1990-2017 年伊朗肌肉骨骼疾病负担:2017 年全球疾病负担研究估计。
Burden of musculoskeletal disorders in Iran during 1990-2017: estimates from the Global Burden of Disease Study 2017.
机构信息
Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, AJA University of Medical Sciences, Tehran, Iran.
出版信息
Arch Osteoporos. 2020 Jul 10;15(1):103. doi: 10.1007/s11657-020-00767-8.
UNLABELLED
Musculoskeletal diseases (MSDs) are the leading cause of disability and facing them demands updated reports on their burden for efficient policymaking. We showed Iran had the highest female-to-male ratio and highest increase in the burden of musculoskeletal diseases, in the past three decades, worldwide. We further confirmed the role of population aging as the main cause.
PURPOSE
MSDs comprise most of the top causes of years lived with disability (YLDs) worldwide and are rapidly increasing in lower- and middle-income countries. Here, we present disability and mortality due to MSDs in Iran at the national level from 1990 to 2017.
METHODS
We used Global Burden of Disease (GBD) 2017 Study data and standard methodology and presented the burden of MSDs in rates of years of life lost (YLLs), YLDs, and disability-adjusted life years (DALYs) during 1990-2017, for population aged ≥ 5 years old. We further explored attributable risk factors and decomposed the changing trend in DALYs to assess underlying causes.
RESULTS
In Iran, MSDs were responsible for 1.82 million (95%uncertainty interval [UI] 1.3-2.4) DALYs, in 2017. During the past 28 years, with 1.75% annualized percentage change (APC), Iran had the highest percentage increase in the all-ages MSD DALYs rate worldwide, while the age-standardized DALYs APC was negligible. Low back pain was the greatest contributor to DALYs and caused 4.5% of total DALYs. The female population is experiencing considerably higher burden of MSDs, with 115% and 48% higher all-ages YLLs and YLDs rates per 100,000, respectively (YLLs 28.7; YLDs 2629.1), than males (YLLs 13.2; YLDs 1766.1). However, due to wide UIs, difference was not significant. Only 17.6% of MSD YLDs are attributable to assessed risk factors.
CONCLUSION
Despite that MSDs are rising as an important cause of disability in Iran, these conditions are not sufficiently addressed in health policies. There is urgent need for cross-sectoral engagement, especially addressing the MSDs in females.
背景
肌肉骨骼疾病(MSD)是导致残疾的主要原因,因此需要及时报告其负担情况,以便制定有效的政策。我们发现,在过去的 30 年里,伊朗的女性与男性 MSD 发病率比值最高,且 MSD 负担增长最快,这一结果在全球范围内都是最高的。我们进一步证实了人口老龄化是主要原因。
目的
MSD 是造成全世界伤残调整生命年(YLDs)的主要原因之一,且在中低收入国家呈快速上升趋势。本研究旨在评估 1990 年至 2017 年伊朗的 MSD 相关疾病所致残疾和死亡情况。
方法
我们使用全球疾病负担(GBD)2017 年研究数据和标准方法,呈现了年龄在 5 岁及以上人群中 1990-2017 年 MSD 所致 YLLs、YLDs 和残疾调整生命年(DALYs)的发病率,并进一步探讨了归因风险因素,以评估潜在原因。
结果
2017 年,伊朗有 182 万人(95%不确定区间[UI]为 130-240 万人)患有 MSD,占总 DALYs 的 10.7%。在过去的 28 年里,伊朗的全年龄段 MSD 发病率以每年 1.75%的速度增长,在全球范围内增长最快,而年龄标准化的 DALYs 年增长率可忽略不计。下腰痛是造成 DALYs 最多的疾病,占总 DALYs 的 4.5%。女性患 MSD 的负担明显高于男性,全年龄段 YLLs 和 YLDs 分别高出 115%和 48%(YLLs 为 28.7;YLDs 为 2629.1)。然而,由于置信区间较宽,两者之间的差异无统计学意义。只有 17.6%的 MSD YLDs 与评估的风险因素有关。
结论
尽管 MSD 作为伊朗导致残疾的一个重要原因,正在不断上升,但在卫生政策中并没有得到充分的重视。需要各部门共同参与,特别是解决女性的 MSD 问题。