Global burden of acute pancreatitis attributable to high alcohol intake from 1990 to 2021: findings and prevention potential based on GBD 2021

Although recent studies have examined alcohol-attributable pancreatitis (AAP), the contributions of population growth, aging, and sociol demographic index (SDI)disparities remain insufficiently quantified.This study aimed to assess the global, regional, and national burden of alcohol-related AP from 1990 to 2021, evaluating trends across socioeconomic and demographic strata to inform policy making. Data were obtained from the Global Burden of Disease (GBD) 2021 study. We analyzed deaths, disability-adjusted life years(DALYs), age-standardized mortality rate(ASMR), and age-standardized DALY rate(ASDR).Population attributable fractions(PAFs) were calculated, joinpoint regression identified temporal trends, and Spearman correlation assessed associations with SDI.Decomposition analysis quantified the contributions of population growth, population aging, and epidemiological changes. Between 1990 and 2021,global DALYs from alcohol-attributable pancreatitis rose from 401,671.32 to 699,335.04,while age-standardized rates showed slight declines(ASDR:8.88 to 8.22; ASMR:0.24 to 0.22 per 100,000). Mortality cases nearly doubled(9,971.79 to 18,749.03), though overall trends in ASDR(AAPC = − 0.21%) and ASMR(AAPC = − 0.20%) were not significant. Joinpoint analysis indicated post-2005 declines in ASDR and post-2009 declines in ASMR, following earlier increases.Marked gender disparities were observed: in 2021, males had 9.33-fold higher DALY rates and 7.58-fold higher mortality than females.Female rates declined steadily(ASDR AAPC=-1.27%; ASMR AAPC = − 1.36%),whereas male rates remained stable.Regionally, Eastern Europe showed the highest burden (ASDR: 64.03; ASMR: 1.35) and fastest growth(ASDR AAPC = 2.00%),while North Africa and the Middle East had the lowest(ASDR:0.36). High-middle SDI regions peaked in ASDR (14.67), whereas high-SDI regions declined consistently(AAPC = − 0.90%). PAFs were highest in high-SDI regions(25.05% for ASDR) and lowest in low-SDI regions(10.08%).Decomposition analysis attributed DALY increases mainly to population growth (+ 88.85%) and aging (+ 25.26%), partly offset by epidemiological improvements (− 14.11%). Projections indicate persistent gender and SDI disparities, with younger males in middle- and low-SDI regions facing increasing risks. Although global age-standardized rates of AAP have remained stable, absolute deaths and DALYs have risen markedly due to demographic shifts, with pronounced gender and regional disparities.The disproportionate burden in males, younger adults, and Eastern Europe highlights the need for targeted prevention. Strengthening alcohol control in low- and middle-SDI countries and promoting early detection in high-risk populations are essential to reduce the preventable burden of AAP.