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Background: Understanding the global burden of gout in the past and future can provide important references for optimizing prevention and control strategies in healthcare systems. Objectives: This study aimed to report variations in the global disease burden and risk factors of gout in 204 countries and territories from 1990 to 2019. Design: We conducted a retrospective analysis of gout based on the latest Global Burden of Disease (GBD) 2019 database. Methods: We collected data on the prevalence, incidence, and disability-adjusted life years (DALYs) of gout from 1990 to 2019. The data were then stratified by age, sex, and economic development level. Decomposition analysis, frontier analysis, and prediction models were used to analyze the changes and influencing factors influencing each indicator. Results: Globally, there were 53,871,846.4 [95% uncertainty interval (UI): 43,383,204.6-66,342,327.3] prevalent cases, 92,228,86.8 (95% UI: 7419,132.1-11,521,165) incident cases, and 1673,973.4 (95% UI: 1,068,061.1-2,393,469.2) cases of DALYs of gout in 2019, more than double those in 1990. Moreover, the pace of increase in the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized DALY rate (ASDR) accelerated during 1990-2019, with estimated annual percentage changes (EAPC) of 0.94 [95% confidence interval (CI): 0.85-1.03], 0.77 (95% CI: 0.69-0.84), and 0.93 (95% CI: 0.84-1.02), respectively, especially among men. The disease burden of gout has increased in all the other 20 GBD regions in the past 30 years, except Western Sub-Saharan Africa. The highest risk of high body mass index (BMI) and kidney dysfunction was in high-income countries such as North America and East Asia. The global prevalence rate, incidence rate, and DALYs rate of gout in 2030 will reach 599.86, 102.96 per 100,000 population, and 20.26 per 100,000 population, respectively, roughly the same as in 2019. Conclusion: With the development of society, the disease burden of gout will become increasingly severe. It is very important to study the accurate epidemiological data on gout for clinical diagnosis and treatment and health policy.
RESUMO
OBJECTIVE: To explore the effect of CD4+ CD28null T cell on occurrence and progression of atherosclerosis in patients with type 2 diabetes. METHODS: A total of 188 patients who were diagnosed as type 2 diabetes in the department of endocrinology were selected in this study.The carotid atherosclerosis was detected using color Doppler ultrasound.The patients with intima-media thickness>1.1 mm or plaques were classified as the carotid atherosclerosis group (95 cases), the others were classified as the control group (93 cases). According to the intima-media thickening and plaques, carotid atherosclerosis group was divided into three subgroups: the thickening group (30 cases), the plaque group (28 cases) and the thickening+plaque group (37 cases). Percentage of CD4+ CD28null T cell in peripheral blood was detected using a flow cytometry, and thus compared and analyzed between the carotid atherosclerosis group and the control group.The relationships between percentage of CD4+ CD28null T cell and age, C-reactive protein (CRP), blood sugar, blood lipids, the body mass index (BMI), waist circumference, hip circumference, diastolic blood pressure, systolic blood pressure and other data were also analyzed. RESULTS: Percentage of CD4+ CD28null T cell of the carotid atherosclerosis group was significantly higher than that of the control group (4.07%±3.21% vs 2.99%±2.34%, P<0.01). Percentage of CD4+ CD28null T cell of the thickening+ plaque group was higher than that of the plaque group and thickening group (both P<0.05), and percentage of CD4+ CD28null T cell of the plaque group was higher than the thickening group (P<0.05). Logistic regression analysis indicated that CRP, FPG and percentage of CD4+ CD28null T cell were the independent risk factors of atherosclerosis in patients with type 2 diabetes.Furthermore, multiple linear regression analysis showed that percentage of CD4+ CD28null T cell was linear correlated to CRP (P<0.01). CONCLUSION: The type 2 diabetes patients with atherosclerosis had a higher percentage of CD4+ CD28null T cell, which was increased with the atherosclerosis progression.CD4+ CD28null T cell may affect arterial intimal thickening and plaque formation via mediating inflammatory response in the patients with type 2 diabetes.
