Hu Pengcheng, He Ming, Cai Junyang, Lin Zequn, Zheng Shiying, Zhuang Zihao, Liu Jialing, Huang Luoming
Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Ophthalmology, Dazhou Integrated Traditional Chinese and Western Medicine Hospital, Dazhou, China.
Tob Induc Dis. 2025 Jul 11;23. doi: 10.18332/tid/205665. eCollection 2025.
Smoking is a major modifiable risk factor for age-related macular degeneration (AMD); however, the long-term trends and sociodemographic disparities in its global burden remain insufficiently characterized. This study aimed to assess the evolving burden of smoking-associated AMD from 1990 to 2021 and project its trajectory to 2040.
Data from the Global Burden of Disease (GBD) 2021 database were used to extract smoking-associated AMD burden, measured by years lived with disability (YLDs) and age-standardized YLDs rate (ASYLDsR). Trends were stratified by sociodemographic index (SDI) and GBD super-regions, analyzed via estimated annual percentage change (EAPC), and projected using an autoregressive integrated moving average (ARIMA) model.
In 2021, the global burden of smoking-associated AMD reached 58858 YLDs (a 47.1% increase from 1990), with an ASYLDsR of 2.47 per 100000 population. The burden in males significantly exceeded the female burden (45442 vs 13417 YLDs in 2021), with a widening disparity. YLDs peaked in the age group of 65-69 years (12528 cases), while ASYLDsR increased with age. East Asia had the highest cases (23248 cases, 39.5% of the global total), whereas Central Asia exhibited rising ASYLDsR. ARIMA projections estimated global YLDs to rise to 72574 (95% CI: 61319-83828) by 2040, with ASYLDsR declining to 1.54 per 100000 (95% CI: 0.90-2.17).
The burden of smoking-associated AMD demonstrates marked demographic and geographical heterogeneity. Aging populations drive rising absolute case numbers, while disparities in tobacco control policies contribute to regional divergence in ASYLDsR.
吸烟是年龄相关性黄斑变性（AMD）的一个主要可改变风险因素；然而，其全球负担的长期趋势和社会人口统计学差异仍未得到充分描述。本研究旨在评估1990年至2021年吸烟相关AMD负担的演变情况，并预测其到2040年的发展轨迹。
使用全球疾病负担（GBD）2021数据库的数据来提取吸烟相关AMD负担，以伤残调整生命年（YLDs）和年龄标准化YLD率（ASYLDsR）衡量。趋势按社会人口统计学指数（SDI）和GBD超级区域进行分层，通过估计年百分比变化（EAPC）进行分析，并使用自回归积分移动平均（ARIMA）模型进行预测。
2021年，吸烟相关AMD的全球负担达到58858个YLDs（比1990年增加了47.1%），ASYLDsR为每10万人2.47。男性的负担显著超过女性负担（2021年分别为45442和13417个YLDs），且差距在扩大。YLDs在65 - 69岁年龄组达到峰值（12528例），而ASYLDsR随年龄增长而增加。东亚的病例数最多（23248例，占全球总数的39.5%），而中亚的ASYLDsR呈上升趋势。ARIMA预测估计，到2040年全球YLDs将增至72574（95%置信区间：61319 - 83828），ASYLDsR降至每10万人1.54（95%置信区间：0.90 - 2.17）。
吸烟相关AMD的负担表现出明显的人口统计学和地理异质性。人口老龄化导致绝对病例数上升，而烟草控制政策的差异导致ASYLDsR的区域差异。
