Stolwijk Carmen, van Onna Marloes, Boonen Annelies, van Tubergen Astrid
Maastricht University Medical Center and School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands.
Arthritis Care Res (Hoboken). 2016 Sep;68(9):1320-31. doi: 10.1002/acr.22831. Epub 2016 Jul 27.
To summarize the prevalence of spondyloarthritis (SpA) and its subtypes in the general population, and to identify demographic and methodologic characteristics that might explain heterogeneity in prevalence estimates.
A systematic literature search was performed to identify relevant articles. Risk of bias was assessed and data were extracted. Pooled prevalences were calculated. Potential sources of heterogeneity were explored by subgroup analysis and meta-regression analysis.
The prevalence of SpA ranged from 0.20% (95% confidence interval [95% CI] 0.00-0.66) in South-East Asia to 1.61% (95% CI 1.27-2.00) in Northern Arctic communities; the prevalence of ankylosing spondylitis (AS) from 0.02% (95% CI 0.00-0.21) in Sub-Saharan Africa to 0.35% (95% CI 0.24-0.48) in Northern Arctic communities; and the prevalence of psoriatic arthritis (PsA) from 0.01% (95% CI 0.00-0.17) in the Middle East to 0.19% (95% CI 0.16-0.32) in Europe. The following characteristics were significantly associated with variation in prevalence of SpA, AS, and/or PsA: proportion of females, mean age of the sample, geographic area and setting (demographic characteristics), year of data collection, case finding, and case ascertainment (methodologic characteristics). For the other SpA subgroups, too few studies were available to conduct a meta-analysis, but prevalence estimates of reactive arthritis (range 0.0-0.2%), SpA related to inflammatory bowel disease (range 0.0-0.1%), and undifferentiated SpA (range 0.0-0.7%) were generally low.
SpA is a common disease, but with large variation in reported prevalence estimates, which can partly be explained by differences in demographic and methodologic characteristics. Particularly, geographic area as well as case finding account for a substantial part of the heterogeneity.
总结普通人群中脊柱关节炎（SpA）及其亚型的患病率，并确定可能解释患病率估计异质性的人口统计学和方法学特征。
进行系统的文献检索以识别相关文章。评估偏倚风险并提取数据。计算合并患病率。通过亚组分析和meta回归分析探索异质性的潜在来源。
SpA的患病率在东南亚为0.20%（95%置信区间[95%CI]0.00 - 0.66），在北极北部社区为1.61%（95%CI 1.27 - 2.00）；强直性脊柱炎（AS）的患病率在撒哈拉以南非洲为0.02%（95%CI 0.00 - 0.21），在北极北部社区为0.35%（95%CI 0.24 - 0.48）；银屑病关节炎（PsA）的患病率在中东为0.01%（95%CI 0.00 - 0.17），在欧洲为0.19%（95%CI 0.16 - 0.32）。以下特征与SpA、AS和/或PsA患病率的变化显著相关：女性比例、样本平均年龄、地理区域和环境（人口统计学特征）、数据收集年份、病例发现和病例确诊（方法学特征）。对于其他SpA亚组，由于可用研究过少无法进行meta分析，但反应性关节炎（范围0.0 - 0.2%）、与炎症性肠病相关的SpA（范围0.0 - 0.1%）和未分化SpA（范围0.0 - 0.7%）的患病率估计通常较低。
SpA是一种常见疾病，但报告的患病率估计差异很大，部分原因可由人口统计学和方法学特征的差异来解释。特别是，地理区域以及病例发现是异质性的重要组成部分。
