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揭示 1990-2021 年墨西哥女性慢性肾脏病负担。

Revealing the burden of chronic kidney disease in Mexican women, 1990-2021.

机构信息

Facultad Lationoamericana de Ciencias Sociales (Sede México), Mexico City, Mexico.

Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.

出版信息

BMC Nephrol. 2024 Oct 12;25(1):346. doi: 10.1186/s12882-024-03797-3.

Abstract

BACKGROUND

Chronic kidney disease (CKD) has become a concerning public health issue, affecting people regardless of their sex, age, or socioeconomic status. We aimed to analyze the burden of female CKD in Mexico between 1990 and 2021, expressed in terms of years lived with disability (YLDs), mortality, years of life lost (YLLs), and disability-adjusted life-years (DALYs). Additionally, we evaluated the relationship between DALYs and the Socio-Demographic Index (SDI) and the Healthcare Access and Quality Index (HAQI).

METHODS

Secondary data analysis from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021. We used mortality, years of life lost due to premature mortality (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs to analyze CKD in women between 1990 and 2021. We used a log-linear segmented regression model to analyze trends in female CKD DALY rates over time. The information was disaggregated by age groups and sub-causes nationally and across the 32 states. Age-standardized rates (ASR) were used.

RESULTS

Between 1990 and 2021, the ASR mortality and ASR-DALYs due to CKD increased significantly at the national level. The DALYs are almost entirely explained by YLLs, indicating that a large proportion of women with CKD in Mexico die prematurely. Disparities in the burden of this disease were observed across different states and age groups within the country. In 2021, the highest ASR-DALY rate was recorded in Tabasco (1,972.0), while the lowest was in Sinaloa (865.1). The SDI and HAQI were associated with the CKD DALYs in most states.

CONCLUSIONS

Mexican women experience a significant burden due to CKD, reflected in premature deaths and years lived with disability, while disparities between states need to be addressed to reduce inequities. Over the past 32 years, improvements in socioeconomic indicators and the quality and access to healthcare have not contributed to reducing the DALYs rate due to CKD, indicating a need to redirect policies to impact women's well-being and health positively.

摘要

背景

慢性肾脏病(CKD)已成为一个令人关注的公共卫生问题,影响着无论性别、年龄或社会经济地位的人群。我们旨在分析 1990 年至 2021 年期间墨西哥女性 CKD 的负担,以残疾调整生命年(DALYs)、死亡率、早逝所致生命损失年(YLLs)和失能生命年(YLDs)表示。此外,我们还评估了 DALYs 与社会发展指数(SDI)和卫生保健获取和质量指数(HAQI)之间的关系。

方法

对 2021 年全球疾病、伤害和危险因素研究(GBD)的二次数据分析。我们使用死亡率、早逝所致生命损失年(YLLs)、残疾调整生命年(YLDs)和残疾调整生命年(DALYs)来分析 1990 年至 2021 年期间女性 CKD 的情况。我们使用对数线性分段回归模型来分析女性 CKD DALY 率随时间的变化趋势。信息按年龄组和国家及 32 个州进行了细分。使用年龄标准化率(ASR)。

结果

1990 年至 2021 年,全国范围内 CKD 的 ASR 死亡率和 ASR-DALY 显著上升。DALYs 几乎完全由 YLLs 解释,这表明墨西哥患有 CKD 的女性中有很大一部分过早死亡。在不同的州和全国的不同年龄组中观察到这种疾病负担的差异。2021 年,塔巴斯科州的 ASR-DALY 率最高(1972.0),而锡那罗亚州的最低(865.1)。社会发展指数和卫生保健获取和质量指数与大多数州的 CKD DALY 相关。

结论

墨西哥女性因 CKD 而承受着巨大的负担,表现为过早死亡和失能生命年,而各州之间的差异需要得到解决,以减少不平等。在过去的 32 年中,社会经济指标的改善以及卫生保健的质量和获取并没有有助于降低 CKD 的 DALY 率,这表明需要调整政策,以积极影响妇女的福祉和健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef52/11470595/5939dc265143/12882_2024_3797_Fig1_HTML.jpg

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