Epidemiological variations and trends in health burden of glaucoma worldwide
Epidemiological variations and trends in health burden of glaucoma worldwide
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全球青光眼健康负担的流行病学变化和趋势。
DOI：
10.1111/aos.14044
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发表时间：
2019-05-01
影响因子：
3.4
通讯作者：
Huang, Wenyong
中科院分区：
文献类型：
--
作者：
Wang, Wei;He, Miao;Huang, Wenyong
目的利用伤残调整生命年（DALYs），按年龄、性别、地区和社会经济状况评估青光眼全球健康负担的趋势和变化。方法从GBD 2015研究数据库中获取全球和各国的DALY数、粗DALY率和年龄标准化DALY率。相应的人类发展指数和人均国内生产总值是从联合国和世界银行获得的。环境数据来自世卫组织全球卫生观察站数据存储库。结果1990 - 2015年青光眼DALY人数和年龄标准化DALY率分别上升了122%和15%。随着年龄的增长，男性和女性都呈现出相似的增长趋势，在60岁时达到峰值，在75岁后再次增加。注意到DALY数量的性别差异，每个年龄组中女性的负担高于男性（均p < 0.001）。青光眼健康负担存在显著不平等，DALY数、粗DALY率和年龄标准化DALY率的基尼系数分别为0.865、0.235和0.254。年龄标准化的DALY与HDI显著相关，占各国差异的22.2% （R-2 = 0.222, p < 0.001）。同样，人均GDP与年龄标准化DALY率呈负相关，但只能解释10.6%的年龄标准化DALY率变化（R-2 = 0.106, p < 0.001）。青光眼的年龄标准化DALY率与国家紫外线辐射水平和PM2.5水平呈正相关。结论青光眼患者健康负担在过去25年中持续增加，且分布不均匀。社会经济水平低、年龄大、女性、环境紫外线辐射高、空气污染高与青光眼负担高相关。
Purpose To evaluate the trends and variations in global health burden of glaucoma by year, age and sex, region and socio-economic status, using disability-adjusted life years (DALYs). Method The DALY numbers, crude DALY rate and age-standardized DALY rate globally and in each country were obtained the GBD 2015 study database. The corresponding human development index (HDI) and gross domestic product (GDP) per capita were obtained from the United Nations and World Bank. Environmental data were obtained from the WHO Global Health Observatory data repository. Results From 1990 to 2015, the DALY number and age-standardized DALY rate due to glaucoma increased by 122% and 15%, respectively. Both male and female showed similar increasing trend with ageing, with the peak at 60 years old and increasing again since 75 years old. Sex disparities in DALY number were noted, with higher burden among female than male in each age group (all p < 0.001). The health burden of glaucoma was substantial unequal, with Gini coefficient of 0.865 for DALY number, 0.235 for crude DALY rate and 0.254 for age-standardized DALY rate, respectively. The age-standardized DALY was significantly associated with HDI, accounting for 22.2% variance across countries (R-2 = 0.222, p < 0.001). Similarly, the GDP per capita was inversely associated with age-standardized DALY rate but can explain only 10.6% variations in age-standardized DALY rate (R-2 = 0.106, p < 0.001). The age-standardized DALY rate due to glaucoma was positively associated with national levels of ultraviolet radiation and PM2.5. Conclusion The health burden of glaucoma continuously increased in the past 25 years and distributed unequally. Lower socio-economic level, older age, female, higher ambient ultraviolet radiation and higher level of air pollution were significantly associated with higher burden of glaucoma.