Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Front Public Health. 2023 Apr 17;11:1138428. doi: 10.3389/fpubh.2023.1138428. eCollection 2023.
OBJECTIVES: This study aims to estimate the trends and disparities in the worldwide burden for health of AMD, overall and by age, sex, socio-demographic index (SDI), region, and nation using prevalence and years lived with disability (YLDs) from Global Burden of Disease (GBD) study 2019. METHODS: This retrospective study presents the prevalent AMD cases and YLDs from 1990-2019, as well as the age-standardized prevalence rate (ASPR) and age-standardized YLD rate (ASYR) of AMD. To measure changes over time, estimated annual percentage changes (EAPCs) of the age-standardized rates (ASRs) were analyzed globally, then studied further by sex, SDI, region, and nation. We included data from the 2019 Global Burden of Disease (GBD) database to examine AMD prevalence and YLDs from 1990-2019 in 204 countries and territories, as well as demographic information such as age, sex, SDI, region, and nation. RESULTS: Globally, the number of prevalent AMD cases increased from 3,581,329.17 (95% uncertainty interval [UI], 3,025,619.4-4,188,835.7) in 1990 to 7,792,530 (95% UI, 6,526,081.5-9,159,394.9) in 2019, and the number of YLDs increased from 296,771.93 (95% uncertainty interval [UI], 205,462.8-418,699.82) in 1990 to 564,055.1 (95% UI, 392,930.7-789,194.64) in 2019. The ASPR of AMD had a decreased trend with an EAPC of -0.15 (95% confidence interval [CI], -0.2 to -0.11) from 1990 to 2019, and the ASYR of AMD showed a decreased trend with an EAPC of -0.71 (95% confidence interval [CI], -0.78 to -0.65) during this period. The prevalence and YLDs of AMD in adults over 50 years of age showed a significant increase. The prevalence and YLDs of AMD were significantly higher in females than males, overall. The ASPRs and ASYRs in low SDI regions was greater than in high SDI regions from 1990 to 2019. In addition, increases in prevalence and YLDs differed by regions and nations, as well as level of socio-economic development. CONCLUSION: The number of prevalent cases and YLDs due to AMD increased over 30 years and were directly linked to age, sex, socio-economic status, and geographic location. These findings can not only guide public health work but also provide an epidemiological basis for global strategy formulation regarding this global health challenge.
目的：本研究旨在使用 2019 年全球疾病负担研究（GBD）的数据，评估全球年龄相关性黄斑变性（AMD）的疾病负担趋势和差异，包括总体情况以及按年龄、性别、社会人口指数（SDI）、地区和国家划分的情况，使用的指标为患病率和伤残调整生命年（YLDs）。
方法：本回顾性研究报告了 1990 年至 2019 年的 AMD 发病病例和 YLDs，以及 AMD 的年龄标准化患病率（ASPR）和年龄标准化 YLD 率（ASYR）。为了衡量随时间的变化，我们分析了全球年龄标准化率（ASRs）的估计年变化百分比（EAPCs），然后按性别、SDI、地区和国家进一步研究。我们纳入了 2019 年全球疾病负担（GBD）数据库的数据，以研究 204 个国家和地区 1990 年至 2019 年的 AMD 患病率和 YLDs，以及年龄、性别、SDI、地区和国家等人口统计信息。
结果：全球范围内，AMD 的发病病例数从 1990 年的 3581329.17（95%置信区间 [CI]，3025619.4-4188835.7）增加到 2019 年的 7792530（95%CI，6526081.5-9159394.9），YLDs 从 1990 年的 296771.93（95%CI，205462.8-418699.82）增加到 2019 年的 564055.1（95%CI，392930.7-789194.64）。AMD 的 ASPR 呈下降趋势，EAPC 为-0.15（95%CI，-0.2 至-0.11），1990 年至 2019 年期间，ASYR 呈下降趋势，EAPC 为-0.71（95%CI，-0.78 至-0.65）。50 岁及以上成年人的 AMD 患病率和 YLDs 显著增加。总体而言，女性的 AMD 患病率和 YLDs 明显高于男性。1990 年至 2019 年，低 SDI 地区的 ASPRs 和 ASYRs 高于高 SDI 地区。此外，患病率和 YLDs 的增加因地区和国家以及社会经济发展水平而异。
结论：30 多年来，AMD 的发病病例和 YLDs 数量增加，与年龄、性别、社会经济地位和地理位置直接相关。这些发现不仅可以指导公共卫生工作，还可以为制定全球战略提供流行病学依据，以应对这一全球性健康挑战。
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