Global, regional and national burden of asthma attributable to metabolic diseases from 1990 to 2021 and projected trends to 2040

Asthma is a prevalent inflammatory condition of the lower respiratory tract, affecting over 272 million people worldwide. Although prevalence and mortality rates have declined, asthma continues to burden healthcare systems, particularly in low-income regions. Metabolic diseases significantly influence the development and progression of asthma. This study aimed to evaluate global, regional, national, and temporal trends in asthma burden attributable to metabolic diseases from 1990 to 2021 and to project changes through 2040. The GBD (Global Burden of Disease) 2021 dataset was used to analyze key epidemiological variables, focusing on disability survival, years of life lost, and disability-adjusted life years (DALYs). Descriptive analyses and trend evaluations illustrated the burden of asthma due to metabolic diseases (MAS) over the last 30 years, while decomposition analyses quantified the impacts of population growth, aging, and epidemiological changes. In 2021, deaths totaled 62,363, with DALYs reaching over 3.28 million. High socio-demographic index (SDI) quintiles reported the highest age-standardized rates of DALYs and years of disability (YLDs), while low-middle SDI quintiles had the highest death rates. South Asia experienced the highest number of MAS-related deaths, years of life lost (YLLs), and DALYs. From 1990 to 2020, rates of deaths, DALYs, YLLs, and YLDs declined, with the most significant decrease occurring from 1993 to 2000. The analysis indicated that females bore a greater burden than males, with changes in DALYs more influenced by population growth. Inequalities associated with SDI decreased significantly, with a notable reduction in the health concentration index. Despite progress in prevention and treatment, the number of MAS cases is expected to continue rising until 2040, highlighting the need for effective public health strategies and ongoing research.