Burden of Atopic Dermatitis in China and Its Provinces, 1990-2021: A Global Burden of Disease 2021 Analysis

Atopic dermatitis (AD) has a high disease burden worldwide. However, the specific impact and geographical variations of AD in China remain unclear.

Using Global Burden of Disease (GBD) 2021 data, we assessed the AD burden (incidence, prevalence, and years lived with disability [YLDs]) across China's 33 provinces (1990-2021). Joinpoint regression analysis was used to identify temporal trends. We examined how urbanization and the human development index (HDI) influence the AD burden.

In 2021, China had 2.17 million (95% uncertainty interval [UI]: 2.08-2.26) new AD cases, 15.42 million (95% UI: 14.84-16.00) patients, and 0.68 million (95% UI: 0.35-1.14 million) YLDs. The crude incidence, prevalence, and YLD rates peaked in female individuals aged < 5 years of age and showed a decreasing gradient from South to North and West to East. Overall, all three rates slightly decrease from 1990 to 2021. Heterogeneity of time trends was observed across age groups, with rapid growth in patients aged < 5 years. Both the speed of urbanization and HDI were positively correlated with the incidence (r_urban = 0.52, r_HDI = 0.48), prevalence (r_urban = 0.50, r_HDI = 0.50), and YLD rates (r_urban = 0.61, r_HDI = 0.62) of average annual percentage change in people aged < 5 years.

The disease burden due to AD is high in China, with a sharp increase in people aged < 5 years. Rapid urbanization may intensify this increase, making it crucial to develop comprehensive AD management strategies that account for urbanization.