Chew Nicholas W S, Chong Bryan, Kuo Si Min, Jayabaskaran Jayanth, Cai Mingshi, Zheng Huili, Goh Rachel, Kong Gwyneth, Chin Yip Han, Imran Syed Saqib, Liang Michael, Lim Patrick, Yong Thon Hon, Liew Boon Wah, Chia Pow Li, Ho Hee Hwa, Foo David, Khoo Deanna, Huang Zijuan, Chua Terrance, Tan Jack Wei Chieh, Yeo Khung Keong, Hausenloy Derek, Sim Hui Wen, Kua Jieli, Chan Koo Hui, Loh Poay Huan, Lim Toon Wei, Low Adrian F, Chai Ping, Lee Chi Hang, Yeo Tiong Cheng, Yip James, Tan Huay Cheem, Mamas Mamas A, Nicholls Stephen J, Chan Mark Y
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Department of Cardiology, National University Heart Centre, National University Health System, Singapore.
Lancet Reg Health West Pac. 2023 May 31;37:100803. doi: 10.1016/j.lanwpc.2023.100803. eCollection 2023 Aug.
Understanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI.
The incidence and mortality contributed by metabolic risk factors in the population with AMI (diabetes mellitus [T2DM], hypertension, hyperlipidemia, overweight/obesity, active/previous smokers) were projected up to year 2050, using linear and Poisson regression models based on the Singapore Myocardial Infarction Registry from 2007 to 2018. Forecast analysis was stratified based on age, sex and ethnicity.
From 2025 to 2050, the incidence of AMI is predicted to rise by 194.4% from 482 to 1418 per 100,000 population. The largest percentage increase in metabolic risk factors within the population with AMI is projected to be overweight/obesity (880.0% increase), followed by hypertension (248.7% increase), T2DM (215.7% increase), hyperlipidemia (205.0% increase), and active/previous smoking (164.8% increase). The number of AMI-related deaths is expected to increase by 294.7% in individuals with overweight/obesity, while mortality is predicted to decrease by 11.7% in hyperlipidemia, 29.9% in hypertension, 32.7% in T2DM and 49.6% in active/previous smokers, from 2025 to 2050. Compared with Chinese individuals, Indian and Malay individuals bear a disproportionate burden of overweight/obesity incidence and AMI-related mortality.
The incidence of AMI is projected to continue rising in the coming decades. Overweight/obesity will emerge as fastest-growing metabolic risk factor and the leading risk factor for AMI-related mortality.
This research was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03) and National Medical Research Council Research Training Fellowship (MOH-001131). The SMIR is a national, ministry-funded registry run by the National Registry of Diseases Office and funded by the Ministry of Health, Singapore.
了解急性心肌梗死（AMI）代谢危险因素的变化轨迹对医疗政策制定至关重要。我们估计了多民族AMI人群中代谢性疾病发病率的未来预测情况。
利用基于2007年至2018年新加坡心肌梗死登记处数据的线性和泊松回归模型，对AMI人群（糖尿病 [T2DM]、高血压、高脂血症、超重/肥胖、现吸烟者/既往吸烟者）中代谢危险因素导致的发病率和死亡率进行了预测，直至2050年。预测分析按年龄、性别和种族进行分层。
从2025年到2050年，预计AMI的发病率将从每10万人482例上升至1418例，增幅达194.4%。预计AMI人群中代谢危险因素增幅最大的是超重/肥胖（增加880.0%），其次是高血压（增加248.7%）、T2DM（增加215.7%）、高脂血症（增加205.0%）以及现吸烟者/既往吸烟者（增加164.8%）。从2025年到2050年，超重/肥胖个体中与AMI相关的死亡人数预计将增加294.7%，而高脂血症患者的死亡率预计将下降11.7%，高血压患者下降29.9%，T2DM患者下降32.7%，现吸烟者/既往吸烟者下降49.6%。与华人相比，印度人和马来人超重/肥胖发病率及与AMI相关的死亡率负担过重。
预计未来几十年AMI的发病率将持续上升。超重/肥胖将成为增长最快的代谢危险因素以及与AMI相关死亡率的主要危险因素。
本研究由NUHS种子基金（NUHSRO/2022/058/RO5+6/Seed-Mar/03）和国家医学研究理事会研究培训奖学金（MOH-001131）资助。新加坡心肌梗死登记处是一个由国家疾病登记办公室运营、新加坡卫生部资助的国家级、由政府部门资助的登记处。
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