基于全球疾病负担数据库的不同地区年龄相关黄斑变性患病率及患病人数随年龄变化的模式分析OA
Age-related macular degeneration burden and its age-specific patterns across different socio-demographic index regions:an analysis based on the Global Burden of Disease database
目的:利用 2021 年全球疾病负担(Global Burden of Disease,GBD)数据,系统分析 1990-2021 年间年龄相关性黄斑变性(age-related macular degeneration,AMD)在全球及不同社会人口学指数(socio-demographic index,SDI)地区的疾病负担和发展趋势,重点探讨其患病率及患病人数随年龄变化的模式在不同 SDI 地区的分布特征,为制定差异化的全球公共卫生策略提供循证依据.方法:本研究数据来源于 GBD 2021 数据库.提取 AMD 相关的患病病例数、患病率、伤残调整生命年(disability-adjusted life years,DALYs)等核心指标,并按 SDI 区域进行分层.采用估算年均变化百分比(estimated annual percentage change,EAPC)等指标量化其长期变化趋势,对各年龄组的患病人数和患病率进行比较,以识别关键年龄模式.结果:1990-2021 年间,全球 AMD 疾病负担显著加重.DALYs 总数从30.3 万增至 57.8 万(95%CI:89.0～94.3),EAPC 为 1.85%(95%CI:1.76～1.94);患病病例数从 364 万增至806 万[总变化百分比(percent change,PC)=121.4%].女性在各项负担指标上均高于男性(P<0.05).疾病负担增速在全球分布极不均衡,中等 SDI 地区 EAPC 最高(2.38%),而高 SDI 地区最低(1.40%).AMD 患病率和患病人数的年龄分布模式有 3 个关键年龄拐点,包括启动拐点、峰值拐点、背离拐点.其中,所有地区 AMD 负担均在 50～54 岁年龄组开始急剧攀升;全球患病人数在 70～74 岁达峰,但在中等 SDI 地区则延迟至 75～79 岁;在高、中高 SDI 地区,80～84 岁后出现患病率持续攀升而患病人数下降的现象.结论:全球范围内,从患病模式来看,50 岁是 AMD 患病率显著攀升的起始点,是启动AMD 预防和筛查的关键窗口期.在过去 30 年,全球 AMD 疾病负担因人口老龄化而持续加重,且在不同 SDI 地区表现不同.中等 SDI 地区因其最快的负担增速,面临着最为严峻的医疗挑战.各地区应根据其特有的年龄模式和负担增速,制定差异化、精准化防治策略,以应对日益加剧的全球 AMD负担.
Objective:To analyze the disease burden and trends of age-related macular degeneration(AMD)globally and across different Socio-Demographic Index(SDI)regions from 1990 to 2021,using the data from the Global Burden of Disease(GBD)2021.Methods:Data were sourced from the GBD 2021 database.Metrics for AMD,including prevalent cases,prevalence,and disability-adjusted life years(DALYs),were extracted and stratified by SDI region.The estimated annual percentage change(EAPC)was used to quantify long-term trends.Prevalent cases and prevalence were compared across age groups to identify critical age thresholds.Results:Between 1990 to 2021,the global burden of AMD increased significantly.Total DALYs rose from 303,000 to 578,000(95%CI:89.0%-94.3%),with an Estimated Annual Percentage Change(EAPC)of 1.85%(95%CI:1.76%-1.94%).Prevalent cases grew from 3.64 million to 8.06 million(121.4%).Females showed a significantly higher burden than males across all SDI regions(P<0.05).The growth rate of the disease burden varied substantially by region;the middle SDI region had the highest EAPC(2.38%),while the high SDI region had the lowest(1.40%).Three critical age-related thresholds for AMD were identified:onset,peak,and divergence.The AMD burden began to rise sharply in the 50-54 age group across all regions.Globally,the number of prevalent cases peaked in the 70-74 age group,but this peak shifted to the 75-79 age group in middle SDI region.In the high and high-middle SDI regions,prevalence continued to increase while the absolute number of cases declined after the 80-84 age group.Conclusions:Globally,age 50 is critical threshold for initiating AMD prevention and screening.Over the past three decades,the global burden of AMD has worsen due to population aging,with substantial variations across SDI regions.The middle SDI region faces the most severe healthcare challenges due to the fastest growth in disease burden.It is recommended that regions should develop targeted prevention strategies tailored to their specific age-related thresholds and burden growth rates to address the rising global burden of AMD.
刘昀祎;杜斓琪;何耀扬;陈士达
中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州 510060||广东省重大致盲眼病防治基础研究卓越中心,广州 510060
医药卫生
年龄相关性黄斑变性全球疾病负担研究数据库社会人口学指数年龄模式
age-related macular degenerationGlobal Burden of Disease Studysocio-demographic indexage-related patterns
《眼科学报》 2026 (5)
346-359,14
国家自然科学基金(82571271)广东省基础与应用基础研究基金(2026A1515010675).This work was supported by the National Natural Science Foundation of China(82571271)and the Guangdong Basic and Applied Basic Research Foundation(2026A1515010675).
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