Wirth James P, Zeng Wu, Petry Nicolai, Rohner Fabian, Glenn Scott, Donkor William E S, Wegmüller Rita, Boy Erick, Lividini Keith
GroundWork, Fläsch, Switzerland.
School of Health, Georgetown University, Washington, DC, United States of America.
PLOS Glob Public Health. 2023 Mar 13;3(3):e0001353. doi: 10.1371/journal.pgph.0001353. eCollection 2023.
Non-communicable diseases (NCDs) account for the largest share of the global disease burden, and increasing evidence shows that zinc deficiency (ZD) contributes to NCDs by inducing oxidative stress, insulin resistance, and impaired lipid metabolism. A systematic review and meta-analysis was conducted to determine whether ZD was associated with fasting plasma glucose (FPG), a key risk factor for NCDs. A random effects meta-analysis was conducted to determine the strength of the association in the form of an odds ratio (OR) and subsequently the population attributable risk (PAR) with population prevalences of high FPG. The disease burden from high FPG attributable to ZD was expressed as disability adjusted life years (DALYS). Data from seven studies were obtained as part of the systematic review. The meta-analysis shows a significant (p<0.01) inverse relationship between ZD and high FPG (OR = 2.34; 95% CI: 1.16, 4.72). Globally, the PAR of ZD's contribution to high FPG is 6.7%, with approximately 8.2 million high FPG DALYs attributable to ZD. Cardiovascular diseases, diabetes, and chronic kidney diseases account for more than 90% of the total DALYs. Total DALYs attributable to ZD are largest in the "Southeast Asia, East Asia, and Oceania" and "High Income" Super Regions. While the disease burden is highest among populous countries (e.g., China, India, USA), the population-standardized DALYs are highest among island nations, particularly island nations in the South Pacific and Caribbean. While ZD accounts for a small share of the high FPG disease burden, the total number of DALYs far surpasses other estimates of the disease burden attributable to ZD, which focus on diarrheal diseases in childhood. Zinc interventions are urgently needed to help address the increasing disease burden from NCDs, and the double burden of malnutrition.
非传染性疾病（NCDs）在全球疾病负担中占比最大，越来越多的证据表明，锌缺乏（ZD）通过诱导氧化应激、胰岛素抵抗和脂质代谢受损，导致非传染性疾病。进行了一项系统综述和荟萃分析，以确定锌缺乏是否与空腹血糖（FPG）相关，空腹血糖是非传染性疾病的一个关键风险因素。进行了随机效应荟萃分析，以确定以比值比（OR）形式表示的关联强度，随后确定具有高FPG人群患病率的人群归因风险（PAR）。由锌缺乏导致的高FPG疾病负担以伤残调整生命年（DALYs）表示。作为系统综述的一部分，获得了七项研究的数据。荟萃分析显示，锌缺乏与高FPG之间存在显著的（p<0.01）负相关（OR = 2.34；95% CI：1.16，4.72）。在全球范围内，锌缺乏对高FPG的PAR为6.7%，约820万高FPG DALYs可归因于锌缺乏。心血管疾病、糖尿病和慢性肾脏病占总DALYs的90%以上。可归因于锌缺乏的总DALYs在“东南亚、东亚和大洋洲”以及“高收入”超级区域最大。虽然疾病负担在人口众多的国家（如中国、印度、美国）中最高，但人口标准化DALYs在岛国中最高，特别是南太平洋和加勒比地区的岛国。虽然锌缺乏在高FPG疾病负担中占比小，但DALYs总数远远超过其他归因于锌缺乏的疾病负担估计数，后者侧重于儿童腹泻疾病。迫切需要进行锌干预，以帮助应对非传染性疾病日益增加的疾病负担以及营养不良的双重负担。
