目的 评估中医药临床研究是否与我国主要疾病负担相关。 方法 首先从1999年－2004年出版的13种中医、中西医结合杂志中手工检索出随机对照试验（RCT），并提取出杂志名称、出版年限、治疗的疾病类别及样本含量等数据。然后采用死亡率和伤残调整寿命年（DALY）作为衡量标准，统计2002年我国疾病负担前30位病因的RCT数量，采用秩相关分析这些疾病负担与发表的中医药RCT及其受试者数量的关系。 结果 最终确认7 422个RCT，约38%的RCT来自于3种国家级杂志。这些RCT覆盖了我国疾病负担中的主要病种，其中4 280个RCT（57.7%）研究前30位病因合并产生的42个病种，只有3个病种（7%）没有任何RCT研究。采用DALY得到的相关系数分别是0.108（P=0.569）、0.092（P=0.628），通过死亡率产生的相关系数分别是0.453（P=0.012）、0.536（P=0.002）。 结论 中医药RCT与采用死亡率衡量的疾病负担明显相关，但采用DALY分析却未发现二者存在相关性。中医药临床研究可能更注重死亡率高的病种，一定程度上忽略了DALY衡量的疾病负担。
ObjectiveTo systematically review the disease burden and epidemiological characteristics of diabetes mellitus in Chinese population, and to provide references for health resources allocation and health policy making. MethodsDatabases such as PubMed, EMbase, CNKI, VIP and WanFang Data were searched for studies investigating disease burden of diabetes mellitus in Chinese population up to January 1st, 2014. According to the inclusion and exclusion criteria, two researchers screened literature, exacted data, and assessed methodological quality of included studies. Statistical analysis was performed with the data of diabetes associated population, mortality and disease burden were analyzed. ResultsA total of 39 studies were included, one of which was not included for further qualitative analysis due to low quality. The results of qualitative analysis involving 38 studies showed that, since 1980, the prevalence of diabetes increased rapidly in China, especially in the younger age group. The disease burden of woman was higher than that of man; it was slightly higher in the city than in the countryside; but the gap between urban and rural areas was gradually narrowed. Disease burdens in Eastern, Central and Western regions orderly decreased, all of which were all at high levels. ConclusionThe disease burden of diabetes mellitus in China is seriously high and the prevention and control work is very hard. It is necessary to rationally and effectively allocate health resources based on different health demands in different regions among urban-rural and age groups; to reduce the burden in the elderly; and to pay more attention to the young age population at the same time. Besides, the emphasis of prevention should be placed on suppressing the increase of prevalence of diabetes mellitus and reducing disease burden due to its complications.
ObjectiveTo systematically review the disease burden of pneumoconiosis in Chinese population so as to provide references for health resources allocation and health policy making.MethodsDatabases including PubMed, EBSCO, Web of Science, CNKI, WanFang Data and VIP databases were searched for studies on investigation of the disease burden of pneumoconiosis in Chinese population from inception to 31st January, 2020. Two reviewers independently screened literature, exacted data, and assessed risk of bias of included studies. Systematic review was performed on data of pneumoconiosis associated population, mortality, and disease burden.ResultsA total of 26 studies were included. Qualitative analysis showed that the decrease of DALY and YLL of pneumoconiosis in China had been lower than that in globally, and the increase of YLD had been higher than that in globally in recent 10 years. 14 factors were included in the analysis of influencing factors on the financial burden or hospitalization expenses of pneumoconiosis patients; among them, the length of hospitalization, related complications, and pneumoconiosis stage were the most important indexes which had influence or difference on patients’ financial burden (or hospitalization expenses). The burden of pneumoconiosis in the Chinese population was primarily concentrated on males. Occupational diseases caused most of them, and middle-aged and older adults were the primary population for pneumoconiosis. However, young patients due to early-onset age, long course of disease and complications, and other factors resulting in a larger YLD phenomenon should also be considered.ConclusionsThe disease burden of pneumoconiosis patients in China is still heavy. It is recommended to continue to reduce the DALY of pneumoconiosis among the Chinese population as a long-term goal, and to strengthen control strategies to curb the early onset and death of pneumoconiosis.
ObjectiveTo analyze the trend of disease burden of colorectal cancer (CRC) in China from 1990 to 2019.MethodsData was obtained from Global Burden of Disease Study 2019 (GBD 2019). Incidence, mortality, disability-adjusted life year (DALY), years of life lost (YLL), years lived with disability (YLD), and their corresponding standardized rate and annual average percentage change (AAPC) were used to describe the changes of disease burden of colorectal cancer in Chinese population between 1990 and 2019.ResultsCompared with 1990, the number of new cases, standardized incidence, the number of deaths and standardized mortality of CRC in China in 2019 increased by 474.03%, 144.01%, 230.14%, and 36.15%, respectively. The standardized mortality and standardized incidence of CRC in China had reached and gradually exceeded the global level since 2010. From 1990 to 2019, the overall standard incidence (AAPC=3.6%, P<0.05), standard mortality rate (AAPC=1.4%, P<0.05), and the standard DALY rate (AAPC=1.2%, P<0.05) of CRC in China showed an increasing trend. The incidence, mortality and DALY rates of males were higher than those of females, and gradually increased with age. Compared with 1990, the DALY, YLL, and YLD of CRC in 2019 increased by 134.3%, 127.69%, and 445.00%, and their corresponding standardized rates increased by 30.53%, 27.03%, and 187.29%, respectively, showing an overall upward trend.ConclusionsFrom 1990 to 2019, the standardized incidence rate and standardized mortality rate of colorectal cancer in China have had a continuously increasing trend, and males and the elderly are high-risk groups. To reduce the burden of colorectal cancer in China, effective measures should be taken for prevention and management.
ObjectiveTo analyze the variation trend of high low density lipoprotein cholesterol (LDL-C) attribution disease burden in China from 1990 to 2019. MethodsThe burden of disease indicators from Global Burden of Disease 2019 (GBD 2019), such as death attributable to high LDL-C, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lost to disability (YLDs) were extracted. The age was standardized using GBD 2019 global standard population, and the trend of rates with the annual percentage change (APC) was analyzed. ResultsFrom 1990 to 2019, the disease burden of high LDL-C increased with age in China. The mortality rate, DALYs rate and YLLs rate of males were higher than those of females, while the YLDs rate of males was lower than that of females. Joinpoint regression results showed that from 1990 to 2019, the high LDL-C attribution mortality rate (APC=3.4%, P<0.05), DALYs rate (APC=2.4%, P<0.05), YLLs rate (APC=2.4%, P<0.05), YLDs rate (APC = 2.9%, P<0.05), the standardized mortality rate (APC=0.8%, P<0.05) and the standardized YLDs rate (APC=0.7%, P<0.05) all increased in China. Regarding age, the mortality rate, DALYs rate and YLLs rate increased in the age group over 70 years old, while the YLDs rate increased significantly in the age group over 45 years old. ConclusionFrom 1990 to 2019, the burden of disease attributable to high LDL-C in China has become increasingly heavy, and the burden varies according to gender and age.
Objective To analyze the burden of cardiovascular diseases (CVDs) and its trend attributed to household air pollution (HAP) from solid fuels in China from 1990 to 2019. Methods Using the data derived from the Global Burden of Disease Study 2019 (GBD 2019), including mortality rates, disability-adjusted life years (DALY), age-standardized mortality rates, age-standardized DALY rates, annual percentage change (APC), and average annual percentage change rate (AAPC), we analyzed the CVD burden and its trend attributed to HAP in China from 1990 to 2019. Results In 2019, HAP in China resulted in 227 000 deaths and 5 182 200 DALYs of CVD; the mortality rate attributed to HAP was 15.96 per 100 000, and the DALY rate was 364.34 per 100 000. In 2019, the age-standardized mortality and DALY rates in China were 12.52 and 262.65 per 100 000, respectively, which were lower than the rates globally, and the rates for males were higher than those for females (13.90 vs. 11.32 per 100 000, 291.76 vs. 234.50 per 100 000). In 2019, both mortality and DALY rates attributed to HAP increased with age, peaking in the age groups of 95 plus and 85-89, respectively. From 1990 to 2019 in China, both age-standardized mortality and DALY rates of CVD attributed to HAP showed a downward trend over time. The average annual percentage change rate (AAPC) of the age-standardized mortality rate was −6.0% (95%CI: −6.2% to −5.8%), and the APCC of the age-standardized DALY rate was −5.8% (95%CI: −6.1% to −5.6%). The burden of the CVD subclass also showed a downward trend. Conclusion From 1990 to 2019, the burden of CVD attributed to HAP from solid fuels in China shows a significant downward trend, with sex and age differences. Females and the elderly are the key groups of disease burden, so effective interventions should be taken for these groups.
ObjectiveTo analyze the disease burden and development trend of non-Hodgkin lymphoma (NHL) in China from 1990 to 2019. MethodsThe changes of incidence, mortality, disability-adjusted life years (DALY) and their corresponding age-normalization rates for NHL were analyzed by using the 2019 Global Burden of Disease Database. Regression analysis was performed by Joinpoint software to calculate annual percentage change (APC) and average annual percentage change (AAPC) of standardized morbidity, standardized mortality, standardized DALY rate to reflect the change trend of disease burden. And the results were compared with global data. ResultsFrom 1990 to 2019, the disease burden of NHL in China showed an overall increasing trend. Compared with 2019, the standard incidence rate, standard mortality rate and standard DALY rate of NHL in China increased by 144.72%, 27.17% and 15.61%, respectively. The annual rates of change were 3.12%, 0.80% and 0.51%, respectively. There were gender and age differences in disease burden. The burden of disease increased with age, and the burden of disease was higher in males than in females. ConclusionThe disease burden of NHL in China shows an increasing trend from 1990 to 2019. With the development of diagnosis and treatment options, the disease burden has decreased in recent years, but it is still higher than the global level. There is still a need to strengthen research on its pathogenesis and treatment options, and to actively intervene in high-risk groups to reduce the disease burden of NHL.
Objective To systematically review the epidemic trend and disease burden of ischemic stroke in the Chinese population and to provide references for formulating reasonable prevention and treatment measures and allocating health resources. Methods Based on Global Burden of Disease (GBD) data, we analyzed the morbidity, mortality, disability-adjusted life year (DALY) and normalized rates for ischemic stroke in China from 1990 to 2019 and evaluated the changes in the disease burden by sex and age group. Meanwhile, joinpoint regression model was constructed to analyze the time trend change in each stage during the study period. Results Compared with 1990, the incidence, mortality and DALY rate of ischemic stroke in China increased by 171.68%, 125.60% and 98.60% in 2019, among which the incidence, mortality and DALY rate of males increased by 184.29%, 148.96% and 115.16%, respectively; the morbidity, mortality and DALY rates of females increased by 160.9%, 101.32% and 81.44%, respectively. The age-standardized incidence increased by 34.70%, while the age-standardized mortality and age-standardized DALY rate decreased by 3.33% and 4.02%, respectively; the age-standardized incidence, mortality and DALY rates of males increased by 39.52%, 8.03% and 3.68%, respectively; the age-standardized incidence rate of females increased by 31.40%, while the age-standardized mortality rate and age-standardized DALY rate decreased by 14.02% and 11.53%, respectively. In 2019, both the mortality rate and DALY rate due to ischemic stroke increased with age, and the highest rate was found in the population over 85 years old. Males over 60 years old were significantly than females. In the 55-84 age group, the incidence of ischemic stroke in females was higher than that in males, while in the 85 and above age group, the incidence of ischemic stroke in females was lower than that in males. The AAPC of age-standardized incidence, age-standardized mortality, and age-standardized DALY rates due to ischemic stroke from 1990 to 2019 were 1.06% (95%CI 1.00% to 1.11%), 0.01% (95%CI −0.45% to 0.48%) and −0.16% (95%CI −0.53% to 0.22%), respectively. All indicators of the AAPC for males were higher than those for females. ConclusionThe curvent age-standardized mortality and DALY rate of ischemic stroke in China have decreased slightly compared with 1990. The crude mortality, morbidity and disease burden have significantly increased. All indicators of the AAPC for males were higher than those for females. To reduce the epidemic trend and disease burden of ischemic stroke, reasonable prevention and treatment measures and rational allocation of health resources should be made according to sex and age.