Epidemiology of asthma in Chinese population from 1990 to 2021: Findings from the Global Burden of Disease Study 2021

Objective: To analyze the burden due to asthma and its changes in China from 1990 to 2023.

Methods: Using data from the Global Burden of Disease 2023 (GBD 2023) study, we analysed six key indicators: the mortality, prevalence, incidence, disability-adjusted life years, years lived with disability, and years of life lost. Age-standardized rates were analysed using the global age structure as a reference. Joinpoint regression was used to assess the annual percentage change and average annual percentage change.

Results: In 2023, 45,991,602 prevalent cases, with 8,028,745 incidence cases and 23,699 deaths due to asthma, were reported from China. The number crude rates of the prevalence, mortality, disability-adjusted life years, and years lived with disability significantly increased in 2023 compared with 1990. The age-standardized rates per 100,000 were 3066.76 for prevalence (+5.65% from 1990), 717.95 for incidence (-2.18%), 1.11 for mortality (-53.36%), 140.90 for disability-adjusted life years (-14.77%), 120.42 for years lived with disability (5.81%), and 20.47 for years of life lost (-31.40%). The burden of asthma was higher in males than in females during 1990-2023. In 2023, the incidence rate was the highest among individuals under 10 years of age. The prevalence rate, mortality rate, disability-adjusted life years rate, and years of life lost rate were the highest among the population aged 95 and over. The years lived with disability rate was the highest among those aged 70-74.

Conclusion: Between 1990 and 2023, China's asthma burden showed age- and sex-specific trends: crude rates for prevalence, mortality, and disability increased, but age-standardized rates for mortality, disability-adjusted life years, and years of life lost declined. Males faced higher burdens than females. Key age groups included: under-10s (highest incidence), ≥95-year-olds (highest prevalence, mortality, disability-adjusted life years, years of life lost), and 70–74-year-olds (highest years lived with disability). Targeted interventions by age and sex are needed to address these disparities.