Department of ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
BMC Public Health. 2021 Nov 1;21(1):1975. doi: 10.1186/s12889-021-12055-2.
To estimate the global disease burden of uncorrected refractive error (URE) among adolescents and assess the contributions of various risk factors to disability-adjusted life-years (DALYs) due to URE.
Global, regional and country-level DALY numbers and rates due to URE among adolescents were acquired from the Global Burden of Disease Study 2019 database. Human Development Index (HDI), Socio-Demographic Index (SDI) and other country-level data were obtained from other open databases as potential indicators. Regression analysis was used to evaluate associations between DALY rates among adolescents and potential predictors.
Global DALYs due to URE among adolescents rose by 8% between 1990 and 2019 but moderately decreased by 4.8% during this period after adjusting for population size. Female adolescents showed higher DALY rates. DALY rates sharply increased from 5 to 9 years of age, then rose more slowly, reaching a plateau before 20 years of age. Country-level DALY rates in 2019 were positively associated with HDI, SDI, and urbanization rates but negatively correlated with primary school dropout rates. Higher disease burden of adolescents visually impaired from URE was associated with lower primary school dropout rates (β = - 0.257, 95% CI - 0.376 to - 0.138, P < 0.001) and higher urbanization rates (β = 0.257, 95% CI 0.067 to 0.256, P = 0.001).
Higher socioeconomic status, urbanization rates and education levels are associated with a heavier disease burden of URE among adolescents. The findings of this study can provide a reference for policy making on resource allocation for URE prevention and control in teenagers.
估计青少年未矫正屈光不正（URE）的全球疾病负担，并评估各种风险因素对 URE 所致残疾调整生命年（DALY）的贡献。
从 2019 年全球疾病负担研究数据库中获取全球、区域和国家青少年 URE 所致 DALY 数量和率。人类发展指数（HDI）、社会发展指数（SDI）和其他国家数据从其他开放数据库中获取，作为潜在指标。回归分析用于评估青少年 DALY 率与潜在预测因子之间的关联。
1990 年至 2019 年期间，青少年 URE 所致全球 DALY 增加了 8%，但在考虑人口规模后，这一期间略有下降 4.8%。女性青少年的 DALY 率更高。DALY 率从 5 岁到 9 岁急剧上升，然后上升速度放缓，在 20 岁之前达到平台期。2019 年的国家 DALY 率与 HDI、SDI 和城市化率呈正相关，与小学辍学率呈负相关。青少年 URE 致盲的疾病负担较高与较低的小学辍学率（β=-0.257，95%CI-0.376 至-0.138，P<0.001）和较高的城市化率（β=0.257，95%CI0.067 至 0.256，P=0.001）相关。
较高的社会经济地位、城市化率和教育水平与青少年 URE 负担较重相关。本研究结果可为青少年 URE 预防和控制资源分配的政策制定提供参考。
