Abstract
BACKGROUND: Inflammatory bowel disease (IBD), including Crohn's disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U), is a chronic immune-mediated gastrointestinal disorder. We analyzed the burden and epidemiological trends of IBD in children aged 0-14 years across Asia and Europe from 1990 to 2021, using the Global Burden of Disease (GBD) 2021 study data. METHODS: We extracted IBD data from the GBD 2021 database, which offers comprehensive estimates for diseases and risk factors across 204 countries and territories. Our analysis focused on prevalence, incidence, mortality, and disability-adjusted life-years (DALYs), emphasizing modifiable risk factors. We applied advanced statistical methods, including estimated annual percentage change (EAPC) to quantify trends, decomposition analysis to assess contributing factors, and Bayesian age-period-cohort (BAPC) modeling to evaluate temporal and demographic effects. ARIMA modeling forecasted future trends. RESULTS: From 1990 to 2021, IBD incidence, prevalence, and DALYs increased significantly in Asia but declined in Europe. In East Asia, prevalence rose from 1,265.78 cases (95% UI: 921.46-1,672.24) in 1990 to 1,402.33 cases (95% UI: 1,043.79-1,825.73) in 2021, while high-income Asian regions saw a decrease. ARIMA forecasts predict a continued rise in Asia's incidence over the next decade, with DALYs expected to decline. In Europe, incidence is projected to stabilize, and DALYs are anticipated to decrease. CONCLUSION: The rising IBD burden in Asian children may be associated with rapid socioeconomic development, lifestyle westernization, and environmental influences, as suggested by prior epidemiologic and mechanistic studies. These findings underscore the need for targeted public health strategies to curb Asia's increasing incidence and optimize disease management in Europe.