Prevalence, Incidence, and Years Lived With Disability Due to Gout and Its Attributable Risk Factors for 195 Countries and Territories 1990-2017: A Systematic Analysis of the Global Burden of Disease Study 2017
Prevalence, Incidence, and Years Lived With Disability Due to Gout and Its Attributable Risk Factors for 195 Countries and Territories 1990-2017: A Systematic Analysis of the Global Burden of Disease Study 2017
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DOI：
10.1002/art.41404
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发表时间：
2020-09-10
影响因子：
13.3
通讯作者：
Smith, Emma
中科院分区：
文献类型：
--
作者：
Safiri, Saeid;Kolahi, Ali Asghar;Smith, Emma
目的描述1990 - 2017年195个国家和地区痛风的点患病率、年发病率和残疾年数（YLD）及其可归因的危险因素的水平和趋势，并根据年龄、性别和社会人口学指数（SDI;一种社会人口学因素的复合物）进行分析。数据来自2017年全球疾病、伤害和风险因素负担（GBD）研究。健康评估与评估研究所的GBD团队与全球研究人员和专家合作，对数据库和疾病模型分析进行了全面的系统审查，以提供1990年至2017年期间全球，区域和国家层面的估计。每10万人口的计数和年龄标准化率，沿着，以及95%的不确定区间（95%UI），报告了点患病率、年发病率和YLD。在全球范围内，痛风的流行病例接近4120万例（95% UI 3670万，4610万），每年有740万例（95% UI 660万，850万）事件病例，2017年有近130万例（95% UI 87万，180万）YLD。2017年全球年龄标准化点患病率估计值和年发病率为510.6（95% UI 455.6，570.3）和91.8（95%UI 81.3，104.1）例/10万人口，分别比1990年上升7.2%（95%UI 6.4%，8.1%）和5.5%（95%UI 4.8%，6.3%）。相应的年龄标准化YLD率为每10万人15.9例（95% UI 10.7，21.8），比1990年增加了7.2%（95% UI 5.9%，8.6%）。2017年，痛风的全球点患病率估计值在男性中较高，在老年组中观察到较高的患病率，并且男性和女性的患病率均随年龄增加而增加。痛风的负担一般在发达地区和国家最高。2017年痛风年龄标准化点患病率估计值最高的3个国家是新西兰（1，394.0例[95% UI 1，290.1，1，500.9]）、澳大利亚（1，171.4例[95% UI 1，038.1，1，322.9]）和美国（996.0例[95% UI 923.1，1，076.8]）。从1990年到2017年，痛风年龄标准化点患病率估计值增幅最高的国家是美国（34.7% [95% UI 27.7%，43.1%]）、加拿大（28.5% [95% UI 21.9%，35.4%]）和阿曼（28.0% [95% UI 21.5%，34.8%]）。在全球范围内，高体重指数和肾功能受损分别占2017年估计值中痛风所致YLD的32.4%（95% UI 18.7%，49.2%）和15.3%（95% UI 13.5%，17.1%）。男性归因于这些危险因素的YLD较高。从1990年到2017年，痛风的负担在世界范围内增加，国家和地区之间的点患病率，年发病率和YLD存在差异。除了改善疾病的临床管理、预防和社区健康促进，以提供有关疾病的基本知识、风险因素、后果和有效的治疗方案（针对中年男性等高危群体），对于避免疾病发作并因此减少全球疾病负担至关重要。
Objective To describe the levels and trends of point prevalence, annual incidence, and years lived with disability (YLD) for gout and its attributable risk factors in 195 countries and territories from 1990 to 2017 according to age, sex, and Sociodemographic Index (SDI; a composite of sociodemographic factors).Methods. Data were extracted from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2017 study. A comprehensive systematic review of databases and the disease-modeled analysis were performed by the GBD team at the Institute for Health Metrics and Evaluation, in collaboration with researchers and experts worldwide, to provide estimates at global, regional, and national levels during 1990 and 2017. Counts and age-standardized rates per 100,000 population, along with 95% uncertainty intervals (95% UIs), were reported for point prevalence, annual incidence, and YLD.Results. Globally, there were similar to 41.2 million (95% UI 36.7 million, 46.1 million) prevalent cases of gout, with 7.4 million (95% UI 6.6 million, 8.5 million) incident cases per year and almost 1.3 million (95% UI 0.87 million, 1.8 million) YLD in 2017. The global age-standardized point prevalence estimates and annual incidence rates in 2017 were 510.6 (95% UI 455.6, 570.3) and 91.8 (95% UI 81.3, 104.1) cases per 100,000 population, respectively, an increase of 7.2% (95% UI 6.4%, 8.1%) and 5.5% (95% UI 4.8%, 6.3%) from 1990. The corresponding age-standardized YLD rate was 15.9 (95% UI 10.7, 21.8) cases per 100,000 persons, a 7.2% (95% UI 5.9%, 8.6%) increase from 1990. In 2017, the global point prevalence estimates for gout were higher in males, and higher prevalence was seen in older age groups and increased with age for both males and females. The burden of gout was generally highest in developed regions and countries. The 3 countries with the highest age-standardized point prevalence estimates of gout in 2017 were New Zealand (1,394.0 cases [95% UI 1,290.1, 1,500.9]), Australia (1,171.4 cases [95% UI 1,038.1, 1,322.9]), and the US (996.0 cases [95% UI 923.1, 1,076.8]). The countries with the highest increases in age-standardized point prevalence estimates of gout from 1990 to 2017 were the US (34.7% [95% UI 27.7%, 43.1%]), Canada (28.5% [95% UI 21.9%, 35.4%]), and Oman (28.0% [95% UI 21.5%, 34.8%]). Globally, high body mass index and impaired kidney function accounted for 32.4% (95% UI 18.7%, 49.2%) and 15.3% (95% UI 13.5%, 17.1%) of YLD due to gout in the 2017 estimates, respectively. The YLD attributable to these risk factors were higher in males.Conclusion. The burden of gout increased across the world from 1990 to 2017, with variations in point prevalence, annual incidence, and YLD between countries and territories. Besides improving the clinical management of disease, prevention, and health promotion in communities to provide basic knowledge of the disease, risk factors, consequences, and effective treatment options (tailoring to high-risk groups such as the middle-aged male population) are crucial to avoid disease onset and hence to decrease the global disease burden.