Yao Weitao, Wei Xin, Jing Qiang, Yuan Xiaobin, Liu Fan, Zhang Xuhui
Department of Urology, The First Clinical Medical School of Shanxi Medical University, Taiyuan, Shanxi, China.
PLoS One. 2025 Jul 1;20(7):e0327343. doi: 10.1371/journal.pone.0327343. eCollection 2025.
One of the most prevalent urinary disorders worldwide, urolithiasis has symptoms and a high rate of recurrence. It has placed a significant strain on the global economy and health care system, particularly among those aged 20-54. Comprehensive research on the global burden and evolving trends of urinary calculi in the 20-54 age range is lacking.
Three important urolithiasis indicators-prevalence, incidence, and Disability-Adjusted Life Years (DALYs)-were used from the Global Burden of Disease (GBD) database between 1990 and 2021 for this study.Point estimates were provided, as well as 95% uncertainty intervals (UIs).. To assess trends in the burden of urolithiasis among the 20-54 age range, we used percentage change and estimated annual percentage change (EAPC). The time trends from 1990 to 2021 were thoroughly examined using joinpoint regression analysis. This method makes it possible to compute the annual percent change (APC) and average annual percent change (AAPC), as well as the 95% Confidence Intervals (CIs)that go with them.
The number of patients, cases, and DALYs linked to urinary stones among people aged 20-54 has significantly increased worldwide. For example, the number of urolithiasis cases increased by 48%, from 1,576,704 in 1990-2,335,010 in 2021. Comparably, the number of new cases increased by 47%, from 42,272,855 in 1990-62,269,033 in 2021. Between 1990 and 2021, the number of DALYs rose from 218,150-290,210, representing a roughly 33% increase. As of 2021, intermediate sociodemographic index (SDI) regions had the highest DALY rates, while medium-high SDI regions had the highest prevalence and incidence rates among the five SDI regions examined for this time period. Individuals between the ages of 50-54 had the greatest incidence rate within the designated cohort for that year, followed by those between the ages of 45-49 and 40-44. Across all age groups, there were noticeable gender differences, with males showing significantly greater rates than girls.
Overall, over the past 32 years, the prevalence of urolithiasis among people aged 20-54 has increased dramatically worldwide, especially in low-SDI nations and among those aged 50-54. With the goal of reducing the social and medical cost and enhancing the working-age population's quality of life and productivity, the study's findings highlight the urgent need for focused intervention techniques to prevent and treat urolithiasis in this age group. For example, in middle - high SDI areas, encourage 3 liters of water and a low - salt diet daily, especially for the over - 50s. In middle SDI areas, enhance primary care diagnostics, like using portable ultrasound. Regular screenings should be set for males in high - risk jobs, such as heat - exposed ones. However, this GBD - based study has limitations like data uncertainty, insufficient local strategies, and lack of trend tracking.
尿石症是全球最常见的泌尿系统疾病之一,有症状且复发率高。它给全球经济和医疗保健系统带来了巨大压力,尤其是在20至54岁的人群中。目前缺乏对20至54岁年龄段尿路结石全球负担和演变趋势的全面研究。
本研究使用了1990年至2021年全球疾病负担(GBD)数据库中的三个重要尿石症指标——患病率、发病率和伤残调整生命年(DALYs)。提供了点估计值以及95%的不确定性区间(UIs)。为了评估20至54岁年龄段尿石症负担的趋势,我们使用了百分比变化和估计年度百分比变化(EAPC)。使用连接点回归分析对1990年至2021年的时间趋势进行了全面检查。这种方法可以计算年度百分比变化(APC)和平均年度百分比变化(AAPC)以及与之相关的95%置信区间(CIs)。
在全球范围内,20至54岁人群中与尿路结石相关的患者数量、病例数和伤残调整生命年显著增加。例如,尿石症病例数增加了48%,从1990年的1576704例增加到2021年的2335010例。同样,新病例数增加了47%,从1990年的42272855例增加到2021年的62269033例。1990年至2021年期间,伤残调整生命年数从218150增加到290210,增长了约33%。截至2021年,在本次研究的五个社会人口指数(SDI)区域中,中等SDI区域的伤残调整生命年率最高,而中高SDI区域的患病率和发病率最高。在当年指定队列中,50至54岁的个体发病率最高,其次是45至49岁和40至44岁的个体。在所有年龄组中,存在明显的性别差异,男性的发病率明显高于女性。
总体而言,在过去32年中,全球20至54岁人群中尿石症的患病率急剧上升,尤其是在低SDI国家以及50至54岁的人群中。为了降低社会和医疗成本,提高劳动年龄人口的生活质量和生产力,研究结果凸显了迫切需要针对性的干预技术来预防和治疗该年龄组的尿石症。例如,在中高SDI地区,鼓励每天饮用3升水并采用低盐饮食,尤其是对于50岁以上的人群。在中等SDI地区,加强初级保健诊断,如使用便携式超声。应为从事高风险工作的男性,如从事高温工作的男性,定期进行筛查。然而,这项基于GBD的研究存在数据不确定性、地方策略不足和缺乏趋势跟踪等局限性。