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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (3): 521-526. doi: 10.19723/j.issn.1671-167X.2020.03.019

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Calculation of the prevalence of progressive muscular atrophy among adults in China based on urban medical insurance data from 15 provinces

Lu XU1,Lu CHEN2,Dong-sheng FAN2,Jing-nan FENG1,Li-li LIU1,Si-yan ZHAN1,3,Sheng-feng WANG1,△()   

  1. 1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    2. Department of Neurology, Peking University Third Hospital, Beijing 100191, China
    3. Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
  • Received:2020-02-05 Online:2020-06-18 Published:2020-06-30
  • Contact: Sheng-feng WANG E-mail:shengfeng1984@126.com

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Abstract:

Objective: To analyze the characteristics of patients with progressive muscular atrophy (PMA) and calculate the prevalence of PMA in China in 2016.Methods: A retrospective analysis based on China’s urban employee basic medical insurance data and the urban residence basic medical insu-rance data from January 1, 2016 to December 31, 2016 was carried out. Children under 18 years old were excluded. Patients with progressive muscular atrophy were identified by disease names and codes. Subgroup analyses by gender, region and age were carried out to calculate the gender-specific, region-specific and age-specific prevalences. Age-adjusted national prevalence was estimated based on 2010 Chinese census data. Sensitivity analyses were done by only considering the observed cases and by excluding the top 10% provinces regarding the missing rate of diagnostic information, respectively.Results: A total of 996.09 million person-years were included in this study, with 518.41 million person-years in males and 477.67 million person-years in females. The age and gender distribution of the study population was similar to that of the 2010 Chinese census data, therefore the study population was nationally representative. The prevalence of PMA in China in 2016 was 0.28 per 100 000 person-years (95%CI: 0.24-0.33), with 0.21 per 100 000 person-years (95%CI: 0.16-0.26) and 0.35 per 100 000 person-years (95%CI: 0.28-0.42) for females and males, respectively. Regional disparity existed in the Chinese PMA prevalence, with the lowest prevalence in Southwest region (0.11 per 100 000 person-years, 95%CI: 0.07-0.15) and the highest prevalence in Northwest region (3.47 per 100 000 person-years, 95%CI: 0.80-7.99). Age trend in the PMA prevalence was not obvious, but the prevalence among those aged 70 years and older was relatively higher. The age-adjusted prevalence based on 2010 Chinese census data was 0.29 per 100 000 person-years (95%CI: 0.27-0.31). The national prevalences calculated by only considering the observed cases and by excluding the top 10% provinces regar-ding the missing rate of diagnostic information were 0.17 per 100 000 person-years (95%CI: 0.14-0.20) and 0.24 per 100 000 person-years (95%CI: 0.20-0.28), respectively.Conclusion: This study is to calculate the prevalence of PMA among adults in urban China, which can provide basic statistics for the enactment of PMA related medical policies, and clues for the studies on the mechanisms of PMA.

Key words: Progressive muscular atrophy, Prevalence, Medical insurance

CLC Number: 

  • R195.4

Table 1

Person-years of urban population in 15 provinces of China in 2016"

Items Total (×106) Male (×106) Female (×106)
Person-years 996.09a 518.41 477.67
Age group/years, n (%)
18-29 283.82 (28.49) 149.75 (28.89) 134.08 (28.07)
30-39 190.23 (19.10) 99.21 (19.14) 91.02 (19.05)
40-49 204.55 (20.54) 105.55 (20.36) 98.99 (20.72)
50-59 143.84 (14.44) 76.18 (14.69) 67.66 (14.16)
60-69 97.81 (9.82) 50.81 (9.80) 47.01 (9.84)
70-79 50.77 (5.10) 25.58 (4.93) 25.19 (5.27)
≥80 25.08 (2.52) 11.34 (2.19) 13.74 (2.88)
Areab, n (%)
East 421.35 (43.07) 217.51 (42.71) 203.83 (43.46)
North 40.18 (4.11) 20.12 (3.95) 20.05 (4.27)
Northeast 117.13 (11.97) 58.61 (11.51) 58.52 (12.48)
Northwest 20.18 (2.06) 10.70 (2.10) 9.48 (2.02)
Southcentral 252.14 (25.77) 135.96 (26.70) 116.18 (24.77)
Southwest 127.35 (13.02) 66.36 (13.03) 60.99 (13.00)

Figure 1

Pyramid of population proportion by age and gender in 2010 Chinese census data (A) and in this study (B)"

Table 2

Characteristics of urban patients with progressive muscular atrophy in 15 provinces of China in 2016"

Characteristic Total Male Female Statistic* P value
n 131 70 61
Age/years, x?±s 46.21±16.86 49.20±17.31 42.77±15.77 -2.21 0.029
Age group/years, n(%) 7.07 0.289
18-29 26 (19.85) 11 (15.71) 15 (24.59)
30-39 22 (16.79) 11 (15.71) 11 (18.03)
40-49 27 (20.61) 13 (18.57) 14 (22.95)
50-59 26 (19.85) 13 (18.57) 13 (21.31)
60-69 16 (12.21) 12 (17.14) 4 (6.56)
70-79 12 (9.16) 9 (12.86) 3 (4.92)
≥80 2 (1.53) 1 (1.43) 1 (1.64)
Area, n (%) 7.82 0.157
East 15 (11.45) 8 (11.43) 7 (11.48)
North 3 (2.29) 3 (4.29) 0 (0)
Northeast 3 (2.29) 0 (0) 3 (4.92)
Northwest 2 (1.53) 1 (1.43) 1 (1.64)
Southcentral 106 (80.92) 56 (80.00) 50 (81.97)
Southwest 2 (1.53) 2 (2.86) 0 (0)

Table 3

The prevalence of progressive muscular atrophy among adults by gender, area, and age group in urban China in 2016 (/100 000 person-years)"

Items Prevalence (95%CI) P*
Gender <0.001
Male 0.35 (0.28-0.42)
Female 0.21 (0.16-0.26)
Area <0.001
East 0.22 (0.17-0.28)
North 0.65 (0.34-1.05)
Northeast 0.35 (0.18-0.58)
Northwest 3.47 (0.80-7.99)
Southcentral 0.38 (0.29-0.48)
Southwest 0.11 (0.07-0.15)
Age group/years 0.222
18-29 0.31 (0.17-0.49)
30-34 0.35 (0.18-0.57)
35-39 0.31 (0.16-0.51)
40-44 0.26 (0.14-0.41)
45-49 0.23 (0.12-0.37)
50-54 0.22 (0.12-0.34)
55-59 0.22 (0.12-0.35)
60-64 0.22 (0.12-0.36)
65-69 0.26 (0.14-0.41)
70-74 0.41 (0.21-0.67)
75-84 0.41 (0.23-0.64)
≥85 0.45 (0.15-0.91)

Figure 2

The age trend of the prevalence of progressive muscular atrophy among adults in urban China in 2016"

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