Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, 157 Baojian Road, Harbin 150081, People's Republic of China; Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Harbin Medical University, Harbin, People's Republic of China; China and Russia Medical Research Center, Harbin Medical University, Harbin, People's Republic of China; Harbin Medical University, Harbin, People's Republic of China.
Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, 157 Baojian Road, Harbin 150081, People's Republic of China; Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Harbin Medical University, Harbin, People's Republic of China; China and Russia Medical Research Center, Harbin Medical University, Harbin, People's Republic of China; Harbin Medical University, Harbin, People's Republic of China.
Semin Arthritis Rheum. 2020 Apr;50(2):366-372. doi: 10.1016/j.semarthrit.2019.07.014. Epub 2019 Aug 2.
Kashin-Beck disease (KBD) is an endemic osteoarthropathy, which causes disability and heavy socioeconomic burdens. The preventive measures have been taken in the past few decades. However, recent KBD-epidemiological trend and comprehensive effect of its preventive measures need to be evaluated.
By employing typical survey, cross-sectional survey, case-control study, intervention trial, and national surveillance, the present study summarizes comprehensive role of KBD-preventive measures.
The endemic KBD is distributed in a long and narrow area of the world. The latest epidemic began in the late 1950s and lasted until the end of 1980s. Epidemiology of the KBD was characterized by early-onset, gender equality, agricultural area, regional discrepancy, family aggregation, annual fluctuation, etc. Multivariate regression analysis suggested that etiology of the KBD was food-related factors such as fungal contamination of grains, selenium deficiency, imbalance of protein intake, etc. A series of intervention measures for KBD control had been implemented since 1990s, and involved more than 300 million residents. National incidences were 22.1% in 1990, 16.0% in 1995, 12.3% in 2000, 5.5% in 2005, 0.38% in 2010, and 0.18 in 2015, respectively. Although new patients were annually decreased, it still affected 22,567,600 inhabitants and there were 574,925 patients in 2016.
Etiology of the KBD is food-sourced. Its decreased incidence may attribute to an effective implementation of preventive measures. It is possible to eradicate KBD from the earth in the near future.
大骨节病（KBD）是一种地方性骨关节病，会导致残疾和沉重的社会经济负担。过去几十年已经采取了预防措施。然而，最近的 KBD 流行病学趋势和其预防措施的综合效果仍需要评估。
通过采用典型调查、横断面调查、病例对照研究、干预试验和国家监测，本研究总结了 KBD 预防措施的综合作用。
地方性 KBD 分布在一个狭长的世界区域。最新的流行始于 20 世纪 50 年代末，一直持续到 80 年代末。KBD 的流行病学特征为发病早、性别平等、农业区、地区差异、家庭聚集、年度波动等。多元回归分析表明，KBD 的病因与真菌污染谷物、硒缺乏、蛋白质摄入失衡等食物相关因素有关。自 20 世纪 90 年代以来，已经实施了一系列的 KBD 控制干预措施，涉及 3000 多万居民。1990 年全国发病率为 22.1%，1995 年为 16.0%，2000 年为 12.3%，2005 年为 5.5%，2010 年为 0.38%，2015 年为 0.18%。虽然每年新增病例数都在减少，但仍有 2256.76 万人受到影响，2016 年患者人数为 574925 人。
KBD 的病因是食物源性的。发病率的降低可能归因于预防措施的有效实施。在不久的将来，有可能从地球上根除 KBD。
