High-BMI-related low back pain in China: a GBD-based observational study on sex–age trends and projections (1990–2021)
Year: 2025
Type: article
Abstract: BACKGROUND: ) quadruples LBP risk. Despite concurrent obesity and LBP epidemics, secular trends of BMI-related disability remain unquantified. OBJECTIVE: Using data from the Global Burden of Disease (GBD) 2021 study, we conducted an observational, cross-sectional analysis of three-decade trends (1990-2021) in disability due to high-BMI-related LBP across China, stratified by age and sex. By comparing national and global trajectories, we inform targeted strategies addressing this dual epidemic. METHODS: GBD 2021 data informed age-standardized years lived with disability (YLD) analyses of BMI-linked LBP disability (1990-2021) in China. Joinpoint regression identified trend inflection points, with annual percentage change and average annual percentage change (APC/AAPC) calculated using R and Joinpoint software for age-sex stratified burden quantification. Bayesian age-period cohort (BAPC) model was used to estimate the trend of burden of low back pain attributable to high BMI from 2022 to 2036. RESULTS: Between 1999 and 2021, China's high-BMI-related LBP disability burden escalated disproportionately, with age-standardized YLD rates rising 116.5% versus 39.1% globally. Females exhibited persistently higher burdens (2021 age-standardized YLD rate (ASYR): 67.51 vs. male 37.45/100,000), while youth (< 30 years) saw accelerated male-dominant growth (20-24 years: 17.57% annual increase post 2015). Joinpoint analysis identified China's unique triphasic acceleration (AAPC = 2.54%, P < 0.05), contrasting with linear global trends. Aging populations showed widening gender gaps (e.g., 60-64 years: female YLD rates 2.67-fold males), highlighting urgent need for sex- and age-tailored interventions. CONCLUSION: China's high-BMI-related LBP burden, though currently below global levels, is escalating disproportionately-accelerating in young males and persistently higher in females. Prioritizing sex- and age-specific interventions is critical to curb this dual metabolic-mechanical epidemic. TRIAL REGISTRATION: This study was an observational study analysis based on the GBD database, and no clinical trial registration was performed.
Authors: Juxiang Xu, Jianhua Li, Heqing Huang, Tiangao Lin, Zhiping Liao, Weibo Zhang, Jianing Wu, Fangchao Wu
Institutions: Sir Run Run Shaw Hospital, Zhejiang University
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W4411464430