Department of Geriatric Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
Department of Rehabilitation Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
BMC Public Health. 2024 Jul 8;24(1):1813. doi: 10.1186/s12889-024-19337-5.
The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019.
To describe burden, and to explore cross-country inequalities according to socio-demographic index (SDI) for stroke and subtypes attributable to diet.
Death and years lived with disability (YLDs) data and corresponding estimated annual percentage changes (EAPCs) were estimated by year, age, gender, location and SDI. Pearson correlation analysis was performed to evaluate the connections between age-standardized rates (ASRs) of death, YLDs, their EAPCs and SDI. We used ARIMA model to predict the trend. Slope index of inequality (SII) and relative concentration index (RCI) were utilized to quantify the distributive inequalities in the burden of stroke.
A total of 1.74 million deaths (56.17% male) and 5.52 million YLDs (55.27% female) attributable to diet were included in the analysis in 2019.Between 1990 and 2019, the number of global stroke deaths and YLDs related to poor diet increased by 25.96% and 74.76% while ASRs for death and YLDs decreased by 42.29% and 11.34% respectively. The disease burden generally increased with age. The trends varied among stroke subtypes, with ischemic stroke (IS) being the primary cause of YLDs and intracerebral hemorrhage (ICH) being the leading cause of death. Mortality is inversely proportional to SDI (R = -0.45, p < 0.001). In terms of YLDs, countries with different SDIs exhibited no significant difference (p = 0.15), but the SII changed from 38.35 in 1990 to 45.18 in 2019 and the RCI showed 18.27 in 1990 and 24.98 in 2019 for stroke. The highest ASRs for death and YLDs appeared in Mongolia and Vanuatu while the lowest of them appeared in Israel and Belize, respectively. High sodium diets, high red meat consumption, and low fruit diets were the top three contributors to stroke YLDs in 2019.
The burden of diet-related stroke and subtypes varied significantly concerning year, age, gender, location and SDI. Countries with higher SDIs exhibited a disproportionately greater burden of stroke and its subtypes in terms of YLDs, and these disparities were found to intensify over time. To reduce disease burden, it is critical to enforce improved dietary practices, with a special emphasis on mortality drop in lower SDI countries and incidence decline in higher SDI countries.
2019 年全球疾病、伤害和危险因素研究（GBD）。
描述负担，并根据社会人口指数（SDI）探索与饮食有关的中风和亚型的国家间不平等情况。
通过年份、年龄、性别、地点和 SDI 估计死亡和残疾生存年（YLDs）数据及其相应的年估计百分比变化（EAPC）。Pearson 相关分析用于评估死亡率、YLDs 及其 EAPC 与 SDI 之间的关系。我们使用 ARIMA 模型预测趋势。斜率指数不平等（SII）和相对集中指数（RCI）用于量化中风负担的分布不平等情况。
2019 年共纳入 174 万例与饮食相关的死亡（56.17%为男性）和 552 万例 YLDs（55.27%为女性）。1990 年至 2019 年间，全球与不良饮食相关的中风死亡人数和 YLDs 分别增加了 25.96%和 74.76%，而死亡率和 YLDs 的年龄标准化率（ASR）分别下降了 42.29%和 11.34%。疾病负担通常随年龄增长而增加。中风亚型的趋势有所不同，其中缺血性中风（IS）是 YLDs 的主要原因，而脑出血（ICH）是死亡的主要原因。死亡率与 SDI 呈负相关（R=−0.45，p<0.001）。就 YLDs 而言，不同 SDI 的国家之间没有显著差异（p=0.15），但 SII 从 1990 年的 38.35 变为 2019 年的 45.18，RCI 从 1990 年的 18.27 变为 2019 年的 24.98。死亡率和 YLDs 的 ASR 最高的国家是蒙古和瓦努阿图，而最低的是以色列和伯利兹。2019 年，高钠饮食、高红肉摄入和低水果饮食是中风 YLDs 的前三大原因。
与饮食相关的中风和亚型的负担在年份、年龄、性别、地点和 SDI 方面存在显著差异。SDI 较高的国家在 YLDs 方面的中风和亚型负担不成比例地更大，而且这些差异随着时间的推移而加剧。为了减轻疾病负担，必须加强改善饮食的实践，特别要关注低 SDI 国家的死亡率下降和高 SDI 国家的发病率下降。
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