The burden of anemia related to inflammatory bowel disease in China: Epidemic trends, subtype differences and driving factors.

BACKGROUND

This study provides the first systematic assessment of the disease burden of inflammatory bowel disease-related anemia (IBD-anemia) and its major subtypes in China, aiming to generate robust evidence to inform targeted prevention and control strategies.

METHODS

We comprehensively evaluated trends in prevalence and years lived with disability of IBD-anemia in China from 1990 to 2023. Disease burden was further disaggregated into anemia attributable to Crohn's disease (CD-anemia) and anemia attributable to ulcerative colitis (UC-anemia). Analyses were stratified by sex and age. Decomposition analyses were conducted to quantify the relative contributions of population growth, population ageing, and epidemiological change to changes in disease burden.

RESULTS

In 2023, the total number of prevalent cases of IBD-anemia in China reached 38,550, with a significantly higher burden observed among females than males. At the subtype level, UC-anemia accounted for the majority of the overall burden, whereas CD-anemia exhibited a distinct sex-specific pattern, characterized by increasing age-standardized prevalence rates among females but declining rates among males. Age- and sex-stratified analyses identified women aged 35-59 years as the core affected population. Decomposition analyses indicated that population ageing was the predominant driver of the increasing burden of IBD-anemia, while the contribution of epidemiological changes differed between CD-anemia and UC-anemia.

CONCLUSIONS

Future efforts should prioritize the reallocation of healthcare resources and strengthened cross-sectoral collaboration to establish a three-dimensional prevention and control framework encompassing risk mitigation, targeted management of high-risk populations, and improved diagnostic and treatment security, in order to reduce the burden of IBD and its anemia-related complications.