Department of Public Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
PECEM (MD/PhD), School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
Sci Rep. 2022 Jun 2;12(1):9190. doi: 10.1038/s41598-022-12831-z.
Diabetes mellitus (DM) is currently one of the leading causes of mortality worldwide. However, the disease evolves differently across countries. This study intends to characterize the trends and assess the potential effects of marginalization on DM mortality between 1990 and 2019 in Mexico. We analyzed death certificates that listed DM as the underlying cause of death (N = 1,907,173), as well as the extent to which DM mortality changes were associated with marginalization through an age-period-cohort analysis. DM mortality increased in Mexico between 1990 and 2019; the change was faster in the first half and slowed down after 2004. The highest marginalization quintiles drove the changes in DM mortality trends during the study period, with a higher risk of dying in these quintiles as age increased. In recent cohorts, the highest marginalization quintiles doubled the risk of dying from DM as compared to the lowest. Renal complications was the main death driver among persons with DM, with a marked increase between 1999 and 2001. In conclusion, Mexico continues to have a substantially high DM mortality, but its pace slowed over time. Moreover, subnational differences in marginalization can partially explain such a trend.
糖尿病（DM）目前是全球主要的死亡原因之一。然而，这种疾病在不同国家的表现方式不同。本研究旨在描述 1990 年至 2019 年期间墨西哥 DM 死亡率的趋势，并评估边缘化对其的潜在影响。我们分析了将 DM 列为根本死因的死亡证明（N=1,907,173），以及通过年龄-时期-队列分析，DM 死亡率的变化与边缘化程度之间的关联程度。1990 年至 2019 年期间，墨西哥的 DM 死亡率呈上升趋势；前半期的变化速度较快，2004 年后放缓。在研究期间，最高边缘化五分位数推动了 DM 死亡率趋势的变化，随着年龄的增长，这些五分位数的死亡风险更高。在最近的队列中，与最低五分位数相比，最高五分位数的 DM 死亡率风险增加了一倍。DM 患者的主要死亡原因是肾脏并发症，其死亡率在 1999 年至 2001 年间显著上升。总之，墨西哥的 DM 死亡率仍然很高，但随着时间的推移，其速度有所放缓。此外，边缘化的次国家级差异可以部分解释这种趋势。
