Schulich School of Medicine, University of Western Ontario, St. Joseph's Health Care, 268 Grosvenor St, D2 Rheumatology, London, ON, N6A 4V2, Canada.
University College Dublin, School of Medicine and Medical Sciences, Dublin 4, Ireland.
Arthritis Res Ther. 2021 Mar 11;23(1):82. doi: 10.1186/s13075-021-02450-w.
Giant cell arteritis (GCA) is a common large vessel vasculitis in those over age 50 years. This meta-analysis examined the geographical and temporal distribution of the incidence, prevalence, and mortality of GCA.
A systematic review was conducted using EMBASE, Scopus, and PubMed from their inceptions until 2019. Studies were included if they reported at least 50 or more GCA patients and defined the location and time frame. Articles on mortality were included and standardized mortality ratio (SMR) was extracted where possible. Mean pooled prevalence, incidence, and SMR were calculated using a random effects model. Linear regression was used to explore correlations between latitude and incidence, prevalence, and mortality.
Of the 3569 citations identified, 107 were included. The pooled incidence of GCA was 10.00 [9.22, 10.78] cases per 100,000 people over 50 years old. This incidence was highest in Scandinavia 21.57 [18.90, 24.23], followed by North and South America 10.89 [8.78, 13.00], Europe 7.26 [6.05, 8.47], and Oceania 7.85 [- 1.48, 17.19]. Pooled prevalence was 51.74 [42.04, 61.43] cases per 100,000 people over age 50. Annual mortality was 20.44 [17.84, 23.03] deaths/1000. Mortality generally decreased over the years of publication (p = 0.0008). Latitude correlated significantly with incidence (p = 0.0011), but not with prevalence, or mortality.
GCA incidence varies nearly 3-fold between regions and is highest in Scandinavia but not significantly. Mortality may be improving over time.
巨细胞动脉炎（GCA）是一种常见的大血管血管炎，主要发生于 50 岁以上人群。本荟萃分析旨在探讨 GCA 的发病率、患病率和死亡率的地域和时间分布。
通过 EMBASE、Scopus 和 PubMed 系统检索自建库至 2019 年的文献，纳入至少报告 50 例以上 GCA 患者且明确地理位置和时间范围的研究。纳入报道死亡率的文章，并尽可能提取标准化死亡率比（SMR）。采用随机效应模型计算平均合并患病率、发病率和 SMR。采用线性回归分析探讨纬度与发病率、患病率和死亡率之间的相关性。
共纳入 3569 篇文献，其中 107 篇符合纳入标准。50 岁以上人群中 GCA 的发病率为 10.00[9.22，10.78]例/10 万人。发病率最高的地区为斯堪的纳维亚（21.57[18.90，24.23]），其次为北美和南美（10.89[8.78，13.00]）、欧洲（7.26[6.05，8.47]）和大洋洲（7.85[-1.48，17.19]）。50 岁以上人群中 GCA 的患病率为 51.74[42.04，61.43]例/10 万人。年死亡率为 20.44[17.84，23.03]例/1000 人。死亡率随发表年份的增加而逐渐下降（p=0.0008）。纬度与发病率显著相关（p=0.0011），但与患病率和死亡率无显著相关性。
GCA 的发病率在不同地区差异近 3 倍，斯堪的纳维亚地区发病率最高，但无统计学差异。死亡率可能随时间推移而逐渐降低。
