1990年至2021年204个国家和地区尿路结石负担的趋势及性别差异
Trends and sex disparities in the burden of urolithiasis in 204 countries and territories, 1990-2021.
作者信息
Zheng Junjiong, Zhang Qihang, Zhang Jie, Yao Yuhui, Chen Li, Liu Yunfei, Song Yi, Lin Tianxin, He Guohua
机构信息
Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong Provincial Clinical Research Center for Urological Diseases, Guangzhou, Guangdong 510120, China.
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100091, China.
出版信息
Chin Med J (Engl). 2025 Aug 20;138(16):1973-1983. doi: 10.1097/CM9.0000000000003622. Epub 2025 Jul 17.
BACKGROUND
Urolithiasis is a widespread disease with a high prevalence worldwide. This study aims to evaluate the disease burden of urolithiasis and its trends from 1990 to 2021 globally, based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database.
METHODS
The numbers and age-standardized rates (ASRs) of incidence, disability-adjusted life years (DALYs), and mortality of urolithiasis were extracted from GBD 2021 to represent the disease burden. Joinpoint regression analyses were conducted to assess the temporal trends in the burden of urolithiasis. The male-to-female ASR ratio indices were used to evaluate sex disparities. Additionally, we explored the relationship between the ASR ratio and the sociodemographic index (SDI).
RESULTS
The total numbers of incidence, DALY, and mortality of urolithiasis were 105,983,780 cases (95% uncertainty interval [UI] = 88,349,356-128,645,155 cases), 693,444 cases (95% UI = 567,765-850,490 cases), and 17,672 cases (95% UI = 13,932-21,241 cases), respectively, in 2021. There is an increasing trend in the number of these measures globally, whereas the ASRs have decreased over the past 30 years. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were significantly higher in males than in females in 2021. The sex disparities in the age-standardized DALY rate (ASDR) and ASMR of urolithiasis were negatively correlated with the SDI. In 2021, the ASIR of urolithiasis was 964.70 (95% UI = 801.26-1175.09) per 100,000 people in China, which is much lower than the global average (1242.84 [95% UI = 1034.94-1506.99] per 100,000 people). Compared with the global average, a more pronounced decline in ASIR was observed in China from 1793.16 (1446.0-2235.14) in 1990 to 964.70 (801.26-1175.09) per 100,000 people in 2021.
CONCLUSIONS
Urolithiasis poses a significant healthcare burden worldwide. More robust global and national strategies are warranted to address the prevention and treatment, especially in low SDI countries and regions.
背景
尿石症是一种在全球范围内广泛流行的疾病。本研究旨在基于《2021年全球疾病、伤害及风险因素负担研究》（GBD 2021）数据库，评估1990年至2021年全球尿石症的疾病负担及其趋势。
方法
从GBD 2021中提取尿石症的发病率、伤残调整生命年（DALYs）和死亡率的数量及年龄标准化率（ASRs），以代表疾病负担。进行Joinpoint回归分析，以评估尿石症负担的时间趋势。使用男性与女性的ASR比率指数来评估性别差异。此外，我们还探讨了ASR比率与社会人口指数（SDI）之间的关系。
结果
2021年，尿石症的发病总数、DALY总数和死亡总数分别为105,983,780例（95%不确定区间[UI]=88,349,356 - 128,645,155例）、693,444例（95% UI = 567,765 - 850,490例）和17,672例（95% UI = 13,932 - 21,241例）。全球这些指标的数量呈上升趋势，而在过去30年中ASRs有所下降。2021年，男性的年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR）显著高于女性。尿石症的年龄标准化DALY率（ASDR）和ASMR的性别差异与SDI呈负相关。2021年，中国尿石症的ASIR为每10万人964.70（95% UI = 801.26 - 1175.09）例，远低于全球平均水平（每10万人1242.84 [95% UI = 1034.94 - 1506.99]例）。与全球平均水平相比，中国的ASIR从1990年的每10万人1793.16（1446.0 - 2235.14）例下降到2021年的每10万人964.70（801.26 - 1175.09）例，下降更为明显。
结论
尿石症在全球范围内造成了重大的医疗负担。需要更有力的全球和国家战略来应对预防和治疗问题，特别是在低SDI国家和地区。
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