Prevalence of unruptured intracranial aneurysms according to comorbidities, risk factors, country, and time period: a systematic review and meta-analysis.

We aimed to investigate whether the decrease in subarachnoid haemorrhage incidenceis paralleled by declines in unruptured intracranial aneurysm (UIA) prevalence.

我们旨在调查蛛网膜下腔出血发病率的下降是否与未破裂颅内动脉瘤（UIA）患病率的下降相平行。

Methods

For this systematic reviewand meta-analysis, we searched Embase, PubMed, and Web of Science for articles published in any language from Jan 1, 2011 to Dec 31, 2025, and reassessed 68 articles published before March 1, 2011 from a 2011 systematic reviewand meta-analysis.

在这项系统评价和荟萃分析中，我们检索了Embase、PubMed和Web of Science，查找了2011年1月1日至2025年12月31日发表的任何语言的文章，并重新评估了2011年系统评价和荟萃分析之前发表的68篇文章。

Articles were eligible for inclusion if they used a cross-sectional or case-control design and provided the crude number of participants and those with UIA.

如果文章使用横断面或病例对照设计，并提供了参与者和UIA患者的原始数量，则符合纳入标准。

We only included studies reporting numbers of UIA separately from ruptured aneurysms and with ten or more patients.

我们只包括了单独报告UIA数量的研究，这些研究与破裂动脉瘤分开，并且患者数量在十人或以上。

Summary data were independently extracted by JD with AZ or CB and conflicts were resolved by GJER.

摘要数据由JD独立提取，AZ或CB协助，并由GJER解决冲突。

The primary outcome was proportion of participants with UIA.

主要结果是具有UIA的参与者的比例。

Relative to a hypothetical reference population (mean age 50 years, 50% women, and no comorbidities), age and/or sex-adjusted prevalenceratios (PRs) for regions, comorbidities, and risk ratios (RRs) for female sex, smoking, and hypertension were estimated using generalised linear mixed models.

相对于一个假想的参考人群（平均年龄50岁，女性占50%，无合并症），使用广义线性混合模型估计了地区、合并症的年龄和/或性别调整后的患病率比（PRs），以及女性性别、吸烟和高血压的风险比（RRs）。

A time trend analysis was done by binomial meta regression using the mid-year of data acquisition.

通过使用数据获取的中间年份进行二项式元回归，进行了时间趋势分析。

We assessed the certainty of evidence using GRADE.

我们使用GRADE评估了证据的确定性。

The study was registered with PROSPERO, number CRD420261296728.

该研究已在PROSPERO注册，编号为CRD420261296728。

Results

Our search screened 4708 studies. 67 reassessed and 95 newly identified articles, reporting on 316 131 participants and 11 822 people with UIAs, were included in our meta-analysis.

我们的搜索筛选了4708项研究。重新评估了67项，新识别了95篇文章，报告了316131名参与者和11822名有未破裂动脉瘤(UIAs)的人，这些都被纳入我们的荟萃分析。

In the reference population, the estimated prevalenceof UIAs was 3·9% (95% CI 3·0-5·1).

在参考人群中，UIAs的估计患病率为3·9%（95% CI 3·0-5·1）。

The prevalenceof UIAs in individuals with atherosclerosis was 5·5% (4·7-6·4; 2229 of 40970 participants) and the adjusted PR was 1·3 (95% CI 0·8-2·0) compared with the reference population.

在动脉粥样硬化患者中，UIAs的患病率为5·5%（4·7-6·4；2229名参与者中有40970名），与参考人群相比，调整后的PR为1·3（95% CI 0·8-2·0）。

For positive family history of aneurysmal subarachnoid haemorrhage (aSAH) or UIA, the UIA prevalencewas 7·9% (5·6-11·1; 412 of 4252 participants) and the adjusted PR was 2·4 (0·5-11·2).

对于有动脉瘤性蛛网膜下腔出血（aSAH）或UIA家族史的个体，UIA的患病率为7·9%（5·6-11·1；4252名参与者中有412名），调整后的PR为2·4（0·5-11·2）。

For connective-tissue disorder, the UIA prevalencewas 10·3% (6·5-16·0; 94 of 879 participants) and the adjusted PR was 3·9 (2·0-7·6).

对于结缔组织疾病，UIA的患病率为10·3%（6·5-16·0；879名参与者中有94名），调整后的PR为3·9（2·0-7·6）。

For autosomal dominant polycystic kidney disease (ADPKD), the UIA prevalencewas 12·8% (9·2-17·6; 293 of 1990 participants) and the adjusted PR was 4·4 (1·5-12·6).

对于常染色体显性多囊肾病（ADPKD），未破裂动脉瘤（UIA）的患病率为12.8%（95%置信区间9.2-17.6；1990名参与者中有293名），调整后的相对风险（PR）为4.4（95%置信区间1.5-12.6）。

RRs were for current smoking 1·4 (1·2-1·6; 798 of 27911 participants), for having hypertension 1·6 (1·5-1·7, 4043 of 83053 participants), and for female sex 1·9 (1·8-2·0; 3415 of 65020 women and 2122 of 76130 men).

相对风险（RRs）对于当前吸烟者为1.4（95%置信区间1.2-1.6；27911名参与者中有798名），对于患有高血压者为1.6（95%置信区间1.5-1.7；83053名参与者中有4043名），对于女性为1.9（95%置信区间1.8-2.0；65020名女性中有3415名，76130名男性中有2122名）。

In studies on healthy individuals with MR angiography or CT angiography as imaging modality, the prevalencein 2016-2022 was 6·6% (6·3-6·8; 2904 of 41191 participants).

在使用磁共振血管造影或CT血管造影作为成像方式的健康个体研究中，2016-2022年的未破裂动脉瘤（UIA）患病率为6.6%（95%置信区间6.3-6.8；41191名参与者中有2904名）。

The adjusted PR was 1·8 (1·1-2·8) for 2016-2022 versus 2002-2015.

调整后的PR为2016-2022年相比2002-2015年为1.8（95%置信区间1.1-2.8）。

Prevalenceof UIAs of 5 mm or larger was 0·7% (0·6-0·8) in 2002-2015 and 1·4% (1·0-1·9) in 2016-2022.

5毫米或更大的未破裂动脉瘤（UIA）患病率在2002-2015年为0.7%（95%置信区间0.6-0.8），而在2016-2022年为1.4%（95%置信区间1.0-1.9）。

The UIA prevalencedid not differ between countries. τ2 showed significant heterogeneity between studies.

未破裂动脉瘤（UIA）的患病率在不同国家之间没有差异。τ2显示研究之间存在显著的异质性。

The certainty of the evidence ranged from very low to moderate.

证据的确定性范围从非常低到中等。

interpretation

Prevalenceof UIA is increasing, particularly over the past two decades.

未破裂动脉瘤（UIA）的患病率正在增加，特别是在过去二十年中。

This increase is only in part explained by improved detection of small UIAs and an ageing population, and other factors-such as environmental-are likely involved.

这种增加只能部分通过提高小未破裂动脉瘤（UIAs）的检测率和人口老龄化来解释，其他因素——如环境因素——可能也参与其中。

Alongside patients with ADPKD and a positive family history of aSAH, patients with connective-tissue disorders had a higher prevalenceof UIA than the reference population.

除了有ADPKD和家族性动脉瘤性蛛网膜下腔出血（aSAH）阳性病史的患者外，患有结缔组织疾病的患者比参考人群有更高的未破裂动脉瘤（UIA）患病率。

Our findings warrant further investigation into the potential benefit of personalised screening and management strategies in groups at high risk for having UIAs.

我们的发现有必要进一步研究在高风险人群中有潜在益处的个性化筛查和管理策略。

funding

None.

无。