Disease burden analysis of peptic ulcer disease from 1990 to 2019_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHANG Xu ¹ , ZHOU Yuanzhi ¹ , CHEN Wenwen ¹ , ZHANG Lu ² , LI Yarui ¹ , REN Mudan ¹ ,  HE Shuixiang ¹

1. Department of Gastroenterology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, P. R. China;
2. Department of Urology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, P. R. China;

Corresponding author：

HE Shuixiang, Email: dyyyjxk@mail.xjtu.edu.cn

Keywords：

Peptic ulcer; Burden of disease; Evolving pattern

DOI：

10.7507/1672-2531.202212031

Video：

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Objective To estimate the level and evolving pattern of peptic ulcer disease (PUD) burden from 1990 to 2019. Methods The related data of PUD from 1990 to 2019 were obtained from GBD 2019 database. The corresponding age-standardized rate, annual percentage change, average annual percentage change were calculated and analyzed by Excel and R software. Results The global standardized prevalence of PUD was 99.4/100 000 (95%CI 83.9 to 117.5) in 2019, and decreased from 143.4/100 000 (95%CI 120.5 to 170.2) in 1990. The standardized disability-adjusted disease years (DALYs) rate was 74.4 (95%CI 69.0 to 81.9) in 2019. The estimated annual percentage change (EAPC) from 1990 to 2019 was −3.47% (95%CI −3.58 to −3.37), indicating that the standardized DALYs rate was declining. The prevalence and DALYs of PUD increased with age. The standardized DALYs rate was higher in males than in females in the same age group. Sociodemographic index (SDI) was negatively correlated with the standardized prevalence of PUD (R=−0.45, P<2.2e⁻¹⁶) and the standardized DALYs rate (R=−0.79, P<2.2e⁻¹⁶). Conclusion The worldwide burden of PUD declined from 1990 to 2019, but the decline had begun to slow or pause in countries with better economic development levels.

Citation： ZHANG Xu, ZHOU Yuanzhi, CHEN Wenwen, ZHANG Lu, LI Yarui, REN Mudan, HE Shuixiang. Disease burden analysis of peptic ulcer disease from 1990 to 2019. Chinese Journal of Evidence-Based Medicine, 2023, 23(4): 391-397. doi: 10.7507/1672-2531.202212031 Copy

1.	Lanas A, Chan FKL. Peptic ulcer disease. Lancet, 2017, 390(10094): 613-624.
2.	黄根. 消化性溃疡的临床特点及变化趋势—2012-2020年住院患者的大样本统计分析. 南昌: 南昌大学, 2021.
3.	Kavitt RT, Lipowska AM, Anyane-Yeboa A, et al. Diagnosis and treatment of peptic ulcer disease. Am J Med, 2019, 132(4): 447-456.
4.	Sung JJ, Kuipers EJ, El-Serag HB. Systematic review: the global incidence and prevalence of peptic ulcer disease. Aliment Pharmacol Ther, 2009, 29(9): 938-946.
5.	Leow AH, Lim YY, Liew WC, et al. Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population-a 20-year experience over three time periods. Aliment Pharmacol Ther, 2016, 43(7): 831-837.
6.	Yamamichi N, Yamaji Y, Shimamoto T, et al. Inverse time trends of peptic ulcer and reflux esophagitis show significant association with reduced prevalence of Helicobacter pylori infection. Ann Med, 2020, 52(8): 506-514.
7.	Azhari H, King JA, Coward S, et al. The global incidence of peptic ulcer disease is decreasing since the turn of the 21st century: a study of the organisation for economic co-operation and development (OECD). Am J Gastroenterol, 2022, 117(9): 1419-1427.
8.	Ahsberg K, Ye W, Lu Y, et al. Hospitalisation of and mortality from bleeding peptic ulcer in Sweden: a nationwide time-trend analysis. Aliment Pharmacol Ther, 2011, 33(5): 578-584.
9.	Malmi H, Kautiainen H, Virta LJ, et al. Incidence and complications of peptic ulcer disease requiring hospitalisation have markedly decreased in Finland. Aliment Pharmacol Ther, 2014, 39(5): 496-506.
10.	Alhammadi N, Asiri AH, Alshahrani FM, et al. Gastrointestinal complications associated with non-steroidal anti-inflammatory drug use among adults: a retrospective, single-center study. Cureus, 2022, 14(6): e26154.
11.	Domper Arnal MJ, Hijos-Mallada G, Lanas A. Gastrointestinal and cardiovascular adverse events associated with NSAIDs. Expert Opin Drug Saf, 2022, 21(3): 373-384.
12.	Kamada T, Satoh K, Itoh T, et al. Evidence-based clinical practice guidelines for peptic ulcer disease 2020. J Gastroenterol, 2021, 56(4): 303-322.
13.	郭佳, 贺媛, 王学梅, 等. 中国居民 1990 年与 2017 年胃癌疾病负担比较. 中国公共卫生, 2022, 38(5): 547-552.
14.	Zhang X, Zhang L, Pu Y, et al. Global, Regional, and national burden of protein-energy malnutrition: a systematic analysis for the global burden of disease study. Nutrients, 2022, 14(13): 2592.
15.	Wu J, Lai T, Han H, et al. Global, regional and national disability-adjusted life years due to HIV from 1990 to 2019: findings from the global burden of disease study 2019. Trop Med Int Health, 2021, 26(6): 610-620.
16.	He H, Liu Q, Li N, et al. Trends in the incidence and DALYs of schizophrenia at the global, regional and national levels: results from the global burden of disease study 2017. Epidemiol Psychiatr Sci, 2020, 29: e91.
17.	Melse JM, Essink-Bot ML, Kramers PG, et al. A national burden of disease calculation: Dutch disability-adjusted life-years. Dutch burden of disease group. Am J Public Health, 2000, 90(8): 1241-1247.
18.	Zhang L, Zhang X, Pu Y, et al. Global, Regional, and national burden of urolithiasis from 1990 to 2019: a systematic analysis for the global burden of disease study 2019. Clin Epidemiol, 2022, 14: 971-983.
19.	Scally B, Emberson JR, Spata E, et al. Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials. Lancet Gastroenterol Hepatol, 2018, 3(4): 231-241.
20.	Marshall BJ, McGechie DB, Rogers PA, et al. Pyloric Campylobacter infection and gastroduodenal disease. Med J Aust, 1985, 142(8): 439-444.
21.	Graham DY, Klein PD, Opekun AR, et al. Effect of age on the frequency of active Campylobacter pylori infection diagnosed by the [13C]urea breath test in normal subjects and patients with peptic ulcer disease. J Infect Dis, 1988, 157(4): 777-780.
22.	Charpignon C, Lesgourgues B, Pariente A, et al. Peptic ulcer disease: one in five is related to neither Helicobacter pylori nor aspirin/NSAID intake. Aliment Pharmacol Ther, 2013, 38(8): 946-954.
23.	Freston JW. Review article: role of proton pump inhibitors in non-H. Pylori-related ulcers. Aliment Pharmacol Ther, 2001, 15(Suppl 2): 2-5.
24.	Peleteiro B, Bastos A, Ferro A, et al. Prevalence of Helicobacter pylori infection worldwide: a systematic review of studies with national coverage. Dig Dis Sci, 2014, 59(8): 1698-1709.
25.	Pilotto A, Franceschi M, Leandro G, et al. NSAID and aspirin use by the elderly in general practice: effect on gastrointestinal symptoms and therapies. Drugs Aging, 2003, 20(9): 701-710.
26.	Sipponen P, Varis K, Fräki O, et al. Cumulative 10-year risk of symptomatic duodenal and gastric ulcer in patients with or without chronic gastritis. a clinical follow-up study of 454 outpatients. Scand J Gastroenterol, 1990, 25(10): 966-973.
27.	Nitsche W. Alcoholism. Classification, epidemiology, etiology. Fortschr Med, 1982, 100(23): 1111-1115.
28.	Liu ES, Wong BC, Cho CH. Influence of gender difference and gastritis on gastric ulcer formation in rats. J Gastroenterol Hepatol, 2001, 16(7): 740-747.
29.	Kurt D, Saruhan BG, Kanay Z, et al. Effect of ovariectomy and female sex hormones administration upon gastric ulceration induced by cold and immobility restraint stress. Saudi Med J, 2007, 28(7): 1021-1027.
30.	Speir E, Yu ZX, Takeda K, et al. Antioxidant effect of estrogen on cytomegalovirus-induced gene expression in coronary artery smooth muscle cells. Circulation, 2000, 102(24): 2990-2996.
31.	Okada K, Inamori M, Imajyo K, et al. Gender differences of low-dose aspirin-associated gastroduodenal ulcer in Japanese patients. World J Gastroenterol, 2010, 16(15): 1896-1900.

1. Lanas A, Chan FKL. Peptic ulcer disease. Lancet, 2017, 390(10094): 613-624.
2. 黄根. 消化性溃疡的临床特点及变化趋势—2012-2020年住院患者的大样本统计分析. 南昌: 南昌大学, 2021.
3. Kavitt RT, Lipowska AM, Anyane-Yeboa A, et al. Diagnosis and treatment of peptic ulcer disease. Am J Med, 2019, 132(4): 447-456.
4. Sung JJ, Kuipers EJ, El-Serag HB. Systematic review: the global incidence and prevalence of peptic ulcer disease. Aliment Pharmacol Ther, 2009, 29(9): 938-946.
5. Leow AH, Lim YY, Liew WC, et al. Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population-a 20-year experience over three time periods. Aliment Pharmacol Ther, 2016, 43(7): 831-837.
6. Yamamichi N, Yamaji Y, Shimamoto T, et al. Inverse time trends of peptic ulcer and reflux esophagitis show significant association with reduced prevalence of Helicobacter pylori infection. Ann Med, 2020, 52(8): 506-514.
7. Azhari H, King JA, Coward S, et al. The global incidence of peptic ulcer disease is decreasing since the turn of the 21st century: a study of the organisation for economic co-operation and development (OECD). Am J Gastroenterol, 2022, 117(9): 1419-1427.
8. Ahsberg K, Ye W, Lu Y, et al. Hospitalisation of and mortality from bleeding peptic ulcer in Sweden: a nationwide time-trend analysis. Aliment Pharmacol Ther, 2011, 33(5): 578-584.
9. Malmi H, Kautiainen H, Virta LJ, et al. Incidence and complications of peptic ulcer disease requiring hospitalisation have markedly decreased in Finland. Aliment Pharmacol Ther, 2014, 39(5): 496-506.
10. Alhammadi N, Asiri AH, Alshahrani FM, et al. Gastrointestinal complications associated with non-steroidal anti-inflammatory drug use among adults: a retrospective, single-center study. Cureus, 2022, 14(6): e26154.
11. Domper Arnal MJ, Hijos-Mallada G, Lanas A. Gastrointestinal and cardiovascular adverse events associated with NSAIDs. Expert Opin Drug Saf, 2022, 21(3): 373-384.
12. Kamada T, Satoh K, Itoh T, et al. Evidence-based clinical practice guidelines for peptic ulcer disease 2020. J Gastroenterol, 2021, 56(4): 303-322.
13. 郭佳, 贺媛, 王学梅, 等. 中国居民 1990 年与 2017 年胃癌疾病负担比较. 中国公共卫生, 2022, 38(5): 547-552.
14. Zhang X, Zhang L, Pu Y, et al. Global, Regional, and national burden of protein-energy malnutrition: a systematic analysis for the global burden of disease study. Nutrients, 2022, 14(13): 2592.
15. Wu J, Lai T, Han H, et al. Global, regional and national disability-adjusted life years due to HIV from 1990 to 2019: findings from the global burden of disease study 2019. Trop Med Int Health, 2021, 26(6): 610-620.
16. He H, Liu Q, Li N, et al. Trends in the incidence and DALYs of schizophrenia at the global, regional and national levels: results from the global burden of disease study 2017. Epidemiol Psychiatr Sci, 2020, 29: e91.
17. Melse JM, Essink-Bot ML, Kramers PG, et al. A national burden of disease calculation: Dutch disability-adjusted life-years. Dutch burden of disease group. Am J Public Health, 2000, 90(8): 1241-1247.
18. Zhang L, Zhang X, Pu Y, et al. Global, Regional, and national burden of urolithiasis from 1990 to 2019: a systematic analysis for the global burden of disease study 2019. Clin Epidemiol, 2022, 14: 971-983.
19. Scally B, Emberson JR, Spata E, et al. Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials. Lancet Gastroenterol Hepatol, 2018, 3(4): 231-241.
20. Marshall BJ, McGechie DB, Rogers PA, et al. Pyloric Campylobacter infection and gastroduodenal disease. Med J Aust, 1985, 142(8): 439-444.
21. Graham DY, Klein PD, Opekun AR, et al. Effect of age on the frequency of active Campylobacter pylori infection diagnosed by the [13C]urea breath test in normal subjects and patients with peptic ulcer disease. J Infect Dis, 1988, 157(4): 777-780.
22. Charpignon C, Lesgourgues B, Pariente A, et al. Peptic ulcer disease: one in five is related to neither Helicobacter pylori nor aspirin/NSAID intake. Aliment Pharmacol Ther, 2013, 38(8): 946-954.
23. Freston JW. Review article: role of proton pump inhibitors in non-H. Pylori-related ulcers. Aliment Pharmacol Ther, 2001, 15(Suppl 2): 2-5.
24. Peleteiro B, Bastos A, Ferro A, et al. Prevalence of Helicobacter pylori infection worldwide: a systematic review of studies with national coverage. Dig Dis Sci, 2014, 59(8): 1698-1709.
25. Pilotto A, Franceschi M, Leandro G, et al. NSAID and aspirin use by the elderly in general practice: effect on gastrointestinal symptoms and therapies. Drugs Aging, 2003, 20(9): 701-710.
26. Sipponen P, Varis K, Fräki O, et al. Cumulative 10-year risk of symptomatic duodenal and gastric ulcer in patients with or without chronic gastritis. a clinical follow-up study of 454 outpatients. Scand J Gastroenterol, 1990, 25(10): 966-973.
27. Nitsche W. Alcoholism. Classification, epidemiology, etiology. Fortschr Med, 1982, 100(23): 1111-1115.
28. Liu ES, Wong BC, Cho CH. Influence of gender difference and gastritis on gastric ulcer formation in rats. J Gastroenterol Hepatol, 2001, 16(7): 740-747.
29. Kurt D, Saruhan BG, Kanay Z, et al. Effect of ovariectomy and female sex hormones administration upon gastric ulceration induced by cold and immobility restraint stress. Saudi Med J, 2007, 28(7): 1021-1027.
30. Speir E, Yu ZX, Takeda K, et al. Antioxidant effect of estrogen on cytomegalovirus-induced gene expression in coronary artery smooth muscle cells. Circulation, 2000, 102(24): 2990-2996.
31. Okada K, Inamori M, Imajyo K, et al. Gender differences of low-dose aspirin-associated gastroduodenal ulcer in Japanese patients. World J Gastroenterol, 2010, 16(15): 1896-1900.

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