Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Zhejiang, Hangzhou, China.
BMC Public Health. 2020 Mar 30;20(1):410. doi: 10.1186/s12889-020-8445-y.
Age-related Macular Degeneration (AMD) is the leading cause of blindness. This study aims to analyze regional differences on the global burden of AMD and help direct related policy making.
Disability-adjusted life years (DALY) data were collected from the Global Burden of Disease Study (GBD) 2017 to estimate the AMD burden. Mean education years, human development index (HDI) and Public Health Expenditure were extracted from the Human Development Report 2018, and latitude data were obtained from the Google Earth. These four factors were analyzed to see their importance in regional differences of AMD burden, using Kruskal-Wallis test, Dunn's multiple comparisons test as well as regression analysis.
Global age-standardized DALY rates have decreased since 2011. Based on the WHO region system, age-standardized DALY rates in African and Eastern Mediterranean region were significantly lower than those of other four regions. Linear regression analysis indicated that age-standardized DALY rates were inversely related to HDI and mean education years.
The age-standardized AMD burden had a decreasing tendency recently. Lower socioeconomic status and fewer education years were associated with higher AMD burden. The finding of this study may highlight the importance of national development and education on relieving AMD burden.
年龄相关性黄斑变性（AMD）是导致失明的主要原因。本研究旨在分析 AMD 全球负担的地区差异，为相关政策制定提供指导。
使用 2017 年全球疾病负担研究（GBD）收集的残疾调整生命年（DALY）数据来评估 AMD 负担。从 2018 年人类发展报告中提取平均受教育年限、人类发展指数（HDI）和公共卫生支出，从谷歌地球获取纬度数据。采用 Kruskal-Wallis 检验、Dunn's 多重比较检验和回归分析，分析这些因素对 AMD 负担地区差异的重要性。
自 2011 年以来，全球年龄标准化 DALY 率呈下降趋势。根据世界卫生组织（WHO）区域系统，非洲和东地中海地区的年龄标准化 DALY 率明显低于其他四个地区。线性回归分析表明，年龄标准化 DALY 率与 HDI 和平均受教育年限呈负相关。
最近，年龄标准化 AMD 负担呈下降趋势。较低的社会经济地位和较少的受教育年限与较高的 AMD 负担相关。本研究的结果可能强调了国家发展和教育对减轻 AMD 负担的重要性。
