Lou Lixia, Yao Chunlei, Jin Yanhua, Perez Victor, Ye Juan
Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.
Department of Ophthalmology, Dongyang People's Hospital, Dongyang, Zhejiang, China.
Invest Ophthalmol Vis Sci. 2016 Nov 1;57(14):6271-6277. doi: 10.1167/iovs.16-20242.
To evaluate the global patterns in health burden of uncorrected refractive error (URE) by year, age and sex, region, and socioeconomic status, using disability-adjusted life years (DALYs).
Global, regional, or national DALY numbers, crude DALY rates, and age-standardized DALY rates caused by URE, by year, or age and sex, were obtained from the Global Burden of Disease Study 2013. Human development index (HDI) in 2013 as a national socioeconomic indicator was obtained from the Human Development Report. Kruskal-Wallis test and linear regression were performed to explore the association between age-standardized DALY rates and HDI.
From 1990 to 2013, global DALY numbers caused by URE rose by 43.8%, crude rates remained relatively constant, and age-standardized rates fell by 8.8%. Global DALY rates increased with age, and older females had higher DALY numbers and rates than males of the same age. Age-standardized DALY rates in Eastern Mediterranean, South-East Asia, and Africa were higher than that at a global level. Multiple comparisons indicated higher age-standardized DALY rates in lower HDI countries. Age-standardized DALY rates were inversely related to HDI (standardized β = -0.616, P < 0.001).
The global health of URE is improving but crude DALY rates are keeping constant, implying that health progress does not mean fewer demands of refractive services. Worldwide, older age, female sex, and lower socioeconomic status are associated with higher URE burden. The findings of this study may raise public awareness of the global URE burden and are important for health policy making.
采用伤残调整生命年（DALYs）评估未矫正屈光不正（URE）的健康负担按年份、年龄、性别、地区和社会经济地位划分的全球模式。
从《2013年全球疾病负担研究》中获取按年份、年龄和性别划分的由URE导致的全球、区域或国家DALY数量、粗DALY率和年龄标准化DALY率。从《人类发展报告》中获取2013年作为国家社会经济指标的人类发展指数（HDI）。进行Kruskal-Wallis检验和线性回归以探讨年龄标准化DALY率与HDI之间的关联。
1990年至2013年，由URE导致的全球DALY数量增加了43.8%，粗率保持相对稳定，年龄标准化率下降了8.8%。全球DALY率随年龄增长而增加，老年女性的DALY数量和率高于同龄男性。东地中海、东南亚和非洲的年龄标准化DALY率高于全球水平。多重比较表明，HDI较低的国家年龄标准化DALY率较高。年龄标准化DALY率与HDI呈负相关（标准化β = -0.616，P < 0.001）。
URE的全球健康状况正在改善，但粗DALY率保持不变，这意味着健康状况的改善并不意味着对屈光服务的需求减少。在全球范围内，老年、女性和较低的社会经济地位与较高的URE负担相关。本研究结果可能会提高公众对全球URE负担的认识，对卫生政策制定具有重要意义。
