School of Public Health, Weifang Medical University, Weifang, China.
Hospital infection management office, The Second People's Hospital of Lianyungang Lianyungang, China.
J Glob Health. 2021 Dec 30;11:08011. doi: 10.7189/jogh.11.08011. eCollection 2021.
Alcohol use disorders (AUD) has long been one of the most disability mental disorders and a major cause of health loss.
Based on open access data from the 2019 Global Burden of Disease (GBD 2019) study, we extracted data of years lived with disability (YLD), years of life lost (YLL) and disability-adjusted life years (DALY) to describe the changes of AUD burden over the period of 1990-2019 stratified by sex in globe, high-income countries (HICs), upper-middle income countries (UMCs), lower-middle income countries (LMCs), low-income countries (LICs) and China. We used Joinpoint regression model to fit the changing trend of years. And pairwise comparison was applied to test the coincidence parallelism and judge whether the difference of the trend among different regions is statistically significant.
LMCs experienced the largest changes in the YLD rate of AUD from 1990 to 2019 (average annual percent change (AAPC) = -0.7, 95% confidence interval (CI) = -0.8, -0.7, < 0.05), with China experienced a higher increase in 1990 to 1993 (annual percent change (APC) = 3.8, 95% CI = 3.2, 4.4, < 0.05) than other regions, and the rate of decline in China from 1996 to 2002 (APC = -3.4, 95% CI = -3.6, -3.1, < 0.05) was higher than that in other regions. UMCs experienced the largest changes in the YLL rate of AUD from 1990 to 2019 (AAPC = -1.1, 95% CI = -1.6, -0.6, < 0.05), with a larger decline in 2004 to 2012 (APC = -6.2, 95% CI = -6.7, -5.7, P < 0.05) than other regions, and China experienced a larger increase in the rate of YLL from 1999 to 2004 (APC = 9.2, 95% CI = 8.5, 9.9, P < 0.05) than other regions. LMCs experienced the largest changes in the DALY rate of AUD from 1990 to 2019 (AAPC = -0.9, 95% CI = -1.0, -0.8, P < 0.05), with a larger decline in 2006 to 2010 (APC = -3.3, 95% CI = -3.6, -2.9, P < 0.05) than other regions, and UMCs showed a larger increase in the rate of DALY from 1990 to 1994 (APC = 4.5, 95% CI = 3.8, 5.1, P < 0.05) than other regions.
Given the large variations in AUD burden of disease by income level, future strategies to prevent and reduce the burden should be developed and implemented based on country-specific development status.
酒精使用障碍（AUD）一直是最具残疾性的精神障碍之一，也是健康损失的主要原因。
基于 2019 年全球疾病负担（GBD 2019）研究的公开数据，我们提取了残疾生命年（YLD）、生命损失年（YLL）和伤残调整生命年（DALY）的数据，以描述 1990-2019 年全球、高收入国家（HICs）、上中等收入国家（UMCs）、下中等收入国家（LMCs）、低收入国家（LICs）和中国按性别分层的 AUD 负担变化情况。我们使用 Joinpoint 回归模型拟合年变化趋势。并采用两两比较检验趋势的一致性和平行性，判断不同地区的趋势差异是否具有统计学意义。
LMCs 在 1990-2019 年 AUD 的 YLD 率变化最大（平均年度百分比变化（AAPC）=-0.7，95%置信区间（CI）=-0.8，-0.7，<0.05），其中中国在 1990-1993 年的增幅更高（年度百分比变化（APC）=3.8，95%CI=3.2，4.4，<0.05），而在 1996-2002 年中国的下降率更高（APC=-3.4，95%CI=-3.6，-3.1，<0.05）。UMCs 在 1990-2019 年 AUD 的 YLL 率变化最大（AAPC=-1.1，95%CI=-1.6，-0.6，<0.05），其中 2004-2012 年降幅更大（APC=-6.2，95%CI=-6.7，-5.7，P<0.05），而中国在 1999-2004 年 YLL 率的增幅更大（APC=9.2，95%CI=8.5，9.9，P<0.05）。LMCs 在 1990-2019 年 AUD 的 DALY 率变化最大（AAPC=-0.9，95%CI=-1.0，-0.8，P<0.05），其中 2006-2010 年降幅更大（APC=-3.3，95%CI=-3.6，-2.9，P<0.05），而 UMCs 在 1990-1994 年 DALY 率的增幅更大（APC=4.5，95%CI=3.8，5.1，P<0.05）。
鉴于 AUD 疾病负担在收入水平上存在较大差异，未来应根据各国的发展状况制定和实施预防和减轻负担的战略。
