The burden of inflammatory bowel disease in five East Asian countries an analysis based on the global burden of disease study 1990-2021.

Abstract

Background: Inflammatory bowel disease (IBD) is a chronic and relapsing gastrointestinal disorder whose global disease burden continues to rise, making it a significant public health issue. In recent years, rapid socioeconomic development in East Asia has led to notable changes in lifestyle and dietary patterns, accompanied by dynamic shifts in the epidemiological characteristics of IBD. However, there remains a lack of systematic comparison and analysis of the long-term disease burden and evolutionary trends of IBD across five East Asian countries and regions: China, Japan, South Korea, North Korea, and Mongolia. Based on data from The Global Burden of Disease Study 2021 (GBD 2021), this study aims to comprehensively describe the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of IBD in The region from 1990 to 2021, thereby providing a basis for differentiated prevention and control strategies.

Methods: Descriptive analysis, Joinpoint regression, and age-period-cohort (APC) modeling were employed to examine epidemiological patterns and trends.

Results: Significant variations in IBD burden were observed across the region. China and South Korea experienced the most rapid increases in incidence and prevalence, exhibiting a profile of "high morbidity and low disability." Japan demonstrated a stabilizing disease burden alongside a continuing decline in standardized mortality rates, reflecting its advanced healthcare system. North Korea and Mongolia currently have a relatively low overall burden; however, a notable rise in incidence among young Mongolians suggests an emerging risk of early-onset IBD. APC analysis further indicated complex influences from environmental factors, healthcare resource allocation, and lifestyle changes such as Westernized diets. The study proposes tailored prevention strategies: high-SDI countries should optimize geriatric care systems, medium-SDI countries should enhance preventive interventions for adolescents, and low-SDI countries should prioritize the establishment of primary screening networks.

Conclusion: These findings provide a scientific basis for differentiated IBD prevention and control in East Asia and contribute to a deeper understanding of the epidemiological transition of chronic diseases.