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Article(id=1322608041778856712, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506396, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750694400000, receivedDateStr=2025-06-24, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793263930028, onlineDateStr=2026-10-29, pubDate=1761321600000, pubDateStr=2025-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793263930028, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793263930028, creator=13701087609, updateTime=1793263930028, updator=13701087609, issue=Issue{id=1322607837742747790, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='1761321600000', pubDateStr='2025-10-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793263881383, creator='13701087609', updateTime=1793264238791, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322609336933794638, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322609336933794639, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3814, endPage=3819, ext={EN=ArticleExt(id=1322608042663854857, articleId=1322608041778856712, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Changing trends in the disease burden of irondeficiency anemia among Chinese children and adolescents aged 0-19 years old, 1990-2021, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the disease burden and changing trends of iron deficiency anemia (IDA) among children and adolescents in China from 1990 to 2021, and to provide evidence for policymakers to formulate prevention and control strategies.

Methods

Data from the Global Burden of Disease (GBD) 2021 study were used to extract indicators of iron deficiency anemia (IDA) among Chinese children and adolescents aged 0-19 years, including prevalent case number, prevalence, disability-adjusted life years (DALYs), and DALYs rate. Joinpoint regression models were established using Joinpoint Regression Program 4.9.0.0 to quantify trends in these indicators.

Results

In 2021, the prevalent case number, prevalence, DALYs, and DALYs rate of IDA among Chinese children and adolescents aged 0-19 years were 1 171.77×104,3 505.11/105,28.94×104, and 86.57/105, respectively. Compared with 1990, these values decreased by 71.94%, 62.65%, 75.88%, and 67.88% (all P<0.001). Gender differences revealed that females had significantly higher values than males in all four indicators except DALYs rate (P<0.001), with smaller declines than males. Age distribution of IDA exhibited a “U-shaped” pattern: the group under 5 years had the highest burden (486.69×104 cases, prevalence 6 034.48/105), while the 15-19 years group showed a rebound, particularly in females (184.61×104 cases, prevalence 5 337.18/105), approaching the levels of the group under 5 years.

Conclusion

The disease burden of IDA among Chinese children and adolescents has significantly decreased. However, notable age- and gender-based disparities persist, necessitating focused efforts to sustain gains in IDA prevention and control among children under 5 years of age, while addressing the resurgence of IDA among adolescent females. Further exploration of tailored nutrition strategies and comprehensive measures is essential.

, authors=Yun JIANG, Ting ZHANG, Xin HONG, Hua-feng YANG, authorsList=Yun JIANG, Ting ZHANG, Xin HONG, Hua-feng YANG, authorCompany=null, correspAuthors=Hua-feng YANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322608046812021516, articleId=1322608041778856712, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=1990—2021年中国0～19岁儿童青少年缺铁性贫血疾病负担变化趋势分析, columnId=1228016573844226129, journalTitle=现代预防医学, columnName=疾病预防控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析1990—2021年中国0~19岁儿童青少年缺铁性贫血（IDA）疾病负担情况及变化趋势，为各级部门制定防控政策提供参考依据。

方法

利用2021年全球疾病负担（GBD）研究数据，提取中国0~19岁人群IDA的患病数、患病率、伤残调整寿命年（DALYs）及DALYs率等指标，运用Joinpoint Regression Program 4.9.0.0软件建立Joinpoint回归模型量化上述指标的变化趋势。

结果

2021年，中国0~19岁儿童青少年IDA患病数、患病率、DALYs及DALYs率分别为1 171.77×104例、3 505.11/10万、28.94万人年、86.57/10万，较1990年分别下降-71.94%、-62.65%、-75.88%、-67.88%（P均<0.001），平均年度变化百分比（AAPC）分别为-4.02%、-3.12%、-4.48%、-3.60%，差异均有统计学意义（P均<0.001）；2021年，除DALYs率外，女性其余3项指标均显著高于男性（P均<0.001），且下降幅度较男性小。IDA年龄分布呈现“U型”特征：5岁以下组负担最重（患病数486.69×104例，患病率6 034.48/10万），15~19岁组出现反弹，尤其女性患病数（184.61×104例）和患病率（5 337.18/10万）已接近5岁以下组水平。

结论

1990—2021年中国儿童青少年IDA疾病负担显著减轻，但存在年龄和性别差异，需重点关注5岁以下儿童防控效果巩固及青春期女生IDA反弹问题，探索并制定更多更有针对性的营养改善政策和综合干预措施。

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姜云（1981—），女，本科，副研究员，研究方向：卫生事业管理及营养与食品卫生学

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杨华凤，E-mail:
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姜云（1981—），女，本科，副研究员，研究方向：卫生事业管理及营养与食品卫生学

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(In Chinese), articleTitle=Undernutrition and anemia in children under 5 years old in China, refAbstract=null)], funds=[Fund(id=1322608060204434235, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, awardId=ZKX18049, language=CN, fundingSource=南京市医学科技发展基金会(ZKX18049), fundOrder=null, country=null), Fund(id=1322608060317680444, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, awardId=null, language=CN, fundingSource=南京市医学重点专科, fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322608048057729807, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, xref=null, ext=[AuthorCompanyExt(id=1322608048070312720, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, companyId=1322608048057729807, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu 210003, China), AuthorCompanyExt(id=1322608048087089937, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, companyId=1322608048057729807, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=南京市疾病预防控制中心，江苏　南京　210003)])], figs=[ArticleFig(id=1322608057356501810, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=EN, label=Fig.1, caption=The changing trends of the disease burden of IDA among Chinese children and adolescents aged 0～19 years old by gender from 1990 to 2021, figureFileSmall=emTMUbUv1qAsj+GOKvbj0g==, figureFileBig=b0JJTycC9Fb7VdR0aTL2Mg==, tableContent=null), ArticleFig(id=1322608057679463219, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=CN, label=图1, caption=1990—2021年中国0～19岁儿童青少年不同性别组IDA疾病负担变化趋势

注：A患病数和患病率；B DALYs和DALYs率。

, figureFileSmall=emTMUbUv1qAsj+GOKvbj0g==, figureFileBig=b0JJTycC9Fb7VdR0aTL2Mg==, tableContent=null), ArticleFig(id=1322608058166002484, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=EN, label=Table 1, caption=

Disease burden in 1990 and 2021and the changing trends of IDA from 1990 to 2021 in Chinese children and adolescents aged 0～19 years old

, figureFileSmall=null, figureFileBig=null, tableContent=
指标性别1990年2021年变化率（%）AAPC（%，95% CI）P值
患病数（万人）男性2 386.87503.49-78.91-4.90（-5.04~-4.77）<0.001
女性1 789.54668.28-62.66-3.15（-3.29~-3.00）<0.001
合计4 176.411 171.77-71.94-4.02（-3.92~-4.11）<0.001
患病率（1/10万）男性10 317.892 818.33-72.69-4.09（-4.22~-3.95）<0.001
女性8 373.744 293.34-48.73-2.13（-2.17~-2.09）<0.001
合计9 384.313 505.11-62.65-3.12（-3.19~-3.06）<0.001
DALYs（万人年）男性77.4211.76-84.81-5.90（-6.03~-5.76）<0.001
女性42.5517.18-59.62-2.88（-2.96~-2.80）<0.001
合计119.9628.94-75.88-4.48（-4.56~-4.40）<0.001
DALYs率（1/10万）男性334.6665.82-80.33-5.12（-5.23~-5.00）<0.001
女性199.08110.38-44.55-1.87（-1.91~-1.83）<0.001
合计269.5686.57-67.88-3.60（-3.68~-3.52）<0.001
), ArticleFig(id=1322608058241499957, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=CN, label=表1, caption=

中国0～19岁儿童青少年1990 和 2021年 IDA疾病负担及1990—2021年变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
指标性别1990年2021年变化率（%）AAPC（%，95% CI）P值
患病数（万人）男性2 386.87503.49-78.91-4.90（-5.04~-4.77）<0.001
女性1 789.54668.28-62.66-3.15（-3.29~-3.00）<0.001
合计4 176.411 171.77-71.94-4.02（-3.92~-4.11）<0.001
患病率（1/10万）男性10 317.892 818.33-72.69-4.09（-4.22~-3.95）<0.001
女性8 373.744 293.34-48.73-2.13（-2.17~-2.09）<0.001
合计9 384.313 505.11-62.65-3.12（-3.19~-3.06）<0.001
DALYs（万人年）男性77.4211.76-84.81-5.90（-6.03~-5.76）<0.001
女性42.5517.18-59.62-2.88（-2.96~-2.80）<0.001
合计119.9628.94-75.88-4.48（-4.56~-4.40）<0.001
DALYs率（1/10万）男性334.6665.82-80.33-5.12（-5.23~-5.00）<0.001
女性199.08110.38-44.55-1.87（-1.91~-1.83）<0.001
合计269.5686.57-67.88-3.60（-3.68~-3.52）<0.001
), ArticleFig(id=1322608059483013942, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=EN, label=Table 2, caption=

Prevalent case number, prevalence in 1990 and 2021and the changing trends of IDA by age groups from 1990 to 2021 in Chinese adolescents and children aged 0～19 years old

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）性别1990年2021年
患病数（万人）患病率（1/10万）患病数（万人）患病率（1/10万）
<5男性1 127.7319 029.34246.355 917.54
女性621.6711 831.66222.346 169.57
合计1 749.4115 646.80468.696 034.48
5~9男性503.929 290.67114.972 256.86
女性293.565 866.75143.413 199.26
合计797.487 647.68258.392 697.97
10~14男性323.986 136.0265.201 417.52
女性256.955 191.58117.922 933.28
合计580.925 679.06183.112 124.47
15~19男性431.246 631.2276.971 920.37
女性617.3610 016.51184.615 337.18
合计1 048.598 278.47261.583 503.09
年龄组（岁）性别变化率（%）AAPC（%，95% CI）
患病数（万人）患病率（1/10万）患病数（万人）患病率（1/10万）
<5男性-78.16-101.32-4.75a（-4.92~-4.57）-3.70a（-3.78~-3.62）
女性-64.24-47.86-3.22a（-3.46~-2.98）-2.08a（-2.11~-2.05）
合计-73.21-61.43-4.12a（-4.33~-3.90）-3.03a（-3.09~-2.96）
5~9男性-77.18-75.71-4.69a（-4.86~-4.51）-4.46a（-4.57~-4.35）
女性-51.15-45.47-2.29a（-2.72~-1.87）-1.94a（-2.00~-1.88）
合计-67.60-64.72-3.59a（-3.95~-3.22）-3.30a（-3.35~-3.25）
10~14男性-79.18-76.90-4.99a（-5.33~-4.65）-4.61a（-4.68~-4.53）
女性-54.11-43.50-2.42a（-2.76~-2.08）-1.83a（-1.87~-1.79）
合计-68.48-62.59-3.60a（-3.96~-3.24）-3.11a（-3.17~-3.06）
15~19男性-82.15-71.04-5.42a（-5.62~-5.22）-3.91a（-4.01~-3.81）
女性-70.10-46.72-3.84a（-4.10~-3.57）-2.01a（-2.05~-1.96）
合计-75.05-57.68-4.39a（-4.62~-4.15）-2.73a（-2.80~-2.67）
), ArticleFig(id=1322608059592065847, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=CN, label=表2, caption=

中国0～19岁儿童青少年不同年龄组1990 和 2021年IDA 患病数与患病率及1990—2021年变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）性别1990年2021年
患病数（万人）患病率（1/10万）患病数（万人）患病率（1/10万）
<5男性1 127.7319 029.34246.355 917.54
女性621.6711 831.66222.346 169.57
合计1 749.4115 646.80468.696 034.48
5~9男性503.929 290.67114.972 256.86
女性293.565 866.75143.413 199.26
合计797.487 647.68258.392 697.97
10~14男性323.986 136.0265.201 417.52
女性256.955 191.58117.922 933.28
合计580.925 679.06183.112 124.47
15~19男性431.246 631.2276.971 920.37
女性617.3610 016.51184.615 337.18
合计1 048.598 278.47261.583 503.09
年龄组（岁）性别变化率（%）AAPC（%，95% CI）
患病数（万人）患病率（1/10万）患病数（万人）患病率（1/10万）
<5男性-78.16-101.32-4.75a（-4.92~-4.57）-3.70a（-3.78~-3.62）
女性-64.24-47.86-3.22a（-3.46~-2.98）-2.08a（-2.11~-2.05）
合计-73.21-61.43-4.12a（-4.33~-3.90）-3.03a（-3.09~-2.96）
5~9男性-77.18-75.71-4.69a（-4.86~-4.51）-4.46a（-4.57~-4.35）
女性-51.15-45.47-2.29a（-2.72~-1.87）-1.94a（-2.00~-1.88）
合计-67.60-64.72-3.59a（-3.95~-3.22）-3.30a（-3.35~-3.25）
10~14男性-79.18-76.90-4.99a（-5.33~-4.65）-4.61a（-4.68~-4.53）
女性-54.11-43.50-2.42a（-2.76~-2.08）-1.83a（-1.87~-1.79）
合计-68.48-62.59-3.60a（-3.96~-3.24）-3.11a（-3.17~-3.06）
15~19男性-82.15-71.04-5.42a（-5.62~-5.22）-3.91a（-4.01~-3.81）
女性-70.10-46.72-3.84a（-4.10~-3.57）-2.01a（-2.05~-1.96）
合计-75.05-57.68-4.39a（-4.62~-4.15）-2.73a（-2.80~-2.67）
), ArticleFig(id=1322608059768226616, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=EN, label=Table 3, caption=

DALYs, DALYs rate in 1990 and 2021and the changing trends of IDA by age groups from 1990 to 2021 in Chinese adolescents and children aged 0～19 years old

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）性别1990年2021年
DALYs（万人年）DALYs率（1/10万）DALYs（万人年）DALYs率（1/10万）
<5男性41.19694.975.39129.39
女性13.72261.154.89135.73
合计54.91491.1010.28132.33
5~9男性19.22354.283.4868.38
女性9.21184.064.55101.59
合计28.43272.608.0483.92
10~14男性12.60238.582.1346.30
女性8.57173.163.9898.99
合计21.17206.936.1170.87
15~19男性4.4267.970.7618.95
女性11.04179.193.76108.63
合计15.46122.094.5260.49
年龄组（岁）性别变化率（%）AAPC（%，95% CI）
DALYs（万人年）DALYs率（1/10万）DALYs（万人年）DALYs率（1/10万）
<5男性-86.92-81.38-6.36a（-6.50~-6.22）-5.27a（-5.36~-5.18）
女性-64.35-48.03-3.23a（-3.47~-3.00）-2.09a（-2.14~-2.04）
合计-81.28-73.05-5.27a（-5.45~-5.10）-4.15a（-4.24~-4.06）
5~9男性-81.87-80.70-5.39a（-5.57~-5.22）-5.17a（-5.30~-5.04）
女性-50.56-44.81-2.26a（-2.68~-1.83）-1.89a（-1.95~-1.83）
合计-71.73-69.21-4.01a（-4.35~-3.67）-3.73a（-3.78~-3.67）
10~14男性-83.10-80.59-5.53a（-5.83~-5.23）-5.14a（-5.15~-5.22）
女性-53.57-42.83-2.39a（-2.72~2.05）-1.78a（-1.82~-1.75）
合计-71.14-65.75-3.88a（-4.18~-3.58）-3.39a（-3.44~-3.34）
15~19男性-82.82-72.12-5.55a（-5.76~-5.33）-4.04a（-4.12~-3.95）
女性-65.98-39.38-3.45a（-3.66~-3.23）-1.59a（-1.65~-1.54）
合计-70.79-50.45-3.92a（-4.14~-3.70）-2.24a（-2.30~-2.18）
), ArticleFig(id=1322608059847918393, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322608041778856712, language=CN, label=表3, caption=

中国0～19岁儿童青少年不同年龄组 1990 和 2021年IDA 疾病DALYs与DALYs率及1990—2021年变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）性别1990年2021年
DALYs（万人年）DALYs率（1/10万）DALYs（万人年）DALYs率（1/10万）
<5男性41.19694.975.39129.39
女性13.72261.154.89135.73
合计54.91491.1010.28132.33
5~9男性19.22354.283.4868.38
女性9.21184.064.55101.59
合计28.43272.608.0483.92
10~14男性12.60238.582.1346.30
女性8.57173.163.9898.99
合计21.17206.936.1170.87
15~19男性4.4267.970.7618.95
女性11.04179.193.76108.63
合计15.46122.094.5260.49
年龄组（岁）性别变化率（%）AAPC（%，95% CI）
DALYs（万人年）DALYs率（1/10万）DALYs（万人年）DALYs率（1/10万）
<5男性-86.92-81.38-6.36a（-6.50~-6.22）-5.27a（-5.36~-5.18）
女性-64.35-48.03-3.23a（-3.47~-3.00）-2.09a（-2.14~-2.04）
合计-81.28-73.05-5.27a（-5.45~-5.10）-4.15a（-4.24~-4.06）
5~9男性-81.87-80.70-5.39a（-5.57~-5.22）-5.17a（-5.30~-5.04）
女性-50.56-44.81-2.26a（-2.68~-1.83）-1.89a（-1.95~-1.83）
合计-71.73-69.21-4.01a（-4.35~-3.67）-3.73a（-3.78~-3.67）
10~14男性-83.10-80.59-5.53a（-5.83~-5.23）-5.14a（-5.15~-5.22）
女性-53.57-42.83-2.39a（-2.72~2.05）-1.78a（-1.82~-1.75）
合计-71.14-65.75-3.88a（-4.18~-3.58）-3.39a（-3.44~-3.34）
15~19男性-82.82-72.12-5.55a（-5.76~-5.33）-4.04a（-4.12~-3.95）
女性-65.98-39.38-3.45a（-3.66~-3.23）-1.59a（-1.65~-1.54）
合计-70.79-50.45-3.92a（-4.14~-3.70）-2.24a（-2.30~-2.18）
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1990—2021年中国0～19岁儿童青少年缺铁性贫血疾病负担变化趋势分析
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姜云 , 张婷 , 洪忻 , 杨华凤
现代预防医学 | 疾病预防控制 2025,52(20): 3814-3819
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现代预防医学 |疾病预防控制 2025 , 52 (20) : 3814 -3819
1990—2021年中国0～19岁儿童青少年缺铁性贫血疾病负担变化趋势分析
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姜云, 张婷, 洪忻, 杨华凤
作者信息
  • 南京市疾病预防控制中心，江苏　南京　210003
通讯作者:
杨华凤，E-mail:
作者简介:

姜云（1981—），女，本科，副研究员，研究方向：卫生事业管理及营养与食品卫生学

Changing trends in the disease burden of irondeficiency anemia among Chinese children and adolescents aged 0-19 years old, 1990-2021
Yun JIANG, Ting ZHANG, Xin HONG, Hua-feng YANG
Affiliations
  • Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu 210003, China
出版时间: 2025-10-25 doi: 10.20043/j.cnki.MPM.202506396
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摘要
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目的

分析1990—2021年中国0~19岁儿童青少年缺铁性贫血（IDA）疾病负担情况及变化趋势，为各级部门制定防控政策提供参考依据。

方法

利用2021年全球疾病负担（GBD）研究数据，提取中国0~19岁人群IDA的患病数、患病率、伤残调整寿命年（DALYs）及DALYs率等指标，运用Joinpoint Regression Program 4.9.0.0软件建立Joinpoint回归模型量化上述指标的变化趋势。

结果

2021年，中国0~19岁儿童青少年IDA患病数、患病率、DALYs及DALYs率分别为1 171.77×104例、3 505.11/10万、28.94万人年、86.57/10万，较1990年分别下降-71.94%、-62.65%、-75.88%、-67.88%（P均<0.001），平均年度变化百分比（AAPC）分别为-4.02%、-3.12%、-4.48%、-3.60%，差异均有统计学意义（P均<0.001）；2021年，除DALYs率外，女性其余3项指标均显著高于男性（P均<0.001），且下降幅度较男性小。IDA年龄分布呈现“U型”特征：5岁以下组负担最重（患病数486.69×104例，患病率6 034.48/10万），15~19岁组出现反弹，尤其女性患病数（184.61×104例）和患病率（5 337.18/10万）已接近5岁以下组水平。

结论

1990—2021年中国儿童青少年IDA疾病负担显著减轻，但存在年龄和性别差异，需重点关注5岁以下儿童防控效果巩固及青春期女生IDA反弹问题，探索并制定更多更有针对性的营养改善政策和综合干预措施。

缺铁性贫血  /  儿童  /  青少年  /  全球疾病负担
Objective

To analyze the disease burden and changing trends of iron deficiency anemia (IDA) among children and adolescents in China from 1990 to 2021, and to provide evidence for policymakers to formulate prevention and control strategies.

Methods

Data from the Global Burden of Disease (GBD) 2021 study were used to extract indicators of iron deficiency anemia (IDA) among Chinese children and adolescents aged 0-19 years, including prevalent case number, prevalence, disability-adjusted life years (DALYs), and DALYs rate. Joinpoint regression models were established using Joinpoint Regression Program 4.9.0.0 to quantify trends in these indicators.

Results

In 2021, the prevalent case number, prevalence, DALYs, and DALYs rate of IDA among Chinese children and adolescents aged 0-19 years were 1 171.77×104,3 505.11/105,28.94×104, and 86.57/105, respectively. Compared with 1990, these values decreased by 71.94%, 62.65%, 75.88%, and 67.88% (all P<0.001). Gender differences revealed that females had significantly higher values than males in all four indicators except DALYs rate (P<0.001), with smaller declines than males. Age distribution of IDA exhibited a “U-shaped” pattern: the group under 5 years had the highest burden (486.69×104 cases, prevalence 6 034.48/105), while the 15-19 years group showed a rebound, particularly in females (184.61×104 cases, prevalence 5 337.18/105), approaching the levels of the group under 5 years.

Conclusion

The disease burden of IDA among Chinese children and adolescents has significantly decreased. However, notable age- and gender-based disparities persist, necessitating focused efforts to sustain gains in IDA prevention and control among children under 5 years of age, while addressing the resurgence of IDA among adolescent females. Further exploration of tailored nutrition strategies and comprehensive measures is essential.

Irondeficiency anemia  /  Child  /  Adolescent  /  Global burden of disease
姜云, 张婷, 洪忻, 杨华凤. 1990—2021年中国0～19岁儿童青少年缺铁性贫血疾病负担变化趋势分析. 现代预防医学, 2025 , 52 (20) : 3814 -3819 . DOI: 10.20043/j.cnki.MPM.202506396
Yun JIANG, Ting ZHANG, Xin HONG, Hua-feng YANG. Changing trends in the disease burden of irondeficiency anemia among Chinese children and adolescents aged 0-19 years old, 1990-2021[J]. Modern Preventive Medicine, 2025 , 52 (20) : 3814 -3819 . DOI: 10.20043/j.cnki.MPM.202506396
正文
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缺铁性贫血（Iron Deficiency Anemia，IDA）是由于体内铁元素不足，导致血红蛋白合成减少而引起的一种贫血类型。血红蛋白是红细胞中携带氧气的重要成分，铁是合成血红蛋白的必需元素，当铁摄入不足、吸收障碍或丢失过多时，血红蛋白合成受阻，红细胞数量减少或功能下降，从而引发贫血。缺铁性贫血是全球最常见的营养缺乏性疾病之一，是发达国家和发展中国家都面临的主要公共卫生问题之一[1-2]。铁缺乏和缺铁性贫血在全球造成的巨大疾病负担，是全球疾病范围内疾病负担的五大原因之一。年龄越小，生长发育越快，代谢率越高，需氧量越大，缺铁性贫血造成的危害就越大，严重时可能导致儿童青少年生长迟缓、智力发育障碍、免疫力下降及行为异常等不可逆的后果[3-4]。目前对国内外0～19岁儿童青少年IDA患病及疾病负担的长期趋势分析的研究尚不多见[5-10]，本研究利用2021年全球疾病负担研究（Global Burden of Disease Study 2021，GBD2021）数据，分析1990—2021年儿童青少年IDA疾病负担及其变化趋势，为该人群缺铁性贫血的防控提供依据。
1　资料与方法
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1.1　资料来源
本研究数据来自于GBD2021数据库，该数据库综合文献研究、监测和调查信息、住院和门诊数据、医疗保险情况等信息，评估了1980—2021年204个国家和地区的256种死因、369种疾病和伤害以及87种风险因素的流行病学数据[11]。本研究在进行数据筛选时，选择疾病为“Iron Deficiency Anemia”，地区为“China”，年份为“1990—2021年”，度量标准为“rate、number”，分析指标为“prevalance”和“DALYs”，性别为“male”、“female”和“both”，年龄段为0～19岁，年龄段分层为“5岁以下”“5～9岁”“10～14岁”“15～19岁”。
1.2　统计学分析
采用Excel 2010软件对1990—2021年中国儿童青少年缺铁性贫血的患病数、患病率及DALYs及率等指标进行描述性统计分析，计算相关指标的变化率，患病数/率变化率=（2021年患病数/率－1990年患病数/率）/1990年患病数/率×100%，DALYs数/率变化率=（2021年DALYs数/率－1990年DALYs数/率）/1990年DALYs数/率×100%。采用美国癌症研究所开发的Joinpoint 4.9.0.0软件进行变化趋势分析，趋势变化速率用平均年度变化百分比( average annual percent change，AAPC) 来表示，当 AAPC>0 时，呈上升趋势，当 AAPC<0 时，呈下降趋势。
2　结果
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2.1　1990— 2021年中国0～19岁儿童青少年缺铁性贫血疾病负担及变化趋势
1990—2021年间，中国0～19岁儿童青少年缺铁性贫血的患病数从4 176.41×104例下降到1 171.77×104例，患病率从9 384.31/10万下降到3 505.11/10万，DALYs从119.96万人年下降到28.94万人年，DALYs率从269.56/10万下降到86.57/10万。患病数、患病率、DALYs、DALYs率降幅分别为-71.94%、-62.65%、-75.88%、-67.88%，AAPC分别为-4.02%、-3.12%、-4.48%、-3.60%（P均<0.001）。见表1。
2.2　1990—2021年中国0～19岁不同性别儿童青少年缺铁性贫血疾病负担及变化趋势
1990—2021年，男性儿童青少年的患病数、患病率、DALYs、DALYs率降幅分别为-78.91%、-72.69%、-84.81%、-80.33%，AAPC分别为-4.90%、-4.09%、-5.90%、-5.12%（P均<0.001）。女性儿童青少年的患病数、患病率、DALYs、DALYs率降幅分别为-62.66%、-48.73%、-59.62%、-44.55%，AAPC分别为-3.15%、-2.13%、-2.88%、-1.87%（P均<0.05）。1990年代男性儿童青少年各项指标均高于女性，但2002年以后出现交叉转折点，女性儿童青少年各项指标开始逐渐高于男性。见表1及图1。
2.3　1990—2021年中国0～19岁不同年龄组儿童青少年缺铁性贫血疾病负担及变化趋势
1990年—2021年，5岁以下、5～9岁、10～14岁和15～19岁组的患病数均呈逐年下降趋势，降幅分别为-73.21%、-67.60%、-68.48%、-75.05%，AAPC分别为-4.12%，-3.59%、-3.60%、-4.39%（P均<0.05）；各年龄组男性儿童青少年患病数降幅均高于女性。从年龄组横向来看，10～14岁年龄组患病数是各年龄段是患病数最低的，15～19年龄组患病数则呈现逆向上升趋势，特别是15～19岁女性青少年患病数，仅次于5岁以下年龄组。1990年—2021年，各年龄组患病率同患病数变化一样，基本呈逐年下降趋势，降幅分别为-61.43%、-64.72%、-62.59%、-57.68%，AAPC分别为-3.03%，-3.30%、-3.11%、-2.73%（P均<0.001），同患病数一致的是，各年龄组男性儿童青少年降幅均高于女性，且15～19岁女性患病率仅次于5岁以下年龄组。随着年龄增长，DALYs数和DALYs率总体呈现下降趋势，1990—2021年，DALYs降幅为-81.28%、-71.73%、-71.14%、-70.79%，AAPC分别为-5.27%、-4.01%、-3.88%、-3.92%（P均<0.001）；DALYs率改善程度随年龄增长而减弱，降幅为-73.05%、-69.21%、-65.75%、-50.45%，AAPC分别为-4.15%、-3.73%、-3.39%、-2.24%，（P均<0.001）。各年龄组男性儿童青少年的DALYs数和DALYs率降幅均高于女性。见表2和表3。
3　讨论与建议
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我国政府于上世纪80年代起将儿童IDA纳入“四病”（维生素D缺乏性佝偻病、营养不良、肺炎、腹泻）防治体系，作为儿科与儿童保健重点任务。通过三级政府协同推进、全民营养健康宣教及铁强化食品普及，防治工作取得显著成效[3]。本研究发现，1990—2021年0～19岁儿童青少年IDA核心指标（患病数、患病率、DALYs数、DALYs率）均呈现持续下降趋势，各指标降幅均超过60%（62.65%-75.88%），与其他研究结果基本一致[12-13]。
1990—2021年我国女性儿童青少年总体IDA患病数、患病率及伤残调整寿命年（DALYs）等各项研究指标的降幅均低于男性。造成这种性别差异的情况可能与女生生理和心理原因相关，尤其是在女生青春前期和青春期阶段IDA风险显著升高，同时还可能与偏远地区重男轻女观念有关，或者“男性优先摄入动物性食物”的传统，导致女生在营养资源分配上处于弱势，且女生食量普遍偏低，进一步限制了膳食铁的摄入。政府部门、学校及家庭应给予女生更多的关注，在防控政策与措施上给予更多的倾斜和支持。
1990—2021年我国0～19岁儿童青少年IDA患病情况随着年龄增长呈现“U”型分布特征，其中 10～15岁组为全年龄段患病低谷（最低风险人群），而15～19岁组则呈现逆向上升趋势，其中15～19岁女性青少年群体上升尤为突出，其患病风险仅次于5岁以下儿童，这与该人群的生理因素和行为因素相关，青春期女生生理和心理状态都有了较大的变化，女生生长发育需求激增，铁储备需求激增，月经初潮后生理性失血增加，铁丢失量显著增加，若膳食铁补充不足时易导致铁代谢负平衡，同时该年龄段女生会更加关注和追求外在形象，限食或者偏食等行为造成膳食铁（尤其血红素铁）摄入不足及吸收，导致不同程度贫血的发生[14]。国内外研究也显示这一现象具有普遍性[15-17]。在对儿童青少年群体进行干预时，应着重关注15～19岁的女生群体，这需要家庭和学校共同努力，重视青春期女孩的营养需求，提供富含铁和维生素C的膳食，将IDA防治纳入学校健康教育课程，加强营养知识宣传和健康教育，注重青春期心理健康和咨询，纠正“体重焦虑”“以瘦为美”等错误观念，建立科学体重管理观念。
2021年5岁以下儿童的IDA各项研究指标虽较1990年显著下降（降幅61.43%-81.28%），但其绝对值仍显著高于其他年龄组，提示该群体在0～19岁人群中承受着最重的IDA疾病负担。这一现象与5岁以下儿童（尤其是3岁以下婴幼儿）生长发育快、营养需求大、肠胃功能尚未完全发育成熟、辅食添加不合理及母亲孕期情况影响等因素有关。5岁以下儿童的营养和健康状态将对其整个生命周期的生存和发展产生重要影响[18-19]，尽管我国社会经济持续发展使儿童健康水平整体提升，但营养缺乏性疾病仍是影响我国5岁以下儿童健康的主要威胁，而IDA在该年龄段营养相关疾病中疾病负担居首（占比41.2%）[19]，直接关联其神经发育与长期健康结局，所以各方仍需重点关注5岁以下儿童缺铁性贫血的防治工作：1.进行生命早期干预，加强孕产期保健，将孕妇铁营养监测纳入常规产检，建立“妊娠期—婴幼儿期”连续防控体系，早期预防，系统监测，从生命起点预防和控制相关疾病，2.建立社区支持网络，依托基层卫生机构开展婴幼儿科学喂养指导，纠正喂养误区，重点推广铁强化辅食；3.加强多维度健康促进，依托家庭、社区、幼儿园等，加大科学育儿、合理膳食等知识和技能宣传普及力度，提高监护人及抚养者的健康素养，调整膳食结构，改善喂养方式，促进儿童养成健康行为习惯[20-23]。
本研究存在一定的局限性：1.GBD数据对IDA的估算主要基于全球多元数据间接建模，缺乏中国专项贫血专项数据支持，可能影响特殊人群的准确性；2.GBD数据库区域覆盖不足，西藏、青海等偏远地区数据存在缺口，部分缺失数据依赖邻国数据或统计模型填补，或导致偏差；3.GBD对疾病负担的评估未系统考虑到社会经济与地区差异因素。尽管如此，全球疾病负担研究作为目前当前国际公认的系统性评估框架，在定量描述目前我国0～19岁儿童青少年IDA疾病负担及其长期变化趋势仍具有重要价值，能够呈现出更加全面系统的疾病负担结果。未来研究应结合中国本土流行病学调查数据，纳入社会经济、地区等因素进行分层分析，以提高儿童青少年IDA疾病负担评估的精准性。
综上所述，1990—2021年我国0～19岁儿童青少年缺铁性贫血防治成效显著，但是疾病负担的年龄和性别差异依然突出，5岁以下儿童承担最重疾病负荷，15～19岁女性青少年IDA风险呈逆向上升趋势（仅次于5岁以下年龄组），二者应列为当前IDA防控的优先目标群体。未来需持续关注并动态监测5岁以下儿童和15～19岁女性青少年的IDA变化趋势，在及时总结目前被证明有效的干预措施的同时，深入创新研究，探索AI驱动的精准补铁模型，推动卫健—教育—妇联多部门协作，构建“筛—防—治”一体化服务链，通过精准可行的综合干预措施，进一步提升我国0～19岁儿童青少年铁营养水平，筑牢全民健康基石。
基金
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  • 南京市医学科技发展基金会(ZKX18049)
  • 南京市医学重点专科
文献
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2025年第52卷第20期
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doi: 10.20043/j.cnki.MPM.202506396
  • 接收时间：2025-06-24
  • 首发时间：2026-10-29
  • 出版时间：2025-10-25
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  • 收稿日期：2025-06-24
基金
南京市医学科技发展基金会(ZKX18049)
南京市医学重点专科
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    南京市疾病预防控制中心，江苏　南京　210003

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杨华凤，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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