痛风造成的全球负担逐年上升

摘要 目的：痛风是男性炎性关节炎最常见的原因，但之前并没有纳入全球疾病负担（GBD）研究之列。作为2010年GBD研究的一部分，肌肉骨骼疾病和风险因素专家组评估了痛风的全球负担。

方法：本研究纳入美国风湿病协会诊断的1977例原发性痛风患者，进行了一系列系统评价来收集特定年龄和特定性别的流行病学数据，包括痛风患病率、发病率、死亡率和持续时间。痛风两个主要的致残后遗症定义为急性发作性痛风和慢性多关节炎痛风，收集相应数据得出残疾权重。用流行病学资料和残疾权重计算1990年和2010年痛风患者的残疾生存年（YLDS）。没有发现痛风相关的病因特异性死亡的证据，因此，痛风残疾调整生存年（DALY）与YLDS具有相同的作用。

结果：痛风的全球患病率为0.08%（95%不确定区间UI 0.07-0.08）。DALYs从1990年的76000（95% UI 48-112）增加至2010年的114000（95% UI 72-167）.在2010年GBD的291个研究中，痛风在残疾方面（YLDs）排138位，在总体负担（DALY）上排173位。

结论：痛风造成的负担逐年上升。随着全球人口日益老龄化，在个人、社区及国家层面及时优化痛风的治疗和管理非常重要。

附全文：Abstract OBJECTIVE: Gout is the most common cause of inflammatory arthritis in men, but has not previously been included in Global Burden of Disease (GBD) studies. As part of the GBD 2010 Study, the Musculoskeletal Disorders and Risk Factors Expert Group estimated the global burden of gout. METHODS: The American Rheumatism Association 1977 case definition of primary gout was used in the study. A series of systematic reviews were conducted to gather the age-specific and sex-specific epidemiological data for gout prevalence, incidence, mortality risk and duration. Two main disabling sequelae of gout were identified; acute episode gout and chronic polyarticular gout, and used in the surveys to collect data to derive disability weights. The epidemiological data together with disability weights were then used to calculate years of life lived with disability (YLDs) for gout, for 1990 and 2010. No evidence of cause-specific mortality associated with gout was found. Gout disability-adjusted life years (DALYs), therefore, have the same value as YLDs. RESULTS: Global prevalence of gout was 0.08% (95% uncertainty interval (UI) 0.07 to 0.08). DALYs increased from 76 000 (95% UI 48 to 112) in 1990 to 114 000 (95% UI 72 to 167) in 2010. Out of all 291 conditions studied in the GBD 2010 Study, gout ranked 138th in terms of disability as measured by YLDs, and 173rd in terms of overall burden (DALYs). CONCLUSIONS: The burden of gout is rising. With increasing ageing populations globally, this evidence is a significant prompt to optimise treatment and management of gout at individual, community and national levels

摘自：Smith E1, Hoy D, Cross M, et al. The global burden of gout: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014 Mar 3. doi: 10.1136/annrheumdis-2013-204647. [Epub ahead of print]