Burden and projections of polycystic ovarian syndrome in the belt and road countries from 1990 to 2021 in the framework of predictive, preventive, and personalised medicine: Analysis based on the global burden of disease.

内容摘要

Guided by the paradigm of predictive, preventive, and personalized medicine (PPPM/3PM), this study systematically evaluated the epidemiological burden of Polycystic ovarian syndrome (PCOS) and its future trends in countries along the Belt and Road Initiative (BRI). Utilizing data from the Global Burden of Disease Study, we applied Joinpoint regression, Net Drift analysis, age-period-cohort (APC) modeling, and Bayesian APC forecasting. Findings indicated a persistent upward trend in PCOS burden across most BRI countries from 1990 to 2021, particularly in Equatorial Guinea and the Maldives. By 2021, China reported the highest numbers of both new cases (258,930) and prevalent cases (10,077,520). Italy exhibited the highest age-standardized rates of incidence, prevalence, and disability-adjusted life years; nevertheless, it was the only country to demonstrate a declining burden over the three-decade period, suggesting a potential moderating role of population aging and structural changes. Age-specific analysis pinpointed 15-19 years as the critical window for disease onset, while women aged 20-49 represented the core population affected by PCOS and its associated health impacts. Forecasting suggests that the number of prevalent cases in China will exceed 14,410,378 by 2046, underscoring the urgency of proactive management. The PCOS burden demonstrates marked geographical heterogeneity, closely linked to levels of socioeconomic development. Embracing the PPPM framework, burden data are translated into management strategies that target key screening windows, high-risk populations, and specific phenotypes, which will facilitate cross-border health data sharing and promote the coordinated and equitable allocation of medical resources, thereby addressing regional disparities and providing critical support for achieving precision medicine goals in global women's health. The online version contains supplementary material available at 10.1007/s13167-026-00443-w.