RESUMO
BACKGROUND & AIMS: Gallstones are common and associated with substantial health and economic burden. We aimed to comprehensively evaluate the prevalence and incidence of gallstones in the 21st century. METHODS: We systematically searched PubMed and Embase to identify studies reporting the prevalence and/or incidence of gallstones between January 1, 2000, and November 18, 2023. Pooled prevalence and incidence were calculated using DerSimonian and Laird's random-effects model. We performed subgroup analyses and meta-regression based on age, sex, geographic location, population setting, and modality of detection to examine sources of heterogeneity. RESULTS: Based on 115 studies with 32,610,568 participants, the pooled prevalence of gallstones was 6.1% (95% CI, 5.6-6.5). Prevalence was higher in females vs males (7.6% vs 5.4%), in South America vs Asia (11.2% vs 5.1%), in upper-middle-income countries vs high-income countries (8.9% vs 4.0%), and with advancing age. On sensitivity analysis of population-based studies, the prevalence of gallstones was 5.5% (95% CI, 4.1-7.4; n = 44 studies), and when limiting subgroup analysis to imaging-based detection modalities, the prevalence was 6.7% (95% CI, 6.1-7.3; n = 101 studies). Prevalence has been stable over the past 20 years. Based on 12 studies, the incidence of gallstones was 0.47 per 100 person-years (95% CI, 0.37-0.51), without differences between males and females, and with increasing incidence in more recent studies. CONCLUSIONS: Globally, 6% of the population have gallstones, with higher rates in females and in South America. The incidence of gallstones may be increasing. Our findings call for prioritizing research on the prevention of gallstones.
Assuntos
Cálculos Biliares , Saúde Global , Humanos , Cálculos Biliares/epidemiologia , Incidência , Prevalência , Feminino , MasculinoRESUMO
Nitrogen dioxide (NO2) is a ubiquitous atmospheric pollutant, and fossil fuel combustion is generally considered its predominant source in and around urban areas. As the total nitrogen deposition is high over here, soil NOx emissions from urban green space might also be an important local source of ground-level NO2. In this study, Willems badge samplers were employed to monitor the spatial and seasonal variations of 2-week mean atmospheric NO2 concentrations at a height of 1.7 m on an urban campus in Northeast China from November 2020 to December 2021. We found considerable small-scale spatial variations of ground-level NO2 concentrations on the campus during the growing season, with local soil NOx emissions as the main driver. According to its linear correlation with green space coverage, the increment in ground-level NO2 concentration was partitioned into two components, with one ascribed to the local soil source (referred to as NO2-Isoil) and the other the local vehicle source (NO2-Ivehicle). NO2-Isoil generally reached a maximum (as high as 25.6 µg/m3) during early spring, while its ratio to the background value generally reached a maximum (could be >1) during late spring and could reach 0.52 to 0.92 during summer. Therefore, soil NOx emissions were an important source of ground-level NO2 on the campus, with the contribution even higher than those of other anthropogenic sources during late spring. Even with light traffic on the campus, NO2-Ivehicle could reach 0.48 times the background value at a site with high frequencies of warm starts.