an increasing trendp < 0.001
High-income North America had the lowest prevalence (1547 and 1605 per 100,000 population, respectively) and YLD rates (62.4 and 63.8 per 100,000 population, respectively) in 1990 and 2019 among the 21 GBD regions; however, both the prevalence and YLD rates showed an increasing trend from 1990 to 2019, with AAPCs of 0.13% (95% UI, 0.1%−0.16%; p < 0.001) and 0.08% (95% UI, 0.04%−0.12%; p < 0.001), respectively.