Li Yichong, Zeng Xinying, Liu Jiangmei, Liu Yunning, Liu Shiwei, Yin Peng, Qi Jinlei, Zhao Zhenping, Yu Shicheng, Hu Yuehua, He Guangxue, Lopez Alan D, Gao George F, Wang Linhong, Zhou Maigeng
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Nanwei Road 27, Xicheng District, Beijing, China.
Chinese Center for Disease Control and Prevention, Beijing, China.
BMC Med. 2017 Jul 11;15(1):132. doi: 10.1186/s12916-017-0894-5.
The United Nation's Sustainable Development Goals for 2030 include reducing premature mortality from non-communicable diseases (NCDs) by one third. To assess the feasibility of this goal in China, we projected premature mortality in 2030 of NCDs under different risk factor reduction scenarios.
We used China results from the Global Burden of Disease Study 2013 as empirical data for projections. Deaths between 1990 and 2013 for cardiovascular disease (CVD), diabetes, chronic respiratory disease, cancer, and other NCDs were extracted, along with population numbers. We disaggregated deaths into parts attributable and unattributable to high systolic blood pressure (SBP), smoking, high body mass index (BMI), high total cholesterol, physical inactivity, and high fasting glucose. Risk factor exposure and deaths by NCD category were projected to 2030. Eight simulated scenarios were also constructed to explore how premature mortality will be affected if the World Health Organization's targets for risk factors reduction are achieved by 2030.
If current trends for each risk factor continued to 2030, the total premature deaths from NCDs would increase from 3.11 million to 3.52 million, but the premature mortality rate would decrease by 13.1%. In the combined scenario in which all risk factor reduction targets are achieved, nearly one million deaths among persons 30 to 70 years old due to NCDs would be avoided, and the one-third reduction goal would be achieved for all NCDs combined. More specifically, the goal would be achieved for CVD and chronic respiratory diseases, but not for cancer and diabetes. Reduction in the prevalence of high SBP, smoking, and high BMI played an important role in achieving the goals.
Reaching the goal of a one-third reduction in premature mortality from NCDs is possible by 2030 if certain targets for risk factor intervention are reached, but more efforts are required to achieve risk factor reduction.
联合国2030年可持续发展目标包括将非传染性疾病(NCDs)导致的过早死亡率降低三分之一。为评估该目标在中国的可行性,我们预测了在不同风险因素降低情景下2030年非传染性疾病的过早死亡率。
我们使用《2013年全球疾病负担研究》中的中国结果作为预测的实证数据。提取了1990年至2013年心血管疾病(CVD)、糖尿病、慢性呼吸道疾病、癌症和其他非传染性疾病的死亡人数以及人口数量。我们将死亡人数分解为可归因和不可归因于高收缩压(SBP)、吸烟、高体重指数(BMI)、高总胆固醇、缺乏身体活动和高空腹血糖的部分。将按非传染性疾病类别划分的风险因素暴露情况和死亡人数预测到2030年。还构建了八个模拟情景,以探讨如果到2030年实现世界卫生组织的风险因素降低目标,过早死亡率将受到何种影响。
如果每个风险因素的当前趋势持续到2030年,非传染性疾病导致的过早死亡总数将从311万增加到352万,但过早死亡率将下降13.1%。在所有风险因素降低目标均实现的综合情景下,30至70岁人群中因非传染性疾病导致的近100万例死亡将得以避免,所有非传染性疾病合并计算的降低三分之一的目标将得以实现。更具体地说,心血管疾病和慢性呼吸道疾病的目标将得以实现,但癌症和糖尿病的目标无法实现。高收缩压、吸烟和高体重指数患病率的降低在实现这些目标中发挥了重要作用。
如果达到某些风险因素干预目标,到2030年有可能实现将非传染性疾病过早死亡率降低三分之一的目标,但需要做出更多努力来降低风险因素。