1990 年至 2019 年归因于高低密度脂蛋白胆固醇的全球疾病负担。

The Global Burden of Diseases attributed to high low-density lipoprotein cholesterol from 1990 to 2019.

机构信息

Department of Medical Geriatrics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Public Health. 2022 Aug 16;10:891929. doi: 10.3389/fpubh.2022.891929. eCollection 2022.

BACKGROUND

To demonstrate the real-word situation of burdens that are attributed to the risk factor of high low-density lipoprotein cholesterol (LDL-C) at the global, regional, national levels, among different age groups and between genders.

METHODS

We analyzed data from the Global Burden of Disease study 2019 related to global deaths, disability-adjusted life years (DALYs), summary exposure value (SEV), average annual percentage change (AAPC), and observed to expected ratios (O/E ratios) attributable to high LDL-C from 1990 to 2019.

RESULTS

Globally, in 2019, the total numbers of deaths and DALYs attributed to high LDL cholesterol were 1.47 and 1.41 times higher than that in 1990. The age-standardized deaths and DALYs rate was 1.45 and 1.70 times in males compared to females, while the age-standardized SEVs rate was 1.10 times in females compared to males. The deaths, DALYs, and SEV rates increased with age. In 2019, the highest age-standardized rates of both deaths and DALYs occurred in Eastern Europe while the lowest occurred in high-income Asia Pacific. High-income North America experienced a dramatic reduction of risk related to high LDL-C. Correlation analysis identified that the age-standardized SEV rate was positively correlated with Socio-demographic Index (SDI; = 0.7753, < 0.001). The average annual percentage change (AAPC) of age-standardized SEV rate decreased in the high SDI and high-middle SDI regions but increased in the middle SDI, low-middle SDI, and low SDI regions. High LDL-C mainly contributed to ischemic heart diseases.

CONCLUSION

High LDL-C contributed considerably to health burden worldwide. Males suffered worse health outcomes attributed to high LDL-C when compared to females. The burden attributed to high LDL-C increased with age. Lower SDI regions and countries experienced more health problem challenges attributed to high LDL-C as the result of social development and this should be reflected in policymaking.

背景

为了在全球、区域和国家各级、不同年龄组和性别之间展示归因于高 LDL-C（低密度脂蛋白胆固醇）风险因素的负担的实际情况。

方法

我们分析了 2019 年全球疾病负担研究中与全球死亡人数、伤残调整生命年（DALYs）、综合暴露值（SEV）、年平均百分比变化（AAPC）和归因于高 LDL-C 的观察到的与预期比值（O/E 比值）相关的数据，这些数据来自 1990 年至 2019 年。

结果

全球范围内，2019 年归因于高 LDL 胆固醇的死亡人数和 DALYs 总数分别比 1990 年增加了 1.47 倍和 1.41 倍。与女性相比，男性的年龄标准化死亡率和 DALYs 率分别为 1.45 倍和 1.70 倍，而女性的年龄标准化 SEV 率则为 1.10 倍。死亡率、DALYs 和 SEV 率随年龄增长而增加。2019 年，东欧的年龄标准化死亡率和 DALYs 率最高，而高收入亚太地区的死亡率和 DALYs 率最低。高收入北美地区与高 LDL-C 相关的风险显著降低。相关分析发现，年龄标准化 SEV 率与社会人口指数（SDI）呈正相关（ = 0.7753， < 0.001）。高 SDI 和高-中 SDI 地区的年龄标准化 SEV 率的年平均百分比变化（AAPC）下降，但中 SDI、中-低 SDI 和低 SDI 地区的 AAPC 则增加。高 LDL-C 主要导致缺血性心脏病。