1990-2020年全球、地区和国家痛风负担以及到2050年的预测:2021年全球疾病负担研究的系统分析。

IF 15 1区 医学 Q1 RHEUMATOLOGY Lancet Rheumatology Pub Date : 2024-08-01 DOI:10.1016/S2665-9913(24)00117-6
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引用次数: 0

摘要

背景:痛风是一种炎症性关节炎,表现为急性发作的剧烈关节疼痛和肿胀,可发展为慢性痛风或慢性侵蚀性痛风,或两者兼而有之。在此,我们介绍了《2021 年全球疾病负担、伤害和风险因素研究》(GBD)按性别、年龄和地区对全球、地区和国家痛风患病率和残疾生活年数(YLDs)的最新估计,以及到 2050 年的患病率预测:方法:利用 35 个国家的人口数据以及美国和中国台湾(省)的索赔数据,对 1990 年至 2020 年的痛风患病率和 YLD 进行了估算。采用嵌套贝叶斯元回归模型,按年龄、性别和地点估算痛风的患病率和YLD。采用混合效应模型对2050年的患病率进行了预测:2020年,全球有5500-800万人(95%不确定区间为44-4-69-8)患有痛风,年龄标准化患病率为每10万人中有659-3人(525-4-822-3),自1990年以来增加了22-5%(20-9-24-2)。从全球来看,2020 年男性痛风患病率是女性的 3-26 倍(3-11-3-39),并且随着年龄的增长而增加。据估计,到2050年,痛风患病总人数将达到9500万-800万(8100万-1116万),其中人口增长是导致患病人数增加的最大原因,而痛风患病率的预测变化只起到很小的作用。预计 2050 年年龄标准化痛风患病率为每 10 万人 667(531-830)例。2020 年全球痛风的年龄标准化 YLD 率为每 10 万人 20-5(14-4-28-2)。高体重指数占痛风YLD的34-3%(27-7-40-6),肾功能障碍占11-8%(9-3-14-2):我们的预测模型估计,从2020年到2050年,痛风患者人数将增加70%以上,主要原因是人口增长和老龄化。由于痛风致残与高体重指数之间存在关联,因此需要在人口层面进行以减轻体重为重点的饮食和生活方式调整,以减轻痛风的负担,同时采取干预措施预防和控制痛风复发。尽管标准化的 GBD 方法和建模非常严谨,但在许多国家,尤其是低收入和中等收入国家,估算数据都是基于建模数据而非原始数据,而且也缺乏严重程度和致残率的估算数据。我们强烈鼓励将这些数据的收集工作纳入未来的《全球残疾发展报告》迭代中:比尔及梅林达-盖茨基金会和全球肌肉骨骼健康联盟。
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Global, regional, and national burden of gout, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Background

Gout is an inflammatory arthritis manifesting as acute episodes of severe joint pain and swelling, which can progress to chronic tophaceous or chronic erosive gout, or both. Here, we present the most up-to-date global, regional, and national estimates for prevalence and years lived with disability (YLDs) due to gout by sex, age, and location from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, as well as forecasted prevalence to 2050.

Methods

Gout prevalence and YLDs from 1990 to 2020 were estimated by drawing on population-based data from 35 countries and claims data from the USA and Taiwan (province of China). Nested Bayesian meta-regression models were used to estimate prevalence and YLDs due to gout by age, sex, and location. Prevalence was forecast to 2050 with a mixed-effects model.

Findings

In 2020, 55·8 million (95% uncertainty interval 44·4–69·8) people globally had gout, with an age-standardised prevalence of 659·3 (525·4–822·3) per 100 000, an increase of 22·5% (20·9–24·2) since 1990. Globally, the prevalence of gout in 2020 was 3·26 (3·11–3·39) times higher in males than in females and increased with age. The total number of prevalent cases of gout is estimated to reach 95·8 million (81·1–116) in 2050, with population growth being the largest contributor to this increase and only a very small contribution from the forecasted change in gout prevalence. Age-standardised gout prevalence in 2050 is forecast to be 667 (531–830) per 100 000 population. The global age-standardised YLD rate of gout was 20·5 (14·4–28·2) per 100 000 population in 2020. High BMI accounted for 34·3% (27·7–40·6) of YLDs due to gout and kidney dysfunction accounted for 11·8% (9·3–14·2).

Interpretation

Our forecasting model estimates that the number of individuals with gout will increase by more than 70% from 2020 to 2050, primarily due to population growth and ageing. With the association between gout disability and high BMI, dietary and lifestyle modifications focusing on bodyweight reduction are needed at the population level to reduce the burden of gout along with access to interventions to prevent and control flares. Despite the rigour of the standardised GBD methodology and modelling, in many countries, particularly low-income and middle-income countries, estimates are based on modelled rather than primary data and are also lacking severity and disability estimates. We strongly encourage the collection of these data to be included in future GBD iterations.

Funding

Bill & Melinda Gates Foundation and the Global Alliance for Musculoskeletal Health.

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来源期刊
Lancet Rheumatology
Lancet Rheumatology RHEUMATOLOGY-
CiteScore
34.70
自引率
3.10%
发文量
279
期刊介绍: The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials. With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.
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