Global, regional, and National burden of urticaria (1990–2021), its potential risk factors, and projections to 2046

Urticaria is a common inflammatory skin disorder that causes distressing symptoms, significantly impacting the quality of life of patients and imposing a substantial burden on society. This study aimed to enhance policymakers' awareness of the burden of urticaria and encourage the rational allocation of health resources. We utilized data from the Global Burden of Disease (GBD) Results (2021) to obtain prevalence, incidence, and disability-adjusted life years (DALYs) for urticaria from 1990 to 2021, categorized by age, gender, and region. A Bayesian age-period-cohort (BAPC) model with integrated nested Laplace approximation (INLA) was employed to project global incidence trends through 2046. Correlations between air pollution levels, dietary intake, and urticaria incidence were analyzed using Spearman's rank-order correlation. From 1990 to 2021, the global burden of urticaria increased gradually, reaching 66.48 million cases in 2021. Females and younger age groups had higher burdens. Projections indicate a continued rise through 2046. Moderate positive correlations were found between urticaria incidence and ozone (rho = 0.349, p < 0.0001) and particulate matter (PM) (rho = 0.389, p < 0.0001), with a weak correlation to NO₂ (rho = 0.249, p = 0.0003). Dietary intake of calcium, milk, processed meats, sugar-sweetened beverages (SSBs), trans fats, and vegetables was positively associated with urticaria, while legumes, nuts, omega-3 fatty acids, and whole grains were negatively correlated. Urticaria poses a significant global health concern, with rising incidence projected by 2046. The findings highlight correlations between air pollution and dietary factors, suggesting potential protective effects of certain foods.