Department of Medical Record, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
Department of Hepatobiliary Surgery, Baogang Hospital of Inner Mongolia, Baotou, 014010, China.
Nutr Diabetes. 2024 Aug 3;14(1):59. doi: 10.1038/s41387-024-00321-2.
Due to the essential role of calcium in vital biological functions, diet low in calcium (DLC) is associated with various diseases. However, there is a lack of study about the current prevalence and health burden due to DLC using reliable data sources.
We used data from the Global Burden of Disease study 2019 (GBD 2019) to estimate the prevalence and health burden of DLC in 204 countries from 1990 to 2019, by age, sex, and sociodemographic index (SDI). The estimates were produced in DisMod-MR 2.1, a Bayesian meta-regression tool. Summary exposure value (SEV) was used to show the prevalence of DLC, while diseases adjusted life year (DALY) was used to represent the disease burden. The disease burden was estimated for DLC-induced colorectal cancer. Spearman Rank Order correlation was used for correlation analysis, and estimated annual percentage (EAPC) was used to reflect the temporal trends.
From 1990 to 2019, the global prevalence of DLC decreased (EAPC of SEV, -0.47; 95% CI, -0.5 to -0.43), but have increased in Oceania region and in many countries, such as United Arab Emirates, New Zealand, Japan, and France. The global DALYs associated with low in calcium were estimated to be 3.14 million (95% uncertainty interval (UI), 2.25-4.26 million) in 2019, with an age standardized rate of 38.2 (95% UI, 27.2-51.8) per 100,000. Unlike the prevalence, the global age standardized DALY rates has remained unchanged (EAPC, -0.03; 95% CI, -0.12 to 0.07), but has increased in over 80 of the 204 countries, located mainly in Asia, Africa, and South America. In all years and regions, the age standardized SEV and DALY rates were higher in male people than that in female people. The prevalence (rho = -0.823; P < 0.001) and disease burden (rho = -0.433; P < 0.001) associated with diet in low calcium were strongly correlated to SDI. The prevalence decreased with age, but the DALY rates increased with age and peaked at about 90 years. The prevalence of DLC has decreased worldwide and in most countries, but the disease burden of DLC induced colorectal cancer has increased in over 40% of countries worldwide.
Countries with low sociodemographic level and male people are more likely to experience the risk of DLC and related disease burden. Related measures in improve dietary calcium intake are in need to address diet in low calcium related health problems.
由于钙在重要的生物功能中起着至关重要的作用，低钙饮食（DLC）与各种疾病有关。然而，由于缺乏可靠数据源的 DLC 当前流行率和健康负担的研究。
我们使用来自 2019 年全球疾病负担研究（GBD 2019）的数据，通过年龄、性别和社会人口指数（SDI），在 204 个国家/地区估计 1990 年至 2019 年期间 DLC 的流行率和健康负担。估计结果是在贝叶斯荟萃回归工具 DisMod-MR 2.1 中生成的。汇总暴露值（SEV）用于显示 DLC 的流行率，而疾病调整生命年（DALY）用于表示疾病负担。估计了 DLC 诱导的结直肠癌的疾病负担。Spearman 秩相关用于相关性分析，估计年度百分比（EAPC）用于反映时间趋势。
1990 年至 2019 年，全球 DLC 的流行率下降（SEV 的 EAPC，-0.47；95%CI，-0.5 至-0.43），但在大洋洲地区和许多国家/地区有所增加，如阿拉伯联合酋长国、新西兰、日本和法国。2019 年，全球与低钙相关的 DALY 估计为 314 万（95%不确定区间（UI），225 至 426 万），年龄标准化率为 38.2（95%UI，27.2 至 51.8）/100,000。与流行率不同，全球年龄标准化 DALY 率保持不变（EAPC，-0.03；95%CI，-0.12 至 0.07），但在 204 个国家/地区中的 80 多个国家/地区有所增加，主要位于亚洲、非洲和南美洲。在所有年份和地区，男性的年龄标准化 SEV 和 DALY 率均高于女性。与低钙饮食相关的流行率（rho=−0.823；P<0.001）和疾病负担（rho=−0.433；P<0.001）与 SDI 密切相关。流行率随年龄下降，但 DALY 率随年龄增长而增加，在约 90 岁时达到峰值。全球范围内 DLC 的流行率有所下降，在大多数国家/地区也是如此，但 DLC 诱导的结直肠癌相关疾病负担在全球 40%以上的国家/地区有所增加。
社会人口水平较低和男性的国家/地区更有可能面临 DLC 风险和相关疾病负担。需要采取改善饮食钙摄入量的相关措施来解决与 DLC 相关的健康问题。
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