Cho Yoonsu, Cudhea Frederick, Park Ju-Hyun, Lee Jong-Tae, Mozaffarian Dariush, Singh Gitanjali, Shin Min-Jeong
Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul, Republic of Korea.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.
BMJ Open. 2016 Dec 21;6(12):e013283. doi: 10.1136/bmjopen-2016-013283.
Over the past 10 years, the burden of chronic diseases in Korea has increased. However, there are currently no quantitative estimates of how changes in diet and metabolic factors have contributed to these shifting burdens. This study aims to evaluate the contributions of dietary and metabolic risk factors to death from cardiometabolic diseases (CMDs) such as cardiovascular conditions, strokes and diabetes in Korea, and to estimate how these contributions have changed over the past 10 years (1998-2011).
We used data on 6 dietary and 4 metabolic risk factors by sex, age and year from the Korea National Health and Nutrition Examination Survey. The relative risks for the effects of the risk factors on CMD mortality were obtained from meta-analyses. The population-attributable fraction attributable to the risk factors was calculated by using a comparative risk assessment approach across sex and age strata (males and females, age groups 25-34, 35-44, 45-54, 55-64, 65-74 and 75+ years) from 1998 to 2011.
The results showed that a suboptimal diet and high blood pressure were the main risk factors for CMD mortality in Korea. High blood pressure accounted for 127 096 (95% uncertainty interval (UI): 121 907 to 132 218) deaths from CMD. Among the individual dietary risk factors, a high intake of sodium (42 387 deaths; 95% UI: 42 387 to 65 094) and a low intake of fruit (50 244 deaths; 95% UI: 40 981 to 59 178) and whole grains (54 248 deaths; 95% UI: 47 020 to 61 343) were responsible for the highest number of CMD deaths in Korea.
Indicating the relative importance of risk factors in Korea, the results suggest that metabolic and dietary risk factors were major contributors to CMD mortality.
在过去10年里,韩国慢性病负担有所增加。然而,目前尚无关于饮食和代谢因素变化如何导致这些负担转移的定量估计。本研究旨在评估饮食和代谢风险因素对韩国心血管疾病、中风和糖尿病等心脏代谢疾病(CMD)死亡的贡献,并估计这些贡献在过去10年(1998 - 2011年)中是如何变化的。
我们使用了韩国国民健康与营养检查调查中按性别、年龄和年份划分的6种饮食和4种代谢风险因素的数据。通过荟萃分析获得风险因素对CMD死亡率影响的相对风险。采用比较风险评估方法,计算了1998年至2011年期间不同性别和年龄层(男性和女性,25 - 34岁、35 - 44岁、45 - 54岁、55 - 64岁、65 - 74岁和75岁及以上年龄组)中风险因素的人群归因分数。
结果表明,饮食不合理和高血压是韩国CMD死亡的主要风险因素。高血压导致了127096例(95%不确定区间(UI):121907至132218)CMD死亡。在个体饮食风险因素中,高钠摄入(42387例死亡;95% UI:42387至65094)以及水果(50244例死亡;95% UI:40981至59178)和全谷物(54248例死亡;95% UI:47020至61343)摄入不足导致韩国CMD死亡人数最多。
该结果表明了韩国风险因素的相对重要性,提示代谢和饮食风险因素是CMD死亡的主要促成因素。