1990—2021年中国及全球增龄性听力损失的疾病负担与未来趋势预测

doi:10.19723/j.issn.1671-167X.2025.03.019

摘要/Abstract

摘要：

目的: 描述1990—2021年中国及全球不同社会人口指数(socio-demographic index, SDI)地区增龄性听力损失的疾病负担变化趋势, 并预测2022—2036年增龄性听力损失的患病率及伤残损失寿命年(years lived with disability, YLD)率, 为防控增龄性听力损失疾病负担提供参考。方法: 利用2021年全球疾病负担(Global Burden of Disease 2021, GBD2021)数据, 选取增龄性听力损失的年龄标准化患病率(age-standardized prevalence rate, ASPR)和YLD为指标, 分不同SDI、不同性别描述1990—2021年中国及全球增龄性听力损失疾病负担的现状和长期变化趋势, 采用Joinpoint回归计算平均年度变化百分比(average annual percent change, AAPC)评估疾病负担的趋势变化, 利用分解分析探讨老龄化、人口增长和流行病学改变这三个因素对疾病负担改变的相对影响, 使用自回归移动平均(autoregressive integrated moving average, ARIMA)模型预测2022—2036年的ASPR和YLD率。结果: 2021年中国的增龄性听力损失患病率为82 162.49/10万(73 288.08/10万, 89 187.21/10万), 高于全球SDI水平的66 238.16/10万(59 982.54/10万, 72 669.82/10万)、高SDI地区的57 650.42/10万(52 059.12/10万, 63 889.02/10万)、中高SDI地区的69 115.59/10万(62 494.18/10万, 75 340.64/10万)、中SDI地区的72 365.56/10万(65 181.43/10万, 78 912.01/10万)、中低SDI地区的64 439.66/10万(58 368.22/10万, 71 468.27/10万)和低SDI地区的61 725.25/10万(55 749.18/10万, 68 477.67/10万)。中国增龄性听力损失的YLD率为2 762.98/10万[95%不确定性区间(uncertainty interval, UI): 1 855.28~3 880.68], 高于全球SDI水平的2 236.75/10万(95%UI: 1 511.56~3 155.88)、高SDI地区的1 805.79/10万(95%UI: 1 212.69~2 577.17)、中高SDI地区的2 316.58/10万(95%UI: 1 557.53~3 274.87)、中SDI地区的2 480.99/10万(95%UI: 1 678.17~3 489.24)、中低SDI地区的2 313.28/10万(95%UI: 1 578.35~3 271.50)和低SDI地区的2 383.55/10万(95%UI: 1 623.66~3 365.68)。1990—2021年, 中国增龄性听力损失的患病率及YLD率均呈上升趋势, 平均每年分别上升0.18%(95%CI: 0.16%~0.19%)和0.29%(95%CI: 0.27%~0.30%)。男性和女性增龄性听力损失的患病率上升速度相同, 男性AAPC为0.18%(95%CI: 0.17%~0.19%, P < 0.001), 女性AAPC为0.18%(95%CI: 0.16%~0.19%, P < 0.001)。男性增龄性听力损失的YLD率上升速度均高于女性, 男性为0.32%(95%CI: 0.27%~0.37%, P < 0.001), 女性为0.27%(95%CI: 0.26%~0.28%, P < 0.001)。分解分析发现, 人口增长是全球及不同SDI地区患病率和YLD率增加的主要影响因素, 而老龄化是中国患病率及YLD率增加的主要影响因素。ARIMA模型预测结果显示, 2022—2036年增龄性听力损失的患病率及YLD率均呈上升趋势, 2036年的患病率和YLD率预计达到89 723.99/10万和2 872.47/10万。结论: 我国60岁及以上人群增龄性听力损失的患病率和疾病负担位居全球首位, 1990—2021年间, 增龄性听力损失的患病率和YLD率呈持续上升趋势, 且始终高于全球各SDI地区, 预测未来15年中国及全球增龄性听力损失的疾病负担呈持续上升趋势。增龄性听力损失的患病率及疾病负担在男性老年人群中表现尤为显著, 对于这一特定人群的增龄性听力损失应给予高度重视, 积极采取早期干预措施。

关键词: 增龄性听力损失, 患病率, 伤残损失寿命年, 疾病负担

Abstract:

Objective: To describe the trend of changes in the disease burden of age-related hearing loss in China and globally from 1990 to 2021, to forecast the prevalence and years lived with disability (YLD) rates of age-related hearing loss from 2022 to 2036, and to provide a reference for the prevention and control of the disease burden associated with age-related hearing loss. Methods: Using the Global Burden of Disease 2021 (GBD2021) data, this study selected age-standardized prevalence rate (ASPR) and YLD as indicators. The disease burden and long-term trends of age-related hearing loss in China and globally from 1990 to 2021 were described by different socio-demographic index (SDI) and gender. Joinpoint regression was used to calculate the average annual percent change (AAPC) to assess the trend changes in the disease burden. Decomposition analysis was applied to explore the relative impacts of aging, population growth, and epidemiological changes on the variation in disease burden. An autoregressive integrated moving average (ARIMA) model was used to forecast the age-standardized pre-valence rate and YLD rates from 2022 to 2036. Results: The prevalence of age-related hearing loss in China in 2021 was 82 162.49 (73 288.08-89 187.21) per 100 000, higher than the global SDI level of 66 238.16 (59 982.54-72 669.82) per 100 000, the high SDI region ' s level of 57 650.42 (52 059.12-63 889.02) per 100 000, the upper-middle SDI region ' s level of 69 115.59 (62 494.18- 75 340.64) per 100 000, the middle SDI region ' s level of 72 365.56 (65 181.43-78 912.01) per 100 000, the lower-middle SDI region ' s level of 64 439.66 (58 368.22-71 468.27) per 100 000, and the low SDI region ' s level of 61 725.25 (55 749.18-68 477.67) per 100 000. The age- related hearing loss YLD rate in China was 2 762.98 [95% uncertainty interval (UI): 1 855.28-3 880.68] per 100 000, higher than the global SDI level of 2 236.75 (95%UI: 1 511.56-3 155.88) per 100 000, the high SDI region ' s level of 1 805.79 (95%UI: 1 212.69-2 577.17) per 100 000, the upper-middle SDI region ' s level of 2 316.58 (95%UI: 1 557.53-3 274.87) per 100 000, the middle SDI region ' s level of 2 480.99 (95%UI: 1 678.17-3 489.24) per 100 000, the lower-middle SDI region ' s level of 2 313.28 (95%UI: 1 578.35-3 271.50) per 100 000, and the low SDI region ' s level of 2 383.55 (95%UI: 1 623.66-3 365.68) per 100 000. From 1990 to 2021, both the prevalence and YLD rate of age-related hearing loss in China showed an increasing trend, rising by an average of 0.18% (95%CI: 0.16%-0.19%) and 0.29% (95%CI: 0.27%-0.30%) per year, respectively. The rates of increase in prevalence were the same for both men and women, with men showing a 0.18% increase (95%CI: 0.17%-0.19%, P < 0.001) and women showing a 0.18% increase (95%CI: 0.16%-0.19%, P < 0.001). However, the YLD rate increase was faster in men than in women, with men experiencing a 0.32% increase (95%CI: 0.27%-0.37%, P < 0.001) and women experiencing a 0.27% increase (95%CI: 0.26%-0.28%, P < 0.001). Decomposition analysis showed that population growth was the main factor driving the increase in prevalence and YLD rate globally and across different SDI regions. However, aging was the primary factor contributing to the increase in prevalence and YLD rate in China. ARIMA model predictions suggested that the prevalence and YLD rate of age-related hearing loss would continue to rise from 2022 to 2036, with the predicted prevalence and YLD rate in 2036 reaching 89 723.99 per 100 000 and 2 872.47 per 100 000, respectively. Conclusion: The prevalence and disease burden of age-related hearing loss in individuals aged 60 and above in China rank first globally. From 1990 to 2021, both the prevalence and YLD rate of age-related hearing loss have shown a continuous upward trend, consistently surpassing the levels observed in various SDI regions worldwide. The prevalence and disease burden of age-related hearing loss are particularly significant among elderly men. Moreover, projections indicate that the disease burden of age-related hearing loss will continue to rise over the next 15 years. Therefore, it is urgent to pay close attention to age-related hearing loss in this specific population, and early intervention measures are crucial to reduce the disease burden associated with age-related hearing loss.

Key words: Age-related hearing loss, Prevalence, Years of life lost due to disability, Disease burden

中图分类号:

R195.4

阿娜尔古丽·阿不都肉什提, 宋迎豪, 闫晓晋, 高永康, 刘波, 胡刚. 1990—2021年中国及全球增龄性听力损失的疾病负担与未来趋势预测[J]. 北京大学学报（医学版）, 2025, 57(3): 545-553.

Abudurexiti ANARGUL, Yinghao SONG, Xiaojin YAN, Yongkang GAO, Bo LIU, Gang HU. Disease burden and future trend predictions of age-related hearing loss in China and worldwide from 1990 to 2021[J]. Journal of Peking University (Health Sciences), 2025, 57(3): 545-553.

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Items	Prevalence (/100 000) (95%UI)
Items	Total	Male	Female
Worldwide	66 238.16 (59 982.54, 72 669.82)	69 157.43 (62 608.42, 75 808.62)	63 650.49 (57 619.38, 69 924.12)
China	82 162.49 (73 288.08, 89 187.21)	83 239.67 (74 116.27, 90 367.20)	81 109.96 (72 320.34, 88 205.83)
High SDI	57 650.42 (52 059.12, 63 889.02)	62 629.90 (56 393.55, 69 611.13)	53 157.72 (48 076.72, 58 752.49)
Upper-middle SDI	69 115.59 (62 494.18, 75 340.64)	72 115.95 (65 119.49, 78 576.69)	66 629.62 (60 161.80, 72 700.20)
Middle SDI	72 365.56 (65 181.43, 78 912.01)	74 117.43 (66 896.74, 80 775.69)	70 764.28 (63 699.81, 77 225.86)
Lower-middle SDI	64 439.66 (58 368.22, 71 468.27)	66 760.33 (60 541.34, 73 990.02)	62 339.07 (56 372.16, 69 287.31)
Low SDI	61 725.25 (55 749.18, 68 477.67)	64391.41 (58 283.87, 71 048.12)	59 216.28 (53 338.05, 65 940.98)

Items	YLD rate (/100 000) (95%UI)
Items	Total	Male	Female
Worldwide	2 236.75 (1 511.56, 3 155.88)	2 340.52 (1 579.79, 3 313.09)	2 146.71 (1 452.03, 3 029.75)
China	2 762.98 (1 855.28, 3 880.68)	2 854.99 (1 910.45, 4 017.34)	2 675.33 (1 796.64, 3 751.90)
High SDI	1 805.79 (1 212.69, 2 577.17)	1 958.63 (1 308.65, 2 798.77)	1 671.24 (1 126.65, 2 381.55)
Upper-middle SDI	2 316.58 (1 557.53, 3 274.87)	2 440.79 (1 639.39, 3 448.78)	2 215.41 (1 491.18, 3 132.33)
Middle SDI	2 480.99 (1 678.17, 3 489.24)	2 559.40 (1 735.57, 3 607.99)	2 409.93 (1 630.03, 3 394.81)
Lower-middle SDI	2 313.28 (1 578.35, 3 271.50)	2 376.01 (1 622.71, 3 355.52)	2 257.96 (1 539.18, 3 194.87)
Low SDI	2 383.55 (1 623.66, 3 365.68)	2 429.69 (1 652.47, 3 414.24)	2 340.55 (1 595.58, 3 305.33)

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