Peng Wen, Chen Shiqi, Chen Xinguang, Ma Yue, Wang Tingting, Sun Xiaomin, Wang Yaogang, Ding Gangqiang, Wang Youfa
Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University; Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, Xining, Qinghai, China.
International Obesity and Metabolic Disease Research Center, Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Lancet Reg Health West Pac. 2023 Jun 20;43:100809. doi: 10.1016/j.lanwpc.2023.100809. eCollection 2024 Feb.
Prevention and control of non-communicable diseases (NCDs) are prioritized in both the Sustainable Development Goal and the Healthy China 2030 Initiatives. Efforts have been devoted to combating NCDs in China. This study examined changes in NCD trajectory.
We described and analyzed the trends in prevalence and control of major NCDs including obesity, hypertension, diabetes, and dyslipidemia and examined selected main behavioral risk factors in China by sex, age group, and residence using nationally representative CDC survey data. Data included were from the China Chronic Disease Risk Factor Surveillance (CCDRFS, 2013 and 2018) and China National Nutrition Survey (CNNS, 2002, 2010-2013, 2015, and 2020). Annual and relative changes in rates were used. Rural-urban ratio of related indicators was assessed.
NCD-attributed deaths increased from 80.0% in 2002 to 86.6% in 2012, and 88.5% in 2019, with cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes accounted for 47.1%, 24.1%, 8.8%, and 2.5% of deaths in 2019, respectively. Prevalence of obesity (7.1%-16.4%), overweight/obesity (29.9%-50.7%), hypertension (18.8%-27.5%), diabetes (2.6%-11.9%), and dyslipidemia (18.6%-35.6%) all increased from 2002 to 2018. These rates increased faster in rural areas than in urban areas. Rates of awareness, treatment and control of hypertension and diabetes increased very slowly from 2012 to 2018. Most rates were between 30 and 40% with the lowest rate of 11% for hypertension control even in 2018. The rates were worse for rural residents compared to urban residents. Furthermore, many modifiable behavioral risk factors showed little improvement and some became worse over time, including smoking, excessive alcohol use, inadequate vegetable/fruit intake, excessive red meat intake, and physical inactivity.
NCD burden in China increased during 2002-2019 despite of the intervention efforts. To reach the global and national targets, China must strengthen its actions, especially in rural areas, including improvement of NCD screening and management and reduction of behavioral risk factors.
The study was supported in part by research grants of National Key R&D Program of China (2017YFC0907200, 2017YFC0907201), International Collaboration Project from the Chinese Ministry of Science and Technology-Prevention and control of chronic diseases and health promotion (G2021170007L), Natural Scientific Foundation of China (82103846), Key R&D and Transformation Program of Qinghai (2023-QY-204).
非传染性疾病（NCDs）的预防和控制在可持续发展目标和《健康中国2030规划纲要》中均被列为优先事项。中国已致力于抗击非传染性疾病。本研究考察了非传染性疾病发展轨迹的变化。
我们利用具有全国代表性的疾病预防控制中心调查数据，按性别、年龄组和居住地描述并分析了肥胖、高血压、糖尿病和血脂异常等主要非传染性疾病的患病率和控制趋势，并考察了选定的主要行为风险因素。纳入的数据来自中国慢性病危险因素监测（CCDRFS，2013年和2018年）以及中国国家营养调查（CNNS，2002年、2010 - 2013年、2015年和2020年）。采用了发病率的年度变化和相对变化。评估了相关指标的城乡比率。
非传染性疾病所致死亡比例从2002年的80.0%增至2012年的86.6%，2019年为88.5%，2019年心血管疾病、癌症、慢性呼吸道疾病和糖尿病分别占死亡人数的47.1%、24.1%、8.8%和2.5%。2002年至2018年，肥胖（7.1% - 16.4%）、超重/肥胖（29.9% - 50.7%）、高血压（18.8% - 27.5%）、糖尿病（2.6% - 11.9%）和血脂异常（18.6% - 35.6%）的患病率均有所上升。农村地区这些发病率的增长速度快于城市地区。2012年至2018年，高血压和糖尿病的知晓率、治疗率和控制率增长非常缓慢。大多数比率在30%至40%之间，即使在2018年，高血压控制率最低为11%。农村居民的这些比率比城市居民更差。此外，许多可改变的行为风险因素几乎没有改善，有些随着时间推移变得更糟，包括吸烟、过量饮酒、蔬菜/水果摄入不足、红肉摄入过多以及身体活动不足。
尽管采取了干预措施，但2002 - 2019年期间中国的非传染性疾病负担仍有所增加。为实现全球和国家目标，中国必须加强行动，特别是在农村地区，包括改善非传染性疾病筛查和管理以及减少行为风险因素。
本研究部分得到了中国国家重点研发计划（2017YFC0907200，2017YFC0907201）、中国科学技术部国际合作项目 - 慢性病防控与健康促进（G2021170007L）、中国国家自然科学基金（82103846）、青海省重点研发与转化计划（2023 - QY - 204）的研究资助。
