Global Burden of Diseases Associated With Iron Deficiency: GBD 2021.

Abstract

Background: Iron deficiency is a major global public health concern associated with various adverse outcomes.

Methods: This study utilized the Global Burden of Disease Study 2021 (GBD 2021) to analyze the contemporary burden of iron deficiency-associated diseases. We conducted an epidemiological analysis using Bayesian age-period-cohort methods for forecasting, decomposition analysis to assess the impact of aging, population growth, and epidemiological shifts, and slope/concentration indices to assess health inequalities.

Results: Between 1990 and 2021, disability-adjusted life years (DALYs) due to iron deficiency increased (2021: 34,519,623, 95% uncertainty interval [UI]: 23,607,706.06-48,762,323.14), despite a decline in age-standardized rates (ASR) (451.58 per 100,000; 95% UI: 308.48-639.42) with an estimated annual percentage change of -0.87 (95% confidence interval [CI]: -0.91 to -0.83). The burden was highest in low socio-demographic index regions, with 13,893,312.7 DALYs (95% UI: 9,567,547.98-19,440,905.71), an ASR of 735.34 per 100,000 (95% UI: 506.01-1027.57), and an annual percentage change (EAPC) of -1.36 (95% CI: -1.41 to -1.32). Deaths totaled 18,628.31 (95% UI: 9082.46-27,243.01), with a mortality rate of 1.77 per 100,000 (95% UI: 0.86-2.60), primarily from maternal health disorders and dietary iron deficiency. Population growth and epidemiological shifts were key contributors to the disease burden.

Conclusions: These findings highlight the persistent global burden of iron deficiency and the need for targeted interventions, particularly in low socio-demographic index regions.