Trends and disparities in the burden of autoimmune diseases in China and globally: A comparative analysis based on the Global Burden of Disease Study 2021

This study aimed to quantify long-term trends and burdens of 5 autoimmune diseases in China and globally from 1990 to 2021 using Global Burden of Disease 2021 data and identify drivers of change to guide prevention and health planning. Using Global Burden of Disease 2021 data, we analyzed type 1 diabetes mellitus (T1DM), inflammatory bowel disease (IBD), multiple sclerosis (MS), psoriasis (PS), and rheumatoid arthritis (RA) in China and worldwide from 1990 to 2021. We assessed age-standardized prevalence, disability-adjusted life years (DALYs), and temporal trends via joinpoint regression, and decomposed DALY changes into contributions from population growth, aging, and epidemiological transition. In 2021, global age-standardized prevalence (per 1,00,000) was highest for PS (515.95), followed by T1DM (238.19), RA (208.90), IBD (44.88), and MS (22.17). In China, RA (240.70) exceeded global levels, PS (474.02) was similar, and the other diseases were lower. All 5 autoimmune diseases showed increasing trends in China (IBD 1.62%, MS 1.21%, PS 0.88%, RA 0.51%, T1DM 1.15%), with growth rates surpassing global averages. DALY decomposition showed declines in IBD (AAPC = -2.86%) and T1DM (AAPC = -1.86%) driven by epidemiological improvements; increases in MS (AAPC = 0.95%) and PS (AAPC = 0.88%) driven by worsening patterns and aging; and stable RA burden (AAPC = -0.02%) mainly influenced by population growth and aging. Over 3 decades, autoimmune disease prevalence in China rose substantially, narrowing gaps with high-income regions. Declines in DALYs for IBD, T1DM, and RA reflect improved detection and care, while rising DALYs for MS and PS highlight the need for precision prevention, early intervention, and equitable resource allocation.