Incidence,prevalence,and causes of spinal injuries in China,1990-2019:Findings from the Global Burden of Disease Study 2019

Background:Spinal injuries are an urgent public health priority;nevertheless,no China-wide studies of these injuries exist.This study measured the incidence,prevalence,causes,regional distribution,and annual trends of spinal injuries in China from 1990 to 2019.Methods:We used data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2019 to estimate the incidence and prevalence of spinal injuries in China.The data of 33 provincial-level administrative regions(excluding Taiwan,China)provided by the National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention(CDC)were use to systematically analyze the provincial etiology,geographical distribution,and annual trends of spinal injuries.The Bayesian meta-regression tool DisMod-MR 2.1 was used to ensure the consistency among incidence,prevalence,and mortality rates in each case.Results:From 1990 to 2019,the number of living patients with spinal injuries in China increased by 138.32%,from 2.14 million to 5.10 million,while the corresponding age-standardized prevalence increased from 0.20%(95%uncertainty interval[UI]:0.18-0.21%)to 0.27%(95%UI:0.26-0.29%).The incidence of spinal injuries in China increased by 89.91%(95%UI:72.39-107.66%),and the prevalence increased by 98.20%(95%UI:89.56-106.82%),both the most significant increases among the G20 countries;71.00%of the increase could be explained by age-specific prevalence.In 2019,the incidence was 16.47(95%UI:12.08-22.00,per 100,000 population),and the prevalence was 358.30(95%UI:333.96-386.62,per 100,000 population).Based on the data of 33 provincial-level administrative regions provided by CDC,age-standardized incidence and prevalence were both highest in developed provinces in Eastern China.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.Conclusions:In China,the overall disease burden of spinal injuries increased significantly during the past three decades but varied considerably according to geographical location.The primary causes were falls and road injuries;however,the prevalence and specific causes differed across provinces.

Global and national burden of atherosclerosis from 1990 to 2019:trend analysis based on the Global Burden of Disease Study 2019

Background:Atherosclerosis-related diseases represent significant health issues among adults globally.Despite their widespread impact,comprehensive data concerning the global and national burden and trends of these diseases remain sparse.Our objective is to examine the trends in the burden of atherosclerosis among adults from 1990 to 2019 at both global and national levels.Methods:We reported the average annual percentage changes(AAPCs)in prevalence,incidence,mortality,and disabilityadjusted life years(DALYs)of atherosclerosis-related diseases(ischemic heart disease[IHD],ischemic stroke,and peripheral arterial disease[PAD])at the global and national levels among individuals based on a trend analysis of the Global Burden of Diseases Study(GBD)2019.We further analyzed these global trends as a function of age,gender,and the social development index.We also used joinpoint regression analysis to identify the year with the most substantial changes in global trends.Results:Globally,the AAPC of IHD incidence rose from 1990 to 2019(0.20;95%confidence interval[CI],0.12-0.28),with substantial surges in 1995,2001,2005,2010,and 2017.Conversely,AAPC of IHD mortality rates exhibited a different trend until a rise in 2014.The AAPC of incidence rates of ischemic stroke and PAD also escalated during the same period,with respective 0.43(95%CI,0.39-0.48)and 0.13(95%CI,0.06-0.21).For ischemic stroke,both incidence and mortality soared in 2014,while PAD incidence declined in 1994 and 1998,then sharply climbed in 2016.Nationally,the Northern Mariana Islands experienced the steepest increase in IHD and PAD incidence and mortality between 1990 and 2019.China saw a significant rise in ischemic stroke incidence,whereas the highest mortality rate increase occurred in Timor-Leste.By sociodemographic index(SDI)quintile,low-middle-,middle-,and high-middle-SDI countries all showed upward trends in IHD,ischemic stroke,and PAD incidence.Simultaneously,IHD and ischemic stroke mortality rates,as well as DALYs,dropped in the low-,high-middle-,and high-SDI nations.However,PAD mortality rates and DALYs saw an uptick across all SDI quintiles.Regarding age demographics,a global decrease in the AAPC IHD incidence as noted in individuals above 55 years old,in contrast to an increase in the 20-55 age group during this period.AAPC of mortality rates for IHD,ischemic stroke,and PAD decreased across all ages.The AAPC showed an increase in IHD incidence in both genders.Conversely,IHD’s DALYs saw a reduction in both males and females.Ischemic stroke patterns mirrored these trends,whereas all measures for PAD exhibited growth for both sexes.Conclusions:From 1990 to 2019,there was an overall increasing trend in the global incidence of all three clinical manifestations of atherosclerosis.Between 1990 and 2019,both the mortality rate and DALYs for IHD and ischemic stroke declined across all age groups.Overall,the burden of atherosclerosis-related diseases has not significantly decreased and even shows signs of trending upward.These findings strongly suggest that despite some progress made,efforts to control atherosclerosis diseases globally need to be intensified.

Asian,regional,and national burdens of respiratory tract cancers and associated risk factors from 1990 to 2019:A systematic analysis for the global burden of disease study 2019

Background:Respiratory cancer is the leading cause of cancer-related deaths worldwide,but its statistics vary between the East and West.This study aimed to estimate the burdens of tracheal,bronchus,and lung(TBL)cancer and larynx cancer and their attributable risks from 1990 to 2019 in Asia,and at regional and national levels.Methods:This research evaluated the incidence,mortality,years lived with disability,years of life lost,and disability-adjusted life years(DALYs)for respiratory tract cancers using the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019 database.Age-standardized rates were calculated for TBL cancer from 1990 to 2019,adjusted for smoking and socio-demographic index(SDI).Deaths from TBL cancer and larynx cancer attributable to each risk factor were estimated for 33 Asian countries.Results:The age-standardized incidence and death rates for TBL cancer in Asia declined from 2010 to 2019,while the incidence rate of larynx cancer increased.Smoking was the leading specific risk factor for deaths from both TBL and larynx cancers.The burden of TBL cancer in Asian countries was influenced by SDI and smoking,particularly among males in Central Asia.Deaths,DALYs,and incidences of larynx cancer in East Asia had not changed significantly over the past 30 years,but showed slight downward trends in males and both sexes combined,and an upward trend in females in recent years.Conclusions:The past decade saw increases in numbers of incident cases and deaths from TBL cancer and larynx cancer in Asia.SDI and smoking were the main factors influencing the disease burden of TBL cancer in Asian countries.This study highlights the need for tailored cancer control programs to address the burden of respiratory tract cancers in different Asian countries.

Global, regional, and national burden of gallbladder and biliary diseases from 1990 to 2019

BACKGROUND Gallbladder and biliary diseases(GABDs)are a major public health issue.AIM To analysis the cause-specific incidence,prevalence,and years lived with disability(YLDs)and its temporal trends of GABDs at the global,regional,and national level.Data on GABD were available from the Global Burden of Disease study 2019.METHODS The estimated annual percentage change(EAPC)was used to quantify temporal trend in GABD age-standardized incidence rates(ASIRs),age-standardized prevalence rate(ASPR),and age-standardized YLD rate(ASYR)by region,sex.We analyzed the relationship between the GABD burden and country development level using the human development index(HDI).RESULTS In 2019,the incident cases of GABD were 52003772,with an ASIR of 63432/100000 population.Globally,the number of incident cases and ASIR of GABD increased 97%and 58.9%between 1990 and 2019.Although,the ASPR and ASYR decreased from 1990 to 2019,the number of prevalent and YLDs cases increased.The highest ASIR was observed in Italy,and the highest ASPR and ASYR was observed in United Kingdom.The highest burden of GABD was found in low-SDI region,and the burden in female was significantly higher than males.A generally negative correlation(ρ=-0.24,P<0.05)of GABD with the EAPC and human development index(HDI)(in 2021)were observed for ASIR.What’s more,no correlation in ASPR(ρ=-0.06,P=0.39)and ASYR(ρ=-0.07,P=0.36)of GABD with the EAPC and HDI(in 2021)were observed,respectively.CONCLUSION GABD remain a major global public health challenge;however,the burden of GABD varies geographically.Globally,the number of incident cases and ASIR of GABD increased between 1990 and 2019.The results of our study provide insight into the global disease burden of GABD and may assist policymakers in formulating effective policies to mitigate modifiable risk factors.

Burden of Cirrhosis and Other Chronic Liver Diseases Caused by Specific Etiologies in China, 1990-2016:Findings from the Global Burden of Disease Study 2016

Objective To estimate the burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China.Methods Data from the Global Burden of Disease Study 2016(GBD 2016)were used.We evaluated the burden by analyzing age-sex-province-specific prevalence,mortality,and disability-adjusted lifeyears(DALYs)of 33 provinces in China.Results From 1990 to 2016,prevalence cases in thousands increased by 73.7%from 6833.3(95%UI:6498.0–7180.6)to 11869.6(95%UI:11274.6–12504.7).Age-standardized mortality and DALY rates per100,000 decreased by 51.2%and 53.3%,respectively.Male and elderly people(aged≥60 years)preponderance were found for prevalence,mortality,and DALYs.The number of prevalence cases,deaths,and DALYs due to hepatitis C virus(HCV)increased by 86.6%,8.7%,and 0.9%,respectively.Also,age-standardized prevalence rates decreased in 31 provinces,but increased in Yunnan and Shandong.The Socio-demographic Index(SDI)values were negatively correlated with age-standardized mortality and DALY rates by provinces in 2016;the correlation coefficients were-0.817 and-0.828,respectively.Conclusion Cirrhosis and other chronic liver diseases remain a huge health burden in China,with the increase of population and the aging of population.Hepatitis B virus(HBV)remains the leading cause of the health burden in China.

1990—2019年中国龋病的疾病负担现状及变化趋势研究

背景龋病是常见的非传染性疾病之一,影响着全球三分之一以上的人口,分析其疾病负担现状及变化趋势能够为龋病的防治策略提供一定的参考价值。目的分析中国龋病的发病、患病和伤残损失寿命年(YLD)现状及变化趋势,为我国制订龋病防治策略提供参考依据。方法提取2019年全球疾病负担(GBD)研究中1990—2019年中国乳牙龋病和恒牙龋病的发病、患病和YLD数据,计算1990—2019年中国乳牙龋病和恒牙龋病的发病人次、患病人数和YLD人年数的变化百分比,并应用Joinpoint回归模型分析1990—2019年中国乳牙龋病和恒牙龋病的年龄标准化发病率、患病率和YLD率的年度变化百分比(APC)与平均年度变化百分比(AAPC)。结果与1990年相比,2019年中国乳牙龋病的发病人次、患病人数和YLD人年数分别减少了25.69%、28.74%和28.63%;恒牙龋病的发病人次、患病人数和YLD人年数分别增加了17.41%、15.84%和15.07%。2019年,在各年龄组中,5~9岁儿童乳牙龋病发病率(118.96%)最高,1~4岁儿童乳牙龋病患病率(53.08%)和YLD率(20.40/10万)最高;20~24岁成年人恒牙龋病的发病率(62.30%)、患病率(32.19%)和YLD率(32.41/10万)均最高。Joinpoint回归模型结果显示:1990—2019年,中国乳牙龋病的年龄标准化发病率(AAPC=0.21%,95%CI=0.19%~0.22%)、患病率(AAPC=0.03%,95%CI=0.01%~0.05%)和YLD率(AAPC=0.03%,95%CI=0.01%~0.05%)整体呈上升趋势;恒牙龋病的年龄标准化发病率(AAPC=-0.05%,95%CI=-0.05%~-0.04%)、患病率(AAPC=-0.23%,95%CI=-0.32%~-0.14%)和YLD率(AAPC=-0.22%,95%CI=-0.31%~-0.13%)整体呈下降趋势。结论中国1990—2019年乳牙龋病疾病负担呈现出加重趋势,尽管恒牙龋病的疾病负担有所下降但依旧严峻,预防龋病不能仅局限于儿童,而应该包括所有年龄段人群。

中国1990—2019年代谢因素对缺血性心脏病疾病负担的长期影响及趋势研究

背景缺血性心脏病(IHD)负担日趋沉重,代谢因素影响逐渐加重,且当前在探讨因代谢因素所致的IHD疾病负担及其变化趋势方面,尚存在研究不足的情况。目的深入分析中国1990—2019年,由于代谢因素所造成的IHD疾病负担的长期影响及其变化趋势,从而为IHD的预防与控制工作提供坚实而有力的科学支撑与依据。方法基于2019年全球疾病负担研究数据,获取1990—2019年中国不同年龄、性别IHD归因于代谢因素的死亡率、伤残调整寿命年(DALY)率及其相应标化指标。运用Joinpoint模型对疾病变化的时间趋势进行系统的评估。结果中国全人群归因于代谢因素的IHD死亡率和DALY率分别从1990年的38.01/10万、944.68/10万上升至2019年的103.34/10万、1972.50/10万。与1990年相比,2019年中国居民归因于代谢因素的IHD死亡率、DALY率及其相应标化指标均表现为男性高于女性,高年龄组高于低年龄组的特点。就性别而言,1990—2019年中国归因于代谢因素的IHD男性的标化死亡率逐渐高于全球水平,而全人群、女性标化死亡率始终低于全球水平。三者标化DALY率均显著低于全球水平。就年龄而言,1990—2019年归因于高BMI的DALY率在人群中均呈上升趋势并占据主导地位,肾功能不全在老年人群中逐渐凸显。结论自1990年以来,中国的IHD疾病负担总体上呈现出上升趋势。代谢因素导致的IHD疾病负担日趋加重,应继续加大IHD防控的宣传力度,尤其是针对男性、老年人等重点人群,开展针对性健康管理,更好地指导卫生政策的制定,提高卫生资源的利用效率,优化医疗服务的布局结构,以更好地满足公众健康需求,更大程度减轻中国IHD疾病负担,助力健康中国目标的实现。

1990~2019年中国颈脊髓损伤的流行病学调查

目的:研究1990~2019年中国颈脊髓损伤的发病率、患病率、致病原因、地域分布及年度变化趋势等流行病学特征。方法:采用全球疾病、伤害和风险因素负担研究报告(Global Burden of Diseases,Injuries,and Risk Factors Study,GBD)2019相关数据来计算中国整体颈脊髓损伤的发病率、患病率、年龄标化发病率和年龄标化患病率,采用中国疾病预防控制中心慢性非传染性疾病预防控制中心提供的不包含台湾地区在内的33个省级行政区数据(包括31个省/自治区/直辖市,香港和澳门特别行政区),对各行政区的颈脊髓损伤致病原因、地域分布及年度变化趋势等进行系统分析。结果:从1990~2019年,中国不包含台湾地区在内的33个省级行政区颈脊髓损伤患病人数从103.4万人增加到248.6万人,增加了140.51%,年龄标化患病率从0.09%增加至0.13%。1990年颈脊髓损伤的患病率在65~69岁达到峰值(男性50~54岁,女性75~79岁),而2019年在90~94岁年龄段达到峰值(男性65~69岁,女性85~89岁)。2019年,东部发达地区的年龄标化发病率和年龄标化患病率最高,如浙江分别为[11.44(7.34~17.48)/10万]和[212.00(196.52~229.10)/10万],上海分别为[10.84(7.15~16.24)/10万]和[226.43(209.93-246.36)/10万],江苏分别为[9.68(6.31~14.70)/10万]和[180.44(167.29~193.92)/10万]。此外,1990~2019年四川的年龄标化发病率和年龄标化患病率变化最大,变化值分别为[0.79(0.64~0.92)/10万]和[0.85(0.73~1.01)/10万]。2019年颈脊髓损伤的主要致病原因是跌倒和道路损伤,但各省级行政区的患病率和具体病因又各有不同。结论:1990~2019年间中国颈脊髓损伤的疾病负担明显加重,但因地域不同又有所差异。鉴于致病原因以跌倒和道路损伤为主,对发达地区和老年患者,应制定精准的预防和治疗策略,从而尽快控制和降低沉重的个人、家庭和社会负担。

2000-2019年中国脑瘤死亡趋势分析及预测研究

背景脑瘤对人们健康的危害已获得广泛关注,但目前仍少有针对我国脑瘤死亡趋势分析与预测的有关研究。目的分析2000—2019年中国脑瘤的死亡变化趋势,并预测未来5年脑瘤的粗死亡率(CMR),为脑瘤防治策略的制订提供资料。方法提取2019年全球疾病负担研究(GBD)数据库中2000—2019年中国脑瘤死亡数据,包括CMR和年龄标化死亡率(以2019年全球人口数据进行标化,ASMR)。应用Joinpoint回归模型分析死亡趋势,采用内生因子估算法(IE算法)和年龄-时期-队列模型(APC模型)估计CMR的年龄、时期和出生队列效应。通过R(4.1.3)软件对2000—2019年脑瘤死亡数据建立GM(1,1)模型,预测未来5年脑瘤CMR。结果Joinpoint回归模型结果显示,2000—2019年全国脑瘤ASMR与不同性别ASMR均呈下降趋势,全国脑瘤ASMR平均每年下降0.68%,男性脑瘤ASMR平均每年下降0.47%,女性脑瘤ASMR平均每年下降0.87%(P<0.05)。APC模型显示,中国男性脑瘤死亡风险随年龄的变化呈先降低后升高再降低的趋势,随时期变化是上升趋势,女性脑瘤的死亡风险均随年龄和时期增加而增大,即男性效应系数从1904—1908年出生队列组的0.62降低至2014—2019年出生队列组的-1.28,女性效应系数从1904—1908年出生队列组的0.36升高到1929—1933年出生队列组的0.57,随后逐渐降低,2014—2019年出生队列组的效应系数最低(-1.16)。GM(1,1)模型预测结果显示,2019年后我国脑瘤CMR将持续上升,2020—2024年CMR将会达到4.34/10万、4.39/10万、4.44/10万、4.49/10万、4.54/10万。结论2000—2019年中国脑瘤ASMR总体呈下降趋势,死亡风险随着年龄的增大和时期的推移而增大,越早出生其死亡风险越大。模型预测结果显示未来5年中国脑瘤死亡率均持续上升,我国脑瘤防控形势依旧严峻,应加强我国脑瘤高发人群的防治宣传工作,提倡良好正确的生活方式,降低脑瘤的疾病负担。

1990-2019年中国、日本与韩国的良性前列腺增生疾病负担比较

目的分析1990-2019年中国、日本和韩国良性前列腺增生(BPH)疾病负担,为合理分配卫生资源提供科学依据。方法使用2019年全球疾病负担研究的数据,采用发病、患病和伤残所致健康寿命损失年(YLD)分析BPH疾病负担现状及其趋势;采用年度百分比变化率和平均年度百分比变化率分析其时间趋势。结果中国的发病率、患病率和YLD率远远高于日本和韩国:1990-2019年中国、日本和韩国BPH的粗发病率平均每年上升2.56%、1.49%和3.59%;粗患病率平均每年上升2.70%、2.34%和4.03%;粗YLD率平均每年上升2.68%、2.33%和4.04%。年龄标化后,中国疾病负担随时间下降,但趋势不显著;日本和韩国标化率随时间显著上升。BPH疾病负担随年龄增长呈上升趋势,60~84岁年龄人群负担最大;此外,3个国家BPH疾病负担随着社会人口学指数(SDI)的增长而增加。结论中国、日本和韩国BPH的疾病负担十分沉重,其中中国疾病负担形势最为严峻,60~84岁为高危人群,应针对重点人群采取干预措施。

1990—2019年中国蛋白质能量营养不良发病趋势及预测研究

背景蛋白质能量营养不良(PEM)是常见的营养缺乏症之一,随着生活方式以及饮食习惯的改变,人们对营养健康问题的关注度日益增加,而PEM可对不同年龄人群的健康产生不同程度影响。目的分析1990—2019年中国PEM发病趋势以及不同年龄的PEM发病状况,并预测2020—2029年PEM发病趋势。方法本研究数据来源于2019年全球疾病负担研究(GBD 2019),从该数据库中获取1990—2019年中国不同年龄段的PEM发病和死亡指标,各标化率的计算均采用世界标准人口计算。将发病数据分为18个年龄组(<5岁,5~9岁,以此类推至80~84岁和85岁及以上)。采用Joinpoint回归分析计算发病率的年度百分比变化(APC)和年度平均百分比变化(AAPC)以及95%置信区间(CI),并描述其变化趋势。利用自回归求和移动平均模型(ARIMA模型)预测中国2020—2029年PEM发病趋势。结果(1)2019年中国全人群PEM标化发病率为1996.5/10万,男性PEM标化发病率(2444.7/10万)高于女性(1536.0/10万)。2019年中国全人群PEM标化发病率低于全球(2099.4/10万),但男性PEM标化发病率高于全球男性(2304.0/10万)。<5岁人群PEM发病率最高(4402.5/10万),其次是80~84岁(2417.7/10万)。5岁以后,无论男女PEM标化发病率均随年龄的增加而增高,且男性仍大于女性。(2)1999—2019年中国PEM标化发病率结果显示:标化发病率整体趋势呈现6个拐点,分别在1995年、2006年、2010年、2014年、2017年、2019年。1990—1995年和2010—2014年中国PEM标化发病率呈下降趋势,APC分别为-1.3%、-2.3%(P<0.05)。1995—2006年、2006—2010年,中国PEM标化发病率均呈现上升趋势,APC分别为0.9%、2.5%(P<0.05)。2017—2019年中国PEM标化发病率的增长趋势最明显,APC为8.9%(P<0.05)。1999—2019年中国PEM标化发病率以年平均变化0.7%的速度上升(AAPC=0.7%,P<0.05)。(3)1999—2019年中国PEM年龄别发病率结果显示:1999—2019年<5岁的人群以年平均变化2.1%的速度下降,其余各年龄段年均变化呈现整体平稳上升趋势(P<0.05)。75~84岁中的2个年龄段,PEM发病率在1999—2019年每个时间间隔均呈上升趋势(P<0.05)。(4)通过ARIMA模型预测结果显示,2020—2029年中国PEM发病率仍持续上升,2029年可达7280.06/10万。结论2019年中国全人群PEM标化发病率(1996.5/10万)低于全球(2099.4/10万),但男性PEM标化发病率高于全球男性(2304.0/10万)。1999—2019年中国PEM标化发病率以年平均变化0.7%的速度上升,且据预测,直到2029年PEM标化发病率仍会继续上升,可达7280.06/10万。

1990—2021年中国中老年人群2型糖尿病疾病负担趋势分析

目的分析1990—2021年我国中老年人群2型糖尿病(type 2 diabetes mellitus,T2DM)的变化趋势,评价近年来T2DM预防策略,为中老年人T2DM的防控措施改进提供理论依据。方法对全球疾病负担研究2021数据库中我国55岁及以上人群T2DM发病率、患病率、死亡率以及伤残调整寿命年(disability adjusted life years,DALYs)数据进行标准化,线图描述各指标的变化趋势,Joinpoint回归模型定量分析变化情况,以年度变化百分比(annual percent change,APC)和平均年度变化百分比(average annual percent change,AAPC)作为观察指标。结果1990—2021年我国55岁及以上人群T2DM的疾病负担仍然较重,发病率、患病率和DALYs率保持上升趋势(AAPC分别为0.39、1.08和0.39,P<0.001),死亡率整体下降(AAPC=-0.16,P<0.001)。女性以及55~74岁人群的发病率较高,随年龄增长中老年人T2DM死亡率升高。结论应加强对中老年人群T2DM健康管理和健康教育,倡导积极健康的生活方式,个人、家庭、社会、政府多方联动,降低我国中老年人群T2DM的疾病负担。

Global and regional burdens of oral cancer from 1990 to 2017:Results from the global burden of disease study

Background:Data on the incidence,mortality,and other burden of oral cancer as well as their secular trends are necessary to provide policy-makers with the information needed to allocate resources appropriately.The purpose of this study was to use the Global Burden of Disease(GBD)2017 results to estimate the incidence,mortality,and disability-adjusted life years(DALYs)for oral cancer from 1990 to 2017.Methods:We collected detailed data on oral cancer from 1990 to 2017 from the GBD 2017.The global incidence,mortality,and DALYs attributable to oral cancer as well as the corresponding age-standardized rates(ASRs)were calculated.The estimated annual percentage changes in the ASRs of incidence(ASRI)and mortality(ASRM)and age-standardized DALYs of oral cancer were also calculated according to regions and countries to quantify the secular trends in these rates.Results:We tracked the incidence,mortality,and DALYs of oral cancer in 195 countries/territories over 28 years.Globally,the incidence,mortality,and DALYs of oral cancer increased by about 1.0-fold from 1990 to 2017.The ASRI of oral cancer showed a similar trend,increasing from 4.41 to 4.84 per 100,000 person-years during the study period.The ASRM remained approximately stable at about 2.4 per 100,000 from 1990 to 2017,as did the age-standardized DALYs,at about 64.0 per 100,000 person-years.ASRI was highest in Pakistan(27.03/100,000,95%CI=22.13-32.75/100,000),followed by Taiwan China,and lowest in Iraq(0.96/100,000,95%CI=0.86-1.06/100,000).ASRM was highest in Pakistan(16.85/100,000,95%CI=13.92-20.17/100,000)and lowest in Kuwait(0.51/100,000,95%CI=0.45-0.58/100,000).Conclusions:The ASRI of oral cancer has increased slightly worldwide,while the ASRM and age-standardized DALY have remained stable.However,these characteristics vary between countries,suggesting that current prevention strategies should be reoriented,and much more targeted and specific strategies should be established in some countries to forestall the increase in oral cancer.

基于2019年全球疾病负担研究数据分析1990—2019年中国高血压心脏病疾病负担变化趋势

目的分析1990—2019年我国高血压心脏病总人群,以及不同性别、不同年龄群体的疾病负担变化趋势。方法利用2019年全球疾病负担研究(GBD)数据,分析1990—2019年高血压心脏病年患病人数、死亡人数、伤残调整寿命年(DALYs)和患病率、死亡率、DALYs率。结果1990—2019年,我国高血压心脏病年龄标化患病率呈先降低后升高趋势。与1990年相比,2019年我国高血压心脏病标化患病率下降6.0%(1990年标化患病率为461.0/10万,2019年为433.5/10万),其中男性标化患病率下降幅度大于女性,而男、女性15~<50岁群体患病率却明显上升。1990—2019年我国高血压心脏病年龄标化死亡率和DALYs率均呈先降低后升高再降低趋势。与1990年相比,2019年我国高血压心脏病标化死亡率和DALYs率分别下降51.2%和54.8%,其中女性下降幅度大于男性,并且以上现象在15~<50岁、50~<70岁、≥70岁各年龄段表现一致。在高血压心脏病死亡归因危险因素方面,2019年与男性患者死亡相关的前4位危险因素分别是高收缩压、高盐膳食、高体质量指数(BMI)和饮酒,而女性前4位分别是高收缩压、高BMI、高盐膳食和低气温。结论1990—2019年我国高血压心脏病患病率整体呈先降低后升高趋势,高血压心脏病死亡和伤残负担呈先降低后升高再降低趋势,并呈现性别和年龄差异特点。

基于全球视角的中国屈光不正疾病负担现状及趋势分析

目的基于全球疾病负担(global burden of disease,GBD)研究,对比日本、印度、美国、英国和全球,分析中国屈光不正疾病负担现状及变化趋势。方法从全球健康交流数据库获取1990—2019年屈光不正的患病率、伤残损伤寿命年(years lived with disability,YLD)率等指标,利用Joinpoint等软件分析屈光不正的疾病负担及变化趋势。结果2019年中国屈光不正人数超过2700万,患病率和YLD率分别为19.18‰和89.40/10万。1990—2019年,全球范围内屈光不正患病率和YLD率均呈增长趋势(印度除外),中国增幅最大(分别上升53.21%、53.96%)。中国、日本、美国和英国年龄标化YLD率均低于全球平均水平,但中国的年龄标化YLD率高于发达国家(日本、美国和英国)。结论1990—2019年,中国屈光不正的控制与发达国家有一定差距,仍需以全球角度了解疾病现状,以期更好的防控屈光不正。

1990-2019年全球胃癌发病率和死亡率变化趋势及地区差异

目的分析全球胃癌发病率和死亡率变化趋势,探讨不同地理区域和社会经济发展水平国家和地区的疾病负担差异。方法基于2019年全球疾病负担研究数据库,采用Joinpoint回归模型计算1990—2019年胃癌年龄标化发病率和死亡率的平均年度变化百分比(AAPC)及95%CI,采用线性回归分析胃癌标化发病率和死亡率的AAPC与社会人口指数(SDI)的关联,采用年龄-时期-队列模型探讨不同SDI水平的地区1900—1999年出生队列胃癌发病和死亡风险的变化趋势。结果1990—2019年全球胃癌标化发病率和死亡率的AAPC分别为-1.27%(95%CI:-1.43%~-1.11%)和-1.87%(95%CI:-2.01%~-1.72%)。SDI与胃癌发病和死亡率AAPC均呈负相关(均P<0.001),SDI较高的国家胃癌发病和死亡率下降较快,中低SDI国家胃癌疾病负担下降速度落后于全球平均水平。年龄-时期-队列模型显示,SDI较高的国家1900—1999年出生队列人群的胃癌发病和死亡风险下降幅度也要更大。结论不同社会经济发展水平国家的胃癌发病率和死亡率下降速度有明显差异,社会经济发展水平较高的国家胃癌疾病负担下降较快。

全球疾病负担研究方法学进展及其对寄生虫病疾病负担的影响

全球疾病负担研究(Global Burden of Disease Study,GBD)是目前最综合、最系统、最大规模的世界性观察流行病学研究项目,采用伤残调整寿命年(disability-adjusted life year,DALY)等一致性指标对威胁人类健康的主要疾病、伤害和危险因素所致的死亡和伤残进行国家、地区和全球水平的人群健康进行综合测量。本文全面介绍了GBD的发展史、评估流程和方法学研究进展及其对寄生虫病疾病负担的影响,从而为GBD方法的推广应用提供参考。

湖南省1990-2017年脑卒中疾病负担

目的描述1990-2017年湖南省脑卒中疾病负担及变化趋势,为其防控政策的制定提供依据。方法描述2017年全球疾病负担研究(global burden of diseases study, GBD)结果中包括湖南省脑卒中死亡数、过早死亡损失寿命年(years of life lost, YLLs)、伤残损失寿命年(years lived with disability, YLDs)、伤残调整寿命年(disability-adjusted life years, DALYs)及各指标的年龄标化率,并计算各指标1990-2017年变化幅度。结果 1990-2017年,湖南省脑卒中死亡数从7.69万上升至11.43万人年,升幅85.84%,男性、女性分别上升122.56%、2.12%;年龄标化死亡率从218.55/10万降至136.41/10万,降幅37.58%,男性、女性分别下降4.16%、58.18%。YLLs从163.74万人年升至203.57万人年,升幅84.79%,男性上升94.94%,女性下降22.62%;年龄标化YLL率下降从3 742.85/10万降至2 183.06/10万,降幅41.67%,女性下降64.45%,高于男性的6.62%。YLDs从11.35万人年上升至30.83万人年,升幅171.63%,男性、女性分别上升197.58%、151.72%;年龄标化YLD率升幅41.74%(1990年:235.13/10万,2017年:333.28/10万),男性、女性分别上升58.89%、28.22%。脑卒中DALYs从175.09万人年升至234.41万人年,升幅33.88%;年龄标化DALY率从3 977.98/10万降至2 516.34/10万,降幅36.74%。其中脑出血DALYs占比最高,缺血性卒中DALYs升幅最高,达142.64%。结论 1990-2017年,湖南省脑卒中疾病负担整体呈增长趋势,有明显性别差异,脑出血疾病负担最重,缺血性卒中疾病负担上升最明显。