilot study. J Asthma Allergy, 2022, 15: 1441-1453.
16. Ryan-Ibarra S, Milet M, Lutzker L, et al. Age, period, and cohort effects in adult lifetime asthma prevalence in California: an application of hierarchical age-period-cohort analysis. Ann Epidemiol, 2016, 26(2): 87-92.
17. Desai M, Oppenheimer JJ. Medication adherence in the asthmatic child and adolescent. Curr Allergy Asthma Rep, 2011, 11(6): 454-464.
18. Benfante A, Tomasello A, Gianquinto E, et al. Diagnostic and therapeutic approaches for elderly asthma patients: the importance of multidisciplinary and multidimensional management. Expert Rev Respir Med, 2023, 17(6): 459-468.
19. Chen Y, Hong J, Tang M, et al. Causal complexity of environmental pollution in China: a province-level fuzzy-set qualitative comparative analysis. Environ Sci Pollut Res Int, 2023, 30(6): 15599-15615.
20. Lommatzsch M, Virchow JC. Severe asthma: definition, diagnosis and treatment. Dtsch Arztebl Int, 2014, 111(50): 847-855.
21. de Granda-Orive JI, Solano-Reina S, de Granda-Beltrán AM, Jiménez-Ruiz C. Asthma and tobacco: dangerous liaisons. Ann Epidemiol, 2017, 27(6): 406-407.
22. Leonard SI, Turi ER, Powell JS, Usseglio J, MacDonell KK, Bruzzese JM. Associations of asthma self-management and mental health in adolescents: A scoping review. Respir Med, 2022, 200: 106897.

Chinese Journal of Respiratory and Critical Care Medicine

Analysis on the Incidence and mortality of asthma in China based on the age-period-cohort model

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