Liu S W, Cai Y, Zeng X Y, Yin P, Qi J L, Liu Y N, Liu J M, Zhao Z P, Zhang M, Wang L M, Wang L J, Xue M, Zhou M G
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Center for Health Statistical and Information, National Health and Family Planning Commission, Beijing 100044, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Aug 10;38(8):1022-1027. doi: 10.3760/cma.j.issn.0254-6450.2017.08.005.
To quantitatively estimate the deaths and life expectancy losses attributable to diet high in sodium in China, and examine the gains and shifts under different control scenarios of sodium consumption. Based on data from the cause-of-death through the National Mortality Surveillance System, and 24 hours urinary sodium values from Global Burden of Disease study on Chinese's estimates, population attributable fractions with the framework of comparative risk assessment were used to analyze the deaths and life expectancy losses due to diet high in sodium. The same methods were followed to examine the gains and shifts under different control scenarios of sodium consumption. In 2013, 1 430 (940 for men and 490 for women) thousand deaths were attributable to diet high in sodium, accounting for 15.6% (17.4% for men and 13.0% for women) of all-cause deaths in China, which causing 2.17 (2.49 for men and 1.71 for women) years of life expectancy loss. Diet with high sodium in 2013 caused 1 200, 50 and 180 thousand deaths from cardiovascular disease, chronic kidney disease and stomach cancer respectively, accounting for 31.5%, 30.8% and 64.8% of those specific causes. Comparing to the baseline in 2013, if the targets of 10% decrease of sodium consumption by 2020 and 15% by 2030 for Chinese chronic disease prevention and treatment planning, and 30% decrease by 2030 for WHO non-communicable disease monitoring framework are achieved, 220, 340 and 730 thousand deaths will be averted, which may gain 0.30, 0.45 and 0.95 years of life expectancy, respectively. As one of the leading risk factors, diet high in sodium had caused heavy burden of disease from cardiovascular disease, chronic kidney disease and stomach cancer on Chinese residents. Intervention programs on sodium-reduction are urgently needed in China and related cost-effectiveness is highly expected.
为定量评估中国高钠饮食所致的死亡和预期寿命损失,并考察不同钠摄入控制情景下的收益和变化情况。基于全国死因监测系统的死因数据以及全球疾病负担研究中关于中国人群估计的24小时尿钠值,采用比较风险评估框架下的人群归因分数来分析高钠饮食导致的死亡和预期寿命损失。采用相同方法考察不同钠摄入控制情景下的收益和变化情况。2013年,143万(男性94万,女性49万)例死亡归因于高钠饮食,占中国全死因死亡的15.6%(男性为17.4%,女性为13.0%),导致预期寿命损失2.17年(男性2.49年,女性1.71年)。2013年高钠饮食分别导致120万、5万和18万例心血管疾病、慢性肾脏病和胃癌死亡,分别占这些特定病因死亡的31.5%、30.8%和64.8%。与2013年基线相比,如果实现中国慢性病防治规划中到2020年钠摄入量降低10%、到2030年降低15%的目标,以及世界卫生组织非传染性疾病监测框架中到2030年降低30%的目标,将避免22万、34万和73万例死亡,分别可使预期寿命增加0.30年、0.45年和0.9年。作为主要危险因素之一,高钠饮食已给中国居民带来了心血管疾病、慢性肾脏病和胃癌的沉重疾病负担。中国迫切需要开展减钠干预项目,并高度期待相关的成本效益。