Global Burden and Temporal Prediction of Intestinal Obstruction (1990–2021) and the Relationship with Blood Metabolites: An Integrated Analysis of GBD and Mendelian Randomization

BACKGROUND: Intestinal obstruction (IO) poses a significant challenge to healthcare systems, particularly in aging societies. This study systematically evaluated the global burden of IO from 1990 to 2021, predicted trends through 2044, and explored potential metabolic risk factors. METHODS: Based on the Global Burden of Disease (GBD) 2021 statistics, we analyzed incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries. Trends were quantified using estimated annual percentage changes (EAPC), while frontier and decomposition analyses assessed the impact of population aging. Future trends were projected using age-period-cohort (APC) models. Additionally, a two-sample Mendelian Randomization (MR) analysis was conducted to investigate the relationship between metabolites and IO. RESULTS: Globally, the age-standardized incidence rate (ASIR) showed a slight upward trend, rising from 185.57 to 191.92 per 100,000 between 1990 and 2021 (EAPC: 0.09), whereas the age-standardized mortality rate (ASMR) declined (EAPC: -1.03). Notably, high-SDI regions(e.g., the United States, the United Kingdom) exhibited rising DALYs, largely driven by population aging. Projections indicate that by 2044, the ASMR will further decrease to 2.20 (females) and 3.11 (males) per 100,000. The MR analysis identified 13 genetically predicted circulating metabolites associated with IO susceptibility, providing hypothesis-generating metabolic signals that warrant further validation. CONCLUSIONS: While IO mortality has decreased globally, the absolute burden of IO remains substantial in the context of rapid population aging. Future health policies should focus on resource allocation and surgical care for older adults. The identified metabolic signals may provide candidate avenues for future early screening and prevention research in geriatric care.