Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China.
Nanshan School, Guangzhou Medical University, Guangzhou, China.
Acta Ophthalmol. 2019 May;97(3):e349-e355. doi: 10.1111/aos.14044. Epub 2019 Feb 20.
To evaluate the trends and variations in global health burden of glaucoma by year, age and sex, region and socio-economic status, using disability-adjusted life years (DALYs).
The DALY numbers, crude DALY rate and age-standardized DALY rate globally and in each country were obtained the GBD 2015 study database. The corresponding human development index (HDI) and gross domestic product (GDP) per capita were obtained from the United Nations and World Bank. Environmental data were obtained from the WHO Global Health Observatory data repository.
From 1990 to 2015, the DALY number and age-standardized DALY rate due to glaucoma increased by 122% and 15%, respectively. Both male and female showed similar increasing trend with ageing, with the peak at 60 years old and increasing again since 75 years old. Sex disparities in DALY number were noted, with higher burden among female than male in each age group (all p < 0.001). The health burden of glaucoma was substantial unequal, with Gini coefficient of 0.865 for DALY number, 0.235 for crude DALY rate and 0.254 for age-standardized DALY rate, respectively. The age-standardized DALY was significantly associated with HDI, accounting for 22.2% variance across countries (R = 0.222, p < 0.001). Similarly, the GDP per capita was inversely associated with age-standardized DALY rate but can explain only 10.6% variations in age-standardized DALY rate (R = 0.106, p < 0.001). The age-standardized DALY rate due to glaucoma was positively associated with national levels of ultraviolet radiation and PM .
The health burden of glaucoma continuously increased in the past 25 years and distributed unequally. Lower socio-economic level, older age, female, higher ambient ultraviolet radiation and higher level of air pollution were significantly associated with higher burden of glaucoma.
使用伤残调整生命年（DALY）评估全球青光眼疾病负担的年度、年龄和性别、地区和社会经济地位的变化趋势。
从 GBD 2015 研究数据库中获取 DALY 数量、全球和各国的粗 DALY 率和年龄标准化 DALY 率。从联合国和世界银行获取相应的人类发展指数（HDI）和人均国内生产总值（GDP）。从世界卫生组织全球卫生观测站数据存储库获取环境数据。
1990 年至 2015 年，青光眼导致的 DALY 数量和年龄标准化 DALY 率分别增加了 122%和 15%。男性和女性均呈现出随年龄增长而增加的相似趋势，峰值出现在 60 岁，75 岁以后再次增加。DALY 数量存在性别差异，各年龄段女性的负担均高于男性（均 p<0.001）。青光眼的疾病负担存在明显的不平等，DALY 数量的基尼系数为 0.865，粗 DALY 率为 0.235，年龄标准化 DALY 率为 0.254。年龄标准化 DALY 与 HDI 显著相关，占各国间差异的 22.2%（R=0.222，p<0.001）。同样，人均 GDP 与年龄标准化 DALY 率呈负相关，但只能解释年龄标准化 DALY 率 10.6%的变异（R=0.106，p<0.001）。青光眼导致的年龄标准化 DALY 率与国家紫外线辐射和 PM 水平呈正相关。
过去 25 年来，青光眼的疾病负担持续增加，分布不均。较低的社会经济水平、年龄较大、女性、较高的环境紫外线辐射和较高的空气污染水平与较高的青光眼负担显著相关。
