全球代谢性疾病负担，1990-2021 年。

Global burden of metabolic diseases, 1990-2021.

机构信息

Department of Medical Record, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Metabolism. 2024 Nov;160:155999. doi: 10.1016/j.metabol.2024.155999. Epub 2024 Aug 14.

DOI:10.1016/j.metabol.2024.155999

PMID:39151887

Abstract

BACKGROUND

Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hypercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global health burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) data enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, highlighting regional, temporal and differences by sex.

METHODS

Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD). Age-standardized DALYs (mortality) per 100,000 population and annual percentage change (APC) between 1990 and 2021 were estimated for trend analyses. Estimates are reported with uncertainty intervals (UI).

RESULTS

In 2021, among five common metabolic diseases, hypertension had the greatest burden (226 million [95 % UI: 190-259] DALYs), whilst T2DM (75 million [95 % UI: 63-90] DALYs) conferred much greater disability than MASLD (3.67 million [95 % UI: 2.90-4.61]). The highest absolute burden continues to be found in the most populous countries of the world, particularly India, China, and the United States, whilst the highest relative burden was mostly concentrated in Oceania Island states. The burden of these metabolic diseases has continued to increase over the past three decades but has varied in the rate of increase (1.6-fold to 3-fold increase). The burden of T2DM (0.42 % [95 % UI: 0.34-0.51]) and obesity (0.26 % [95 % UI: 0.17-0.34]) has increased at an accelerated rate, while the rate of increase for the burden of hypertension (-0.30 % [95 % UI: -0.34 to -0.25]) and hypercholesterolemia (-0.33 % [95 % UI: -0.37 to -0.30]) is slowing. There is no significant change in MASLD over time (0.05 % [95 % UI: -0.06 to 0.17]).

CONCLUSION

In the 21st century, common metabolic diseases are presenting a significant global health challenge. There is a concerning surge in DALYs and mortality associated with these conditions, underscoring the necessity for a coordinated global health initiative to stem the tide of these debilitating diseases and improve population health outcomes worldwide.

摘要

背景

在过去的三十年中，常见的代谢性疾病，如 2 型糖尿病（T2DM）、高血压、肥胖症、高胆固醇血症和代谢相关脂肪性肝病（MASLD），已成为全球健康负担。全球疾病、伤害和危险因素研究（GBD）的数据首次揭示了这些代谢性疾病从 1990 年到 2021 年的趋势和负担，突出了区域、时间和性别差异。

方法

对 GBD 2021 的常见代谢性疾病（T2DM、高血压、肥胖症、高胆固醇血症和 MASLD）的残疾调整生命年（DALYs）和死亡进行了全球估计。1990 年至 2021 年期间，按年龄标准化的每 10 万人 DALY（死亡率）和年变化百分比（APC）进行了趋势分析。估计值附有不确定性区间（UI）。

结果

在 2021 年，在五种常见代谢性疾病中，高血压的负担最大（2.26 亿[95% UI：1.90-2.59]DALY），而 T2DM（7500 万[95% UI：6300-9000]DALY）比 MASLD（367 万[95% UI：2900-4610]）导致更多的残疾。人口最多的国家的绝对负担仍然最大，特别是印度、中国和美国，而最高的相对负担主要集中在大洋洲岛国。这些代谢性疾病的负担在过去三十年中继续增加，但增加速度不同（增加 1.6 至 3 倍）。T2DM（0.42%[95% UI：0.34-0.51]）和肥胖症（0.26%[95% UI：0.17-0.34]）的负担增加速度加快，而高血压（-0.30%[95% UI：-0.34 至-0.25]）和高胆固醇血症（-0.33%[95% UI：-0.37 至-0.30]）的负担增加速度放缓。MASLD 随时间没有明显变化（0.05%[95% UI：-0.06 至 0.17]）。