1990 年至 2021 年按严重程度和病因划分的贫血负担的流行率、残疾生存年数和趋势：来自 2021 年全球疾病负担研究的结果。
Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021.
出版信息
Lancet Haematol. 2023 Sep;10(9):e713-e734. doi: 10.1016/S2352-3026(23)00160-6. Epub 2023 Jul 31.
BACKGROUND
Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories.
METHODS
We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021.
FINDINGS
In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9-24·7), corresponding to 1·92 billion (1·89-1·95) prevalent cases, compared with a prevalence of 28·2% (27·8-28·5) and 1·50 billion (1·48-1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1-75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1-612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2-123·7]), and other neglected tropical diseases (36·3 [24·4-52·8]), collectively accounting for 84·7% (84·1-85·2) of anaemia YLDs.
INTERPRETATION
Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention.
FUNDING
Bill & Melinda Gates Foundation.
背景
贫血是全球范围内的一个主要健康问题。全球贫血负担估计数对于制定适当的干预措施以实现当前国际疾病缓解目标至关重要。我们描述了 204 个国家和地区的贫血患病率、残疾生命年（YLDs）以及贫血及其潜在原因的趋势。
方法
我们根据年龄和性别，估算了 1990 年至 2021 年每个地点的血红蛋白浓度人群分布。然后，我们根据严重程度和相关的 YLDs 计算了贫血负担。结合贫血原因的流行情况以及与血红蛋白浓度相关的具体病因变化，我们使用 2021 年全球疾病负担研究中的数据，对所有地点、年份和人群的 37 种潜在病因导致的贫血比例进行了建模。
发现
2021 年，所有年龄段的全球贫血患病率为 24.3%（95%置信区间 [95%UI] 23.9-24.7），对应的患者人数为 19.2 亿（1.89-1.95），而 1990 年的患病率为 28.2%（27.8-28.5）和 1.50 亿（1.48-1.52）。年龄、性别和地理位置的贫血负担存在很大差异，年龄在 5 岁以下的儿童、女性以及撒哈拉以南非洲和南亚地区的国家受到的影响尤其严重。2021 年，贫血导致了 5200 万（3510-7510）个 YLDs，贫血导致的 YLD 率随着社会人口指数的增加而降低。2021 年，导致贫血 YLDs 的最常见原因是膳食铁缺乏（每 10 万人贫血特异病因 YLD 率：422.4[95%UI 286.1-612.9]）、血红蛋白病和溶血性贫血（89.0[58.2-123.7]）和其他被忽视的热带病（36.3[24.4-52.8]），这三种病因合计占贫血 YLDs 的 84.7%（84.1-85.2）。
解释
贫血仍然是一个严重的全球健康挑战，其存在着持续的年龄、性别和地理位置上的差异。对特定病因贫血负担的估计可以用于设计具有当地针对性的卫生干预措施，旨在改善贫血管理和预防。
资助
比尔及梅琳达·盖茨基金会。
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