Department of Clinical Epidemiology.
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang.
Rheumatology (Oxford). 2020 Jul 1;59(7):1529-1538. doi: 10.1093/rheumatology/kez476.
The burden of gout has been increasing globally. However, little is known about the global, regional and national distribution and time trend of this disease. We present a comprehensive analysis of the Global Burden of Disease Study 2017 on gout burden estimates for 195 countries or territories between 1990 and 2017.
Age-standardized prevalence and disability-adjusted life-years of gout were reported between 1990 and 2017 in 195 countries and territories, and associations between these estimates and sociodemographic index (SDI) were further explored. Total and annual percent change between 1990 and 2017 were calculated to quantify the time trends of gout burden.
Age-standardized prevalence rates (95% uncertainty interval) per 100 000 persons were 790.90 (706.10-881.90) and 253.49 (225.69-284.02) in 2017 in males and females, respectively. The annual percent change in age-standardized prevalence (males, 0.22%; females, 0.38%) and disability-adjusted life-years (males, 0.21%; females, 0.38%) of gout increased every year from 1990 to 2017, globally. The highest increase was detected in high-SDI countries, especially in high-income North America. A non-linear association was observed between burden of gout and SDI, with the lowest estimates of gout burden when SDI value was about 0.6. High BMI was the leading risk factor for the burden of gout.
These study results suggest a globally rising trajectory of gout burden between 1990 and 2017. More effective interventions, such as detailed and intensive dietary managements and other prevention strategies for reducing obesity, should be carried out to reverse this trend, especially in females and high-SDI countries.
痛风的负担在全球范围内不断增加。然而,对于这种疾病的全球、区域和国家分布以及时间趋势,我们知之甚少。我们对 2017 年全球疾病负担研究中 195 个国家或地区的痛风负担估计值进行了全面分析。
报告了 195 个国家或地区 1990 年至 2017 年期间痛风的年龄标准化患病率和残疾调整生命年,并进一步探讨了这些估计值与社会人口指数(SDI)之间的关系。计算了 1990 年至 2017 年之间的总变化和年变化百分比,以量化痛风负担的时间趋势。
2017 年男性和女性每 100000 人年龄标准化患病率(95%不确定区间)分别为 790.90(706.10-881.90)和 253.49(225.69-284.02)。1990 年至 2017 年期间,痛风的年龄标准化患病率(男性,0.22%;女性,0.38%)和残疾调整生命年(男性,0.21%;女性,0.38%)的年变化百分比每年都在增加。在高社会人口指数国家,尤其是高收入北美地区,这种增长最为明显。在疾病负担与 SDI 之间观察到非线性关联,当 SDI 值约为 0.6 时,痛风负担的估计值最低。高 BMI 是痛风负担的主要危险因素。
这些研究结果表明,1990 年至 2017 年期间,痛风负担呈现出全球上升的轨迹。应该采取更有效的干预措施,如详细和强化的饮食管理和其他预防肥胖的策略,以扭转这一趋势,特别是在女性和高社会人口指数国家。