1990―2019年我国肌肉骨骼疾病负担分析

吴惠一; 袁琴; 张洋; 兰亚佳

doi:10.16462/j.cnki.zhjbkz.2023.06.007

1990―2019年我国肌肉骨骼疾病负担分析

doi: 10.16462/j.cnki.zhjbkz.2023.06.007

吴惠一¹,
袁琴²,
张洋^3, ,,
兰亚佳^2, ,

1.
四川大学华西公共卫生学院, 四川大学华西第四医院流行病与卫生统计学系, 成都 610041
2.
四川大学华西公共卫生学院, 四川大学华西第四医院劳动卫生与环境卫生学系, 成都 610041
3.
四川大学华西医院中国循证医学中心, 成都 610041

基金项目:

四川省科技计划项目 2022YFS0422

详细信息

通讯作者:
张洋，E-mail：yangzhang0729@hotmail.com

兰亚佳，E-mail：lanyajia@sina.com

中图分类号: R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2022-06-14
- 修回日期: 2023-09-21
- 网络出版日期: 2023-07-10
- 刊出日期: 2023-06-10

Disease burden of musculoskeletal disorders in China from 1990 to 2019

WU Huiyi¹,
YUAN Qin²,
ZHANG Yang^{3
, ,},
LAN Yajia^{2
, ,}

1.
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
2.
Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
3.
Chinese Evidence based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China

Funds:

Sichuan Science and Technology Program 2022YFS0422

More Information

Corresponding author: ZHANG Yang, E-mail: yangzhang0729@hotmail.com; LAN Yajia, E-mail: lanyajia@sina.com

摘要

摘要: 目的分析1990-2019年我国肌肉骨骼疾病负担变化情况。方法基于全球健康数据交换库(Global Health Data Exchange, GHDx), 利用发病率、患病率和伤残调整寿命年(disability adjusted life year, DALY)等指标评价类风湿性关节炎、骨关节炎、腰痛、颈痛和痛风等肌肉骨骼疾病负担, 利用Joinpoint回归模型计算平均年度变化百分比(average annual percentage change, AAPC), 分析肌肉骨骼疾病负担变化趋势。结果 2019年我国肌肉骨骼疾病标化发病率和DALY率分别为3 764.99/10万和1 585.44/10万, 较1990年分别下降17.80%和6.05%。除痛风外, 女性各类肌肉骨骼疾病的标化发病率和DALY率均高于男性。1990-2019年肌肉骨骼疾病标化发病率和DALY率总体呈下降趋势, AAPC分别为-0.68%和-0.22%, 其中腰痛下降最明显而痛风呈较明显的上升趋势。骨关节炎、腰痛和痛风可归因于高BMI的疾病负担持续增加, 腰痛可归因于吸烟和职业工效学因素的疾病负担下降, 痛风可归因于肾功能损伤的疾病负担上升。结论 1990-2019年我国肌肉骨骼疾病负担总体呈下降趋势, 主要是由于腰痛的疾病负担明显下降, 类风湿性关节炎、骨关节炎、颈痛和痛风等疾病的防控形势依然严峻。
- 肌肉骨骼疾病 /
- 发病率 /
- 疾病负担 /
- 危险因素
Abstract: Objective To analyze the past temporal trends of musculoskeletal disorders in China from 1990 to 2019. Methods Incidence, prevalence and disability adjusted life year (DALY) data for musculoskeletal disorders, including rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout, were retrieved from the Global Health Data Exchange (GHDx), to evaluate the disease burden.The joinpoint regression model was utilized to analyze the trend of these disorders from 1990 to 2019, with the trends measured using the average annual percentage change (AAPC). Results In 2019, the age-standardized incidence rate for musculoskeletal disorders in China was 3 764.99/100 000 and the DALY rate was 1 585.44/100 000.These rates decreased by 17.80% and 6.05%, respectively, compared with 1990.The age-standardized rates of incidence and DALY for all musculoskeletal disorder categories were higher in women, except for gout.From 1990 to 2019, the age-standardized rates of incidence and DALY were decreased for total musculoskeletal disorders, with AAPCs of-0.68% and-0.22%, respectively.The rates for low back pain exhibited a significant decrease, but those for gout markedly increased.The disease burden attributable to high body mass index (BMI) for osteoarthritis, low back pain, and gout demonstrated a declining trend.However, the burden attributed to smoking and occupational ergonomic factors for low back pain decreased, while that attributed to impaired kidney function for gout increased. Conclusions From 1990 to 2019, the overall disease burden of musculoskeletal disorders in China has decreased, primarily due to the decline in low back pain.Nevertheless, the burden caused by other musculoskeletal conditions, such as rheumatoid arthritis, osteoarthritis, neck pain, and gout, remains a significant public health challenge.
- Musculoskeletal disorders /
- Incidence /
- Disease burden /
- Risk factors

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图 1 1990―2019年我国不同性别MSK疾病发病率

MSK: 肌肉骨骼。

Figure 1. The sex-specific rates of incidence of MSK disorders in China from 1990 to 2019

下载: 全尺寸图片幻灯片

图 2 1990和2019年我国各年龄组MSK疾病负担

1. DALY: 伤残调整寿命年; 2. MSK: 肌肉骨骼。

Figure 2. The age-specific DALY rates of MSK disorders in China in 1990 and 2019

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图 3 1990―2019年我国MSK疾病危险因素的归因疾病负担

1. DALY: 伤残调整寿命年; 2. MSK: 肌肉骨骼。

Figure 3. The attributable burden of risk factors for MSK disorders in China from 1990 to 2019

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表 1 1990和2019年我国MSK疾病发病、患病和疾病负担情况

Table 1. The morbidity, prevalence and burden of MSK disorders in China in 1990 and 2019

疾病	年份/年	发病			患病			DALY
疾病	年份/年	人数/10万	粗率/10万^-1	标化率/10万^-1	人数/10万	粗率/10万^-1	标化率/10万^-1	人年数/10万人年	粗率/10万^-1	标化率/10万^-1	占比/%
类风湿性关节炎	1990	1.25	10.57	11.45	20.12	169.99	206.10	3.70	31.29	39.01	2.11
	2019	2.23	15.64	11.74	43.09	302.98	216.89	7.74	54.44	39.47	2.59
骨关节炎	1990	45.91	387.85	472.53	517.60	4 372.84	5 880.58	18.19	153.70	206.38	10.39
	2019	106.81	750.96	509.84	1 328.07	9 337.15	6 330.06	47.25	332.19	224.78	15.78
髋关节炎	1990	0.82	6.89	8.29	15.04	127.03	172.51	0.48	4.09	5.49	0.28
	2019	2.43	17.09	11.42	47.87	336.56	234.09	1.53	10.76	7.46	0.51
膝关节炎	1990	36.84	311.22	377.20	425.71	3 596.48	4 797.01	13.65	115.33	152.74	7.79
	2019	84.26	592.38	402.30	1 081.20	7 601.51	5 125.46	34.65	243.59	163.70	11.57
手关节炎	1990	4.38	37.04	45.66	69.90	590.52	828.04	2.22	18.78	26.08	1.27
	2019	10.98	77.19	52.71	196.37	1 380.63	953.81	6.23	43.81	30.12	2.08
其他骨关节炎	1990	3.87	32.70	41.37	57.84	488.65	702.35	1.84	15.51	22.07	1.05
	2019	9.14	64.29	43.41	152.80	1 074.31	745.83	4.84	34.03	23.50	1.62
腰痛	1990	332.29	2 807.29	3 174.26	752.98	6 361.37	7 245.29	85.53	722.56	815.20	48.82
	2019	401.58	2 823.38	2 280.67	913.39	6 421.72	5 134.73	103.34	726.55	579.05	34.52
颈痛	1990	89.31	754.49	800.68	378.51	3 197.72	3 528.35	38.14	322.22	352.84	21.77
	2019	148.88	1 046.72	809.91	679.66	4 778.43	3 571.96	67.92	477.52	358.13	22.69
痛风	1990	11.82	99.86	121.37	58.64	495.42	624.53	1.87	15.84	19.72	1.07
	2019	30.41	213.82	152.83	161.61	1 136.24	803.31	5.10	35.89	25.33	1.71
其他MSK疾病	1990	―	―	―	300.16	2 535.85	2 784.68	27.75	234.48	254.44	15.84
	2019	―	―	―	756.15	5 316.23	3 940.36	67.98	477.95	358.67	22.71
总的MSK疾病	1990	480.58	4 060.06	4 580.28	1 732.94	14 640.24	17 016.45	175.19	1 480.08	1 687.59	100.00
	2019	689.91	4 850.53	3 764.99	3 244.69	22 812.18	16 887.63	299.34	2 104.54	1 585.44	100.00
注：1. DALY: 伤残调整寿命年。2. MSK: 肌肉骨骼。3. “―”代表GBD数据库未报告。

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表 2 1990―2019年我国MSK疾病标化发病率及DALY率变化情况

Table 2. The trend of the age-standardized rates of incidence and DALY for MSK disorders in China from 1990 to 2019

疾病	标化发病率			标化DALY率
疾病	AAPC/%	95% CI/%	P值	AAPC/%	95% CI/%	P值
类风湿性关节炎	0.08	0.05~0.11	< 0.001	0.03	-0.13~0.18	0.715
骨关节炎	0.25	0.19~0.31	< 0.001	0.28	0.22~0.34	< 0.001
腰痛	-1.16	-1.23~-1.08	< 0.001	-1.20	-1.28~-1.12	< 0.001
颈痛	0.04	0.04~0.04	< 0.001	0.05	0.05~0.06	< 0.001
痛风	0.83	0.74~0.92	< 0.001	0.90	0.81~0.99	< 0.001
总MSK疾病	-0.68	-0.72~-0.63	< 0.001	-0.22	-0.28~-0.16	< 0.001
注：1. MSK肌肉骨骼。2. AAPC平均年度变化百分比。3. DALY：伤残调整寿命年。

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表 3 1990―2019年我国肌肉骨骼疾病危险因素归因疾病负担变化趋势

Table 3. The trend of the attributable burden of risk factors for MSK disorders in China from 1990 to 2019

疾病	危险因素	归因标化DALY率/10万^-1		AAPC/%	95% CI/%	P值
疾病	危险因素	1990年	2019年	AAPC/%	95% CI/%	P值
类风湿性关节炎	吸烟	4.56	4.46	-0.16	-0.37~0.05	0.138
骨关节炎	高BMI	10.94	25.99	3.03	2.88~3.18	< 0.001
腰痛	高BMI	15.35	23.37	1.45	1.32~1.57	< 0.001
	职业工效学因素	310.13	155.30	-2.37	-2.47~-2.27	< 0.001
	吸烟	132.56	86.48	-1.47	-1.59~-1.35	< 0.001
痛风	高BMI	1.94	5.64	3.80	3.64~3.95	< 0.001
	肾功能损伤	1.71	2.44	1.28	1.11~1.45	< 0.001
总MSK疾病	高BMI	28.23	55.00	2.32	2.17~2.47	< 0.001
	肾功能损伤	1.71	2.44	1.28	1.11~1.45	< 0.001
	职业工效学因素	310.13	155.30	-2.37	-2.47~-2.27	< 0.001
	吸烟	137.13	90.94	-1.41	-1.53~-1.3	< 0.001
注：1. MSK：肌肉骨骼。2. DALY：伤残调整寿命年。3. AAPC：平均年度变化百分比。

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