@article {Sunsvn-2021-000909, author = {Yixin Sun and Guoyu Zhou and Jingnan Feng and Lu Chen and Guozhen Liu and Jinxi Wang and Qingliang Wang and Junyou Yu and Xiwang Yang and Zheng Yang and Pei Gao and Shengfeng Wang and Siyan Zhan}, title = {Incidence and prevalence of moyamoya disease in urban China: a nationwide retrospective cohort study}, elocation-id = {svn-2021-000909}, year = {2021}, doi = {10.1136/svn-2021-000909}, publisher = {BMJ Specialist Journals}, abstract = {Background and objective Moyamoya disease (MMD) is an increasingly recognised cause of stroke, mainly described in East Asia. China is the largest nation in Asia, but few studies reported the epidemiology of MMD, especially at a national level. We aimed to estimate the incidence and prevalence of MMD in China.Methods We performed a population-based study using data from the national databases of Urban Basic Medical Insurance between 2013 and 2016, covering approximately 0.50 billion individuals. MMD cases were identified by diagnostic code (International Classification of Diseases, 10th Revision I67.5) or related diagnostic text.Results A total of 1987 MMD patients (mean age 44.45{\textpm}14.30 years, female-to-male ratio 1.12) were identified, representing a national crude incidence of 0.59 (95\% CI: 0.49 to 0.68) and a prevalence of 1.01 (95\% CI: 0.81 to 1.21) per 100 000 person-years in 2016. Rates were higher in females than in males for the incidence (0.66 vs 0.52) and prevalence (1.05 vs 0.90). And the age-specific rates showed a bimodal distribution, with the highest peak in middle-aged group and the second peak in child group.Conclusions Our results confirm that MMD is relatively common in East Asians, but the rates in China were lower than those in other East Asian countries such as Japan and Korea. The unique epidemiological features, including a relatively weak female predominance and a shift in the highest peak of incidence from children to adults, revealed new sight into MMD. Further research is expected to explore the potential pathogenesis of MMD.Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from National Healthcare Security Administration of China but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of National Healthcare Security Administration of China.}, issn = {2059-8688}, URL = {https://svn.bmj.com/content/early/2021/05/03/svn-2021-000909}, eprint = {https://svn.bmj.com/content/early/2021/05/03/svn-2021-000909.full.pdf}, journal = {Stroke and Vascular Neurology} }