Zhang Yue, Luo Zheng, Yi Juan, Zhu Junjie, Qiu Yun, Xu Xiaoyun, Xie Wanying, Wu Jinyi, Lv Huihui, Mou Changhua, Zhang Wei, Li Xiaopan
Key Laboratory of Coal Environmental Pathogenicity and Prevention, Ministry Education, Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China.
Department of Neurology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
Front Nutr. 2023 Jul 26;10:1235271. doi: 10.3389/fnut.2023.1235271. eCollection 2023.
This study aimed to compare the burden and trends of stroke attributed to dietary risk factors in the Belt and Road ("B&R") countries from 1990 to 2019.
The 2019 Global Burden of Disease (GBD) Study was used to gather information on the burden of stroke attributable to dietary risk factors. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs) were determined in 1990 and 2019 among the "B&R" countries. The average annual percent change (AAPC) was used to analyze the temporal trends of diet-induced stroke DALYs from 1990 to 2019 and in the final decade (2010-2019) by Joinpoint regression analysis.
In 2019, the absolute number of stroke deaths and DALYs attributable to dietary risk factors were 671,872 cases (95% UI 436,354-937,093) and 1.67 million cases (95% UI 1.15-2.24) in China. We found geographical differences in mortality and DALYs of diet-attributable stroke among member countries, with Bulgaria, Hungary and Serbia being the three highest countries in 1990, Bulgaria, North Macedonia and Montenegro in Central Asia in 2019. The ASRs of diet-induced stroke mortality and DALYs were generally declining in most member states from 1990 to 2019, however, the corresponding metrics in Mongolia remained high. The fastest decline in ASR of mortality and DALYs for diet-induced stroke was seen in Estonia, Eastern Europe, with AAPC values of -7.09% (95%CI: -7.72, -6.46%) and - 6.62% (95%CI: -7.20, -6.03%), respectively. We noted a substantial downward trend in ASR of mortality and DALYs from diet-induced stroke changes in the final decade (2010-2019) for most member states. The ASR of DALYs for diet-induced stroke decreased greater in females than in males. For those aged 50-74, the DALYs for stroke due to dietary risk factors in all other member countries of the "B&R" showed a decreasing trend, except for the Philippines, which rose (AAPC = 2.13, 95%CI: 1.40-2.87%) and Turkmenistan, which remained stable (AAPC = 0.05, 95%CI: -0.43-0.33%).
The burden of diet-induced stroke varies substantially across "B&R" countries and threaten public health, relevant evidence-based policies and interventions should be adopted to address the future burden of stroke in "B&R" countries through extensive collaboration.
本研究旨在比较1990年至2019年期间“一带一路”（“B&R”）国家中归因于饮食风险因素的中风负担及趋势。
利用2019年全球疾病负担（GBD）研究收集归因于饮食风险因素的中风负担信息。确定了1990年和2019年“一带一路”国家中死亡人数、年龄标准化率（ASRs）、伤残调整生命年（DALYs）。采用平均年度百分比变化（AAPC）通过Joinpoint回归分析来分析1990年至2019年以及最后十年（2010 - 2019年）饮食诱发中风DALYs的时间趋势。
2019年，在中国，归因于饮食风险因素的中风死亡绝对数和DALYs分别为671,872例（95% UI 436,354 - 937,093）和167万例（95% UI 115 - 224）。我们发现成员国中饮食归因中风的死亡率和DALYs存在地理差异，1990年最高的三个国家是保加利亚、匈牙利和塞尔维亚，2019年中亚地区是保加利亚、北马其顿和黑山。1990年至2019年期间，大多数成员国饮食诱发中风死亡率和DALYs的ASRs总体呈下降趋势，然而，蒙古的相应指标仍然很高。饮食诱发中风死亡率和DALYs的ASR下降最快的是东欧的爱沙尼亚，AAPC值分别为 - 7.09%（95%CI： - 7.72， - 6.46%）和 - 6.62%（95%CI： - 7.20， - 6.03%）。我们注意到在最后十年（2010 - 2019年），大多数成员国饮食诱发中风变化导致的死亡率和DALYs的ASR呈大幅下降趋势。饮食诱发中风DALYs的ASR在女性中下降幅度大于男性。对于50 - 74岁的人群，“一带一路”所有其他成员国中归因于饮食风险因素的中风DALYs呈下降趋势，但菲律宾上升（AAPC = 2.13，95%CI：1.40 - 2.87%），土库曼斯坦保持稳定（AAPC = 0.05，95%CI： - 0.43 - 0.33%）。
饮食诱发中风的负担在“一带一路”国家中差异很大并威胁公众健康，应通过广泛合作采取相关循证政策和干预措施来应对“一带一路”国家未来的中风负担。
