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中国居民1990 — 2019年乙型病毒性肝炎及其危险因素所致疾病负担变化趋势分析

Changing trends in disease burden of viral hepatitis B and its risk factors among Chinese residents from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019

    摘要
  • 摘要:
    目的 分析中国居民1990 — 2019年乙型病毒性肝炎（乙肝）及其危险因素所致疾病负担的变化趋势，为乙肝的预防控制提供参考依据。
    方法 收集2019年全球疾病负担研究（GBD 2019）中1990 — 2019年中国居民乙肝疾病负担及其危险因素相关数据，采用乙肝标化发病率、标化患病率、标化死亡率和标化伤残调整寿命年（DALYs）率等指标进行描述性分析，并采用Joinpoint回归模型分析中国居民1990 — 2019年乙肝及其吸烟、饮酒、吸毒和高体质指数4种危险因素所致疾病负担的变化趋势。
    结果 中国居民1990 — 2019年乙肝标化发病率、标化患病率、标化死亡率和标化DALYs率均呈下降趋势（AAPC = – 2.29%、 – 2.13%、 – 3.82%和 – 3.98%，均P < 0.001），分别从1990年的2725.98/10万、12239.53/10万、24.67/10万和793.38/10万下降至2019年的1397.31/10万、6566.12/10万、8.07/10万和247.71/10万，下降速度虽快于全球居民但乙肝标化发病率、标化患病率、标化死亡率和标化DALYs率水平仍高于全球居民；不同性别居民乙肝标化发病率（AAPC男性 = – 2.14%和AAPC女性 = – 2.49%）、标化患病率（AAPC男性 = – 2.04%和AAPC女性 = – 2.26%）、标化死亡率（AAPC男性 = – 3.48%和AAPC女性 = – 4.82%）、标化DALYs率（AAPC男性 = – 3.63%和AAPC女性 = – 5.15%）整体均呈下降趋势（均P < 0.001），且男性居民疾病负担高于女性居民；与1990年相比，2019年归因于吸烟、饮酒、吸毒和高体质指数的乙肝标化死亡率和标化DALYs率均呈下降趋势（均P < 0.01），标化死亡率的变化率分别为 – 62.20%、 – 62.01%、 – 44.44%和 – 18.18%，标化DALYs率的变化率分别为 – 63.90%、 – 63.54%、 – 47.71%和 – 18.76%。
    结论 中国居民1990 — 2019年乙肝疾病负担虽有下降但仍高于全球居民，对吸烟、饮酒、吸毒和高体质指数的男性居民仍需重点加以关注。

     

    Abstract:
    Objective To analyze the changing trends of the disease burden of viral hepatitis B (HB) and its risk factors among Chinese residents from 1990 to 2019, to provide a reference for HB prevention and control.
    Methods Data on the disease burden of HB and its risk factors among Chinese residents from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). Descriptive statistics were performed using standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rate of HB. Joinpoint regression model was used to analyze the trends of disease burden of HB attributable to smoking, alcohol consumption, drug abuse, and high body mass index (BMI) among Chinese residents from 1990 to 2019.
    Results During the 30-year period among Chinese residents there were significant decreasing trends in the HB standardized rate (1/100 000) of incidence (2 725.98 to 1 397.31), prevalence (12 239. 53 to 6 566.12), mortality (24.67 to 8.07), and DALYs (793.38 to 247.71), with average annual percentage changes (AAPC) of – 2.29%, – 2.13%, – 3.82%, and – 3.98%, respectively (P < 0.001 for all), and although declining more rapidly in a global comparison, these standardized rates were still higher than those in the total world population. The values of APPC were significantly higher negatively in the female population than in the male population for HB　standardized of incidence (– 2.49% vs. – 2.14%), prevalence (– 2.26% vs. – 2.04%), mortality (– 4.82% vs. – 3.48%), and DALYs (– 5.15% vs. – 3.63%) rates (all P < 0.001),　indicating that there was still a higher disease burden of HB in the male Chinese population. During this period, the standardized mortality rate and DALYs rate of HB attributable to smoking, drinking alcohol, drug use, and high BMI showed a significant decreasing trend (both P < 0.01), with the AAPC of – 62.20%, – 62.01%, – 44.44%, and – 18.18% for the mortality rate and – 63.90%, – 63.54%, – 47.71%, and – 18.76% for the DALYs rate.
    Conclusion Although the disease burden of viral hepatitis B among Chinese residents has decreased from 1990 to 2019, it is still higher than that of the world population, and male residents who smoke, consume alcohol, take drugs and have high body mass index still need to pay more attention.

     

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