1990 年至 2019 年中国 1 型和 2 型糖尿病死亡率的世俗发病趋势及人口老龄化的影响：来自 2019 年全球疾病负担研究的发现。
Secular incidence trends and effect of population aging on mortality due to type 1 and type 2 diabetes mellitus in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019.
机构信息
Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, China.
Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, New Jersey, USA.
出版信息
BMJ Open Diabetes Res Care. 2021 Nov;9(2). doi: 10.1136/bmjdrc-2021-002529.
INTRODUCTION
Diabetes and population aging have become public health issues of global concern. The secular incidence trends and the impact of population aging on mortality due to type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in China remain unclear.
RESEARCH DESIGN AND METHODS
The incidence and mortality rates of T1DM and T2DM from 1990 to 2019 were abstracted from the Global Burden of Disease Study (GBD) 2019 database. Joinpoint regression and age-period-cohort models were used to calculate the average annual percentage change and relative risk (RR), respectively. A decomposition method was used to attribute changes in total deaths to population growth, population aging, and the mortality rate change from 1990 to 2019.
RESULTS
From 1990 to 2019, the T1DM age-standardized incidence rate (ASIR) increased by 2.01% (95% CI 1.78% to 2.23%) in males and 1.70% (1.61% to 1.80%) in females, and the T1DM age-standardized mortality rate (ASMR) decreased by 1.96% (-2.22% to -1.71%) in males and 4.02% (-4.48% to -3.57%) in females. The T2DM ASIR increased by 0.81% (0.62% to 0.99%) in males and 0.37% (0.16% to 0.58%) in females, and the T2DM ASMR increased by 1.06% (0.87% to 1.25%) in males and decreased by 0.24% (-0.54% to 0.07%) in females. Compared with 1990, the proportions of deaths attributed to population aging ranged from 18.85% (T1DM) to 148.21% (T2DM) for males and 29.80% (T1DM) to 118.82% (T2DM) for females in 2019.
CONCLUSIONS
The T1DM and T2DM incidence rates continually increased in China, particularly among young individuals. T1DM-related mortality decreased, while T2DM-related mortality increased in males. Population aging might be associated with a substantial change in the number of deaths from 1990 to 2019. To address the increase in T2DM-related deaths due to population aging, policymakers should promote aging-related health research and implement proven, cost-effective T2DM interventions.
简介
糖尿病和人口老龄化已成为全球关注的公共卫生问题。中国 1 型糖尿病（T1DM）和 2 型糖尿病（T2DM）的发病率变化趋势及其对死亡率的影响随人口老龄化的变化尚不清楚。
研究设计和方法
从全球疾病负担研究（GBD）2019 数据库中提取了 1990 年至 2019 年 T1DM 和 T2DM 的发病率和死亡率。使用 Joinpoint 回归和年龄-时期-队列模型分别计算平均年百分比变化和相对风险（RR）。采用分解方法将总死亡人数的变化归因于人口增长、人口老龄化以及 1990 年至 2019 年死亡率的变化。
结果
1990 年至 2019 年，男性 T1DM 年龄标准化发病率（ASIR）增加了 2.01%（95%CI 1.78%至 2.23%），女性增加了 1.70%（1.61%至 1.80%），男性 T1DM 年龄标准化死亡率（ASMR）下降了 1.96%（-2.22%至-1.71%），女性下降了 4.02%（-4.48%至-3.57%）。男性 T2DM ASIR 增加了 0.81%（0.62%至 0.99%），女性增加了 0.37%（0.16%至 0.58%），男性 T2DM ASMR 增加了 1.06%（0.87%至 1.25%），女性减少了 0.24%（-0.54%至 0.07%）。与 1990 年相比，2019 年男性 T1DM 的归因于人口老龄化的死亡比例为 18.85%（T1DM）至 148.21%（T2DM），女性为 29.80%（T1DM）至 118.82%（T2DM），而女性的比例为 29.80%（T1DM）至 118.82%（T2DM）。
结论
中国 T1DM 和 T2DM 的发病率持续上升，尤其是在年轻人中。T1DM 相关死亡率下降，而男性 T2DM 相关死亡率上升。人口老龄化可能与 1990 年至 2019 年死亡人数的大量变化有关。为了应对因人口老龄化导致的 T2DM 相关死亡人数的增加，政策制定者应促进与老龄化相关的健康研究，并实施经过验证的、具有成本效益的 T2DM 干预措施。
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