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类风湿关节炎的全球负担:来自 2010 年全球疾病负担研究的估计。

The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study.

机构信息

Institute of Bone & Joint Research, University of Sydney, Royal North Shore Hospital, St Leonards, New South Wales, Australia.

School of Population Health, University of Queensland, Herston, Queensland, Australia.

出版信息

Ann Rheum Dis. 2014 Jul;73(7):1316-22. doi: 10.1136/annrheumdis-2013-204627. Epub 2014 Feb 18.

Abstract

OBJECTIVES

To estimate the global burden of rheumatoid arthritis (RA), as part of the Global Burden of Disease 2010 study of 291 conditions and how the burden of RA compares with other conditions.

METHODS

The optimum case definition of RA for the study was the American College of Rheumatology 1987 criteria. A series of systematic reviews were conducted to gather age-sex-specific epidemiological data for RA prevalence, incidence and mortality. Cause-specific mortality data were also included. Data were entered into DisMod-MR, a tool to pool available data, making use of study-level covariates to adjust for country, region and super-region random effects to estimate prevalence for every country and over time. The epidemiological data, in addition to disability weights, were used to calculate years of life lived with disability (YLDs). YLDs were added to the years of life lost due to premature mortality to estimate the overall burden (disability-adjusted life years (DALYs)) for RA for the years 1990, 2005 and 2010.

RESULTS

The global prevalence of RA was 0.24% (95% CI 0.23% to 0.25%), with no discernible change from 1990 to 2010. DALYs increased from 3.3 million (M) (95% CI 2.6 M to 4.1 M) in 1990 to 4.8 M (95% CI 3.7 M to 6.1 M) in 2010. This increase was due to a growth in population and increase in aging. Globally, of the 291 conditions studied, RA was ranked as the 42nd highest contributor to global disability, just below malaria and just above iodine deficiency (measured in YLDs).

CONCLUSIONS

RA continues to cause modest global disability, with severe consequences in the individuals affected.

摘要

目的

估算类风湿关节炎(RA)的全球负担,这是 2010 年全球疾病负担研究中 291 种疾病的一部分,以及 RA 的负担与其他疾病的负担相比如何。

方法

本研究中 RA 的最佳病例定义是美国风湿病学会 1987 标准。进行了一系列系统评价,以收集 RA 患病率、发病率和死亡率的年龄性别特异性流行病学数据。还包括了特定病因的死亡率数据。数据被输入 DisMod-MR,这是一个汇总可用数据的工具,利用研究水平的协变量来调整国家、地区和超地区的随机效应,以估计每个国家和随时间的患病率。流行病学数据,以及残疾权重,用于计算因残疾而丧失的生命年(YLDs)。将 YLDs 与因过早死亡而丧失的生命年相加,以估算 1990 年、2005 年和 2010 年 RA 的总负担(残疾调整生命年(DALYs))。

结果

RA 的全球患病率为 0.24%(95%CI 0.23%至 0.25%),1990 年至 2010 年期间没有明显变化。DALYs 从 1990 年的 330 万(95%CI 260 万至 410 万)增加到 2010 年的 480 万(95%CI 370 万至 610 万)。这种增加是由于人口增长和老龄化增加所致。在全球范围内,在所研究的 291 种疾病中,RA 排在第 42 位,是导致全球残疾的主要原因,仅次于疟疾,略高于碘缺乏症(以 YLDs 衡量)。

结论

RA 仍在全球范围内造成适度的残疾,对受影响的个人造成严重后果。

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