Comparative disease burden and trends of autoimmune diseases in China and G20 countries: an analysis of the global burden of disease study 2023.

Autoimmune diseases (ADs) represent a growing global public health burden. However, there is still a lack of systematic comparison of long-term epidemiological trends of ADs between China and the Group of Twenty (G20) nations. Therefore, this study aims to systematically compare the disease burden and long-term trends of autoimmune diseases between China and G20 countries, to inform targeted public health strategies. Using data from the Global Burden of Disease Study 2023, we extracted estimates for rheumatoid arthritis (RA), inflammatory bowel disease (IBD), multiple sclerosis (MS), and psoriasis (PS) from 1990 to 2023. Age-standardized rates (ASRs) of incidence, prevalence, mortality, and disability-adjusted life years (DALYs), as well as absolute DALYs numbers, were analyzed. Estimated annual percentage change (EAPC) and joinpoint regression were employed to assess temporal trends and identify significant change points. From 1990 to 2023, age-standardized DALY rates (ASDR) declined in both China and the G20 for IBD (China EAPC: -2.78; G20 EAPC: -0.58), MS (China: -1.26; G20: -0.22), and RA (China: -0.22; G20: -0.05), but increased for psoriasis (China: 1.06; G20: 0.69). Despite declining rates, absolute DALYs rose substantially for most diseases. The burden peaked in middle-aged and older adults (55–74 years) and was generally higher among females. Joinpoint analysis revealed heterogeneous multi-stage trends; for instance, China’s IBD ASDR plummeted between 2004 and 2014 (Annual Percent Change, APC: -5.26). Comparative risk analysis showed that in 2023, the proportion of RA DALYs attributable to smoking was higher in China than in the G20 (8.91% vs. 6.96%), driven by a large disparity in males (22.94% vs. 15.88%). In both China and the G20, the overall ASDR of most autoimmune diseases declined between 1990 and 2023, with inflammatory bowel disease showing estimated annual percentage changes of -0.58 and − 2.78, respectively. However, the absolute disease burden increased substantially. Epidemiological analyses revealed pronounced gender disparities, such as a 22.94% smoking-attributed rheumatoid arthritis burden in Chinese males compared to 1.90% in females, and divergent multi-phase temporal trends between regions. These findings highlight both shared and distinct public health challenges, underscoring the need for tailored interventions guided by precise burden metrics and risk factor profiles to mitigate the growing global impact of these conditions.