基于GBD 2021数据分析孤独症谱系障碍全球疾病负担的性别差异（英文）

刘慧琴; 丁金锋; 许达欣; 袁金秋; 倪钊; 刘帮杉; 张君威; 林嘉玲; 吉彬彬; 秦希文

doi:10.11817/j.issn.1672-7347.2026.260021

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基于GBD 2021数据分析孤独症谱系障碍全球疾病负担的性别差异（英文）

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基于GBD 2021数据分析孤独症谱系障碍全球疾病负担的性别差异（英文）
Sex differences in the global burden of autism spectrum disorders: An analysis based on GBD 2021 data
中南大学学报(医学版) 中南大学学报(医学版) 2026年51卷第2期页码：299-311
作者机构：

1.中南大学湘雅二医院精神病学科，国家精神心理疾病临床医学研究中心，国家精神疾病医学中心，长沙 410011
2.中南大学精神卫生研究所，精神疾病诊治技术国家地方联合工程实验室，精神疾病诊治技术湖南省工程实验室，精神病学与精神卫生学湖南省重点实验室，湖南省精神医学中心，长沙 410011
3.中南大学湘雅护理学院，长沙 410013
4.西澳大学全球与人口健康学院，澳大利亚珀斯 6009
5.广州市南沙区珠江街社区卫生服务中心，广州 511462
6.中山大学附属第七医院临床大数据研究中心，流行病学与生物统计学系，深圳 518106
7.中国健康风险管理协作组，广东省消化疾病重点实验室，深圳 518107
8.中山大学附属第七医院消化医学中心，深圳 518106
9.耶鲁大学护理学院，美国纽黑文 06477
10.辅仁大学附属医院精神科，新北市 24352
11.辅仁大学医学院，新北市 24352
12.新南威尔士大学未来健康系统国际中心，澳大利亚悉尼 2052
13.湖南中医药大学护理学院，长沙 410208
14.暨南大学医学部公共卫生与预防医学系，广州 510632
作者简介：

LIU Huiqin, Email: liuhuiqin@csu.edu.cn, ORCID: 0000-0002-5754-2623
JI Binbin, associate professor, Email: 004286@hnucm.edu.cn, ORCID: 0009-0001-9823-1485
QIN Xiwen, associate professor, Email: simon.qin@uwa.edu.au, ORCID: 0009-0008-5287-7003
基金信息：

the National Natural Science Foundation of China(72304096)
DOI：10.11817/j.issn.1672-7347.2026.260021
中图分类号：
CSTR：
收稿：2025-12-20，

纸质出版：2026-02-28
稿件说明：

刘慧琴, 丁金锋, 许达欣, 袁金秋, 倪钊, 刘帮杉, 张君威, 林嘉玲, 吉彬彬, 秦希文. 基于GBD 2021数据分析孤独症谱系障碍全球疾病负担的性别差异[J]. 中南大学学报(医学版), 2026, 51(2): 299-311.

LIU Huiqin, DING Jinfeng, XU Daxin, YUAN Jinqiu, NI Zhao, LIU Bangshan, CHANG Chunwei, LIN Jialing, JI Binbin, QIN Xiwen. Sex differences in the global burden of autism spectrum disorders: An analysis based on GBD 2021 data[J]. Journal of Central South University. Medical Science, 2026, 51(2): 299-311.
刘慧琴, 丁金锋, 许达欣, 袁金秋, 倪钊, 刘帮杉, 张君威, 林嘉玲, 吉彬彬, 秦希文. 基于GBD 2021数据分析孤独症谱系障碍全球疾病负担的性别差异[J]. 中南大学学报(医学版), 2026, 51(2): 299-311. DOI：10.11817/j.issn.1672-7347.2026.260021.

LIU Huiqin, DING Jinfeng, XU Daxin, YUAN Jinqiu, NI Zhao, LIU Bangshan, CHANG Chunwei, LIN Jialing, JI Binbin, QIN Xiwen. Sex differences in the global burden of autism spectrum disorders: An analysis based on GBD 2021 data[J]. Journal of Central South University. Medical Science, 2026, 51(2): 299-311. DOI：10.11817/j.issn.1672-7347.2026.260021.

摘要

目的

孤独症谱系障碍(autism spectrum disorder，ASD)已成为全球范围内日益严峻的公共卫生挑战，导致的疾病负担持续增加，并伴有显著的性别差异。本研究评估ASD疾病负担性别差异的长期趋势与全球分布模式，并预测其未来变化，旨在为ASD的干预及管理提供依据。

方法

基于2021年全球疾病负担(Global Burden of Disease，GBD)数据，提取204个国家及地区ASD的伤残调整寿命年(disability-adjusted life years，DALYs)，结合社会人口学指数(sociodemographic index，SDI)，采用平均年度百分比变化(average annual percentage change，AAPC)分析1990—2021年ASD疾病负担时间趋势与空间分布的性别差异，并预测2022—2050年的变化。

结果

1990—2021年全球ASD年龄标准化DALY率(age-standardized DALY rate，ASDR)男性显著高于女性，预计2022—2050年趋势相同。其中，基于性别的ASDR的绝对差异为103.5/10万~105.3/10万，相对差异为1.0~1.1，且该性别差异在东亚和高SDI地区最为显著。男性ASDR在1990—2021年呈上升趋势，女性ASDR预计在2021年后增长，该趋势在非洲尤为明显。2021年，全球ASD的DALYs在5岁以下儿童中达到峰值(男性为221.9/10万；女性为112.8/10万)，且DALYs的相对差异随年龄增长而增加。成年期DALYs的绝对差异整体下降，但在青年及≥70岁人群中呈上升趋势，且与相对差异变化模式一致。在国家层面，性别差异与SDI、全民健康覆盖(universal health coverage，UHC)呈正相关，与性别不平等指数(gender inequality index，GII)呈负相关(均

0.001)；西班牙、日本、新加坡、韩国及中国偏离此关联。

结论

ASD疾病负担的性别差异在全球持续存在，并随年龄增长而加剧，需制订针对不同性别与年龄阶段的精准防控策略。

Abstract

Objective

Autism spectrum disorder (ASD) has become an increasingly serious global public health challenge

with a continuously rising disease burden and marked sex differences. This study aims to evaluate the long-term trends and global distribution patterns of sex differences in the burden of ASD and to project future changes

thereby providing evidence for ASD prevention and management.

Methods

Based on the Global Burden of Disease (GBD) 2021 data

disability-adjusted life years (DALYs) for ASD were extracted for 204 countries and territories. Combined with the sociodemographic index (SDI)

the average annual percentage change (AAPC) was used to analyze sex differences in temporal trends and spatial distribution of ASD burden from 1990 to 2021

and to project trends from 2022 to 2050.

Results

From 1990 to 2021

the global age-standardized DALY rate (ASDR) for ASD was significantly higher in males than in females

and this pattern is projected to persist through 2050. The absolute difference (AD) in ASDR ranged from 103.5 to 105.3 per 100 000

and the relative difference (RD) ranged from 1.0 to 1.1

with the most pronounced sex differences observed in East Asia and high-SDI regions. The male ASDR showed an increasing trend from 1990 to 2021

whereas the female ASDR is projected to increase after 2021

particularly in Africa. In 2021

global DALYs for ASD peaked among children under 5 years of age (221.9 per 100 000 in males and 112.8 per 100 000 in females)

and the relative difference in DALYs increased with age. The absolute difference in DALYs during adulthood generally declined but increased among young adults and those aged ≥70 years

consistent with the pattern observed for relative differences. At the national level

sex differences were positively correlated with SDI and universal health coverage (UHC)

and negatively correlated with the gender inequality index (GII) (all

0.001). Spain

Japan

Singapore

South Korea

and China were i

dentified as outliers to these associations.

Conclusion

Sex differences in the burden of ASD persist globally and increase with age. Targeted prevention and control strategies tailored to different sexes and age groups are warranted.

关键词

Keywords

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