目的利用全球疾病负担(Global Burden of Disease,GBD)2019研究数据分析中国60岁及以上人群因伤残所导致的疾病负担及其变化情况。方法利用GBD 2019中国60岁及以上人群的伤残寿命损失年(years lived with disability,YLD)资料,分析2009-...目的利用全球疾病负担(Global Burden of Disease,GBD)2019研究数据分析中国60岁及以上人群因伤残所导致的疾病负担及其变化情况。方法利用GBD 2019中国60岁及以上人群的伤残寿命损失年(years lived with disability,YLD)资料,分析2009-2019年中国老年人群伤残疾病负担及变化情况,用2010年第六次人口普查的60岁及以上人口进行率的标准化计算。结果2019年中国60岁及以上人群的YLD达5637.1万人年,其中YLD排名前6种疾病为年龄相关及其他原因听力损失(以下简称“听力损失”)、脑卒中、下背痛、慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)、失明及视力损失、糖尿病,YLD分别为558.7、428.9、370.6、322.4、309.7、308.7万人年,YLD标化率分别为2181.9/10万、1680.3/10万、1443.3/10万、1265.0/10万、1210.0/10万、1199.3/10万。2019年男性、女性60岁及以上人群的YLD分别为2454.9和3182.1万人年。男性、女性60岁及以上人群YLD排名前16种疾病中,5种疾病(糖尿病、COPD、失明及视力损失、下背痛、听力损失)YLD标化率均下降,男性COPD和女性糖尿病降幅最大,YLD标化率的变化率分别为18.6%、15.2%。10年间跌倒、道路伤害(主要为男性)、脑卒中、阿尔茨海默病和其他痴呆YLD和YLD标化率增幅最大。结论2009-2019年我国在60岁及以上人群听力损失、下背痛、COPD、失明及视力损失和糖尿病的防治方面取得一定进展,但总体YLD负担仍呈加重趋势。今后应继续关注听力损失、脑卒中、下背痛、COPD、失明及视力损失和糖尿病等YLD标化率较高的疾病,同时跌倒、道路伤害、脑卒中、阿尔茨海默病和其他痴呆YLD标化率增幅较大的疾病也不容忽视,应采取措施加以防控。展开更多
The distribution of temperature and temperature-health association varied largely across different regions in China,a region-specific definition for heatwave was therefore needed.We collected the data on daily mortali...The distribution of temperature and temperature-health association varied largely across different regions in China,a region-specific definition for heatwave was therefore needed.We collected the data on daily mortality,meteorological factors and air pollution in 84 Chinese cities during 2013–2016,which was divided into seven regions.Based on the association between daily maximum temperature and mortality in each city in a threshold distributed lag non-linear model,where the threshold was defined as the temperature corresponding to the lowest mortality risk,we calculated the number of deaths that could be avoided for 1℃ decrease in maximum temperature under different thresholds,then a random-effect meta-analysis was used to generate regional results,in which the temperature with the highest avoidable mortality number for 1℃ decrease was considered as the most appropriate heatwave definition.We observed an immediate detrimental effect of high temperature within three lag days.Our analysis suggested to use 29.5℃,31.5℃,29.0℃,31.5℃,30.0℃,and 28.5℃ as the heatwave standard for east,north,northeast,central,south,and southwest region,with the avoidable mortality number of 1.54(95%Confidence interval(CI):0.88,2.19),0.55(95%CI:0.16,0.94),0.59(95%CI:0.32,0.86),1.14(95%CI:0.68,1.59),1.22(95%CI:0.54,1.90),and 0.78(95%CI:0.01,1.55),respectively,while the estimated number 0.19(95%CI:−0.02,0.40)in northwest region was not statistically significant.The concept of‘avoidable mortality for 1℃ decrease’was proposed to define the heatwave event,and varied maximum temperature between 28.5 and 31.5℃ was suggested for region-specific heatwave definition in China.展开更多
基金We thank for the support by National Key R&D Program of China(2018YFA0606200)the Natural Science Foundation of China(81972993)the Bill&Melinda Gates Foundation(INV-006371).
文摘The distribution of temperature and temperature-health association varied largely across different regions in China,a region-specific definition for heatwave was therefore needed.We collected the data on daily mortality,meteorological factors and air pollution in 84 Chinese cities during 2013–2016,which was divided into seven regions.Based on the association between daily maximum temperature and mortality in each city in a threshold distributed lag non-linear model,where the threshold was defined as the temperature corresponding to the lowest mortality risk,we calculated the number of deaths that could be avoided for 1℃ decrease in maximum temperature under different thresholds,then a random-effect meta-analysis was used to generate regional results,in which the temperature with the highest avoidable mortality number for 1℃ decrease was considered as the most appropriate heatwave definition.We observed an immediate detrimental effect of high temperature within three lag days.Our analysis suggested to use 29.5℃,31.5℃,29.0℃,31.5℃,30.0℃,and 28.5℃ as the heatwave standard for east,north,northeast,central,south,and southwest region,with the avoidable mortality number of 1.54(95%Confidence interval(CI):0.88,2.19),0.55(95%CI:0.16,0.94),0.59(95%CI:0.32,0.86),1.14(95%CI:0.68,1.59),1.22(95%CI:0.54,1.90),and 0.78(95%CI:0.01,1.55),respectively,while the estimated number 0.19(95%CI:−0.02,0.40)in northwest region was not statistically significant.The concept of‘avoidable mortality for 1℃ decrease’was proposed to define the heatwave event,and varied maximum temperature between 28.5 and 31.5℃ was suggested for region-specific heatwave definition in China.
