The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Danyang, China.
Front Endocrinol (Lausanne). 2024 Aug 5;15:1408691. doi: 10.3389/fendo.2024.1408691. eCollection 2024.
Currently ischemic stroke poses a serious disease burden globally, and high fasting plasma glucose is one of the important risk factors. The aim of this study was to investigate the disease burden of ischemic stroke due to fasting glucose during 1990-2019 in China, to estimate the effect of age, period, and cohort on the trend of ischemic stroke disease burden, and to predict the disease burden of ischemic stroke in 2020-2030.
Ischemic stroke burden data were obtained by screening from the Global Burden of Disease Study 2019 (GBD 2019) database for high-risk populations in China. Annual average percentage change (AAPC) was calculated using the Joinpoint regression model to assess the trend of ischemic stroke burden between 1990 and 2019. Age-period-cohort models were introduced to estimate the independent effects of age, period, and cohort on ischemic stroke burden, and to predict the ischemic stroke burden in 2020-2030 based on Bayesian age-period-cohort models.
From 1990 to 2019, the number of ischemic stroke deaths due to high fasting plasma glucose in China continued to increase with an AAPC of 3.61. Trends in age-standardized incidence rates did not show statistical significance. In the age-period-cohort analysis, the age effect of ischemic stroke burden showed a continuously increasing trend over the study period. The period effect showed an overall favorable trend over the study period. The overall and cohort effects for males showed an overall increasing trend, whereas the cohort effect for females showed a decreasing trend after a decreasing trend for the 1945 birth cohort.
This study found that ischemic stroke due to high fasting plasma glucose in China has generally fluctuated between 1990 and 2019, with a decreasing trend in recent years, and projections also suggest that it will continue to show a decreasing trend in the future. Age and period of birth were the main elements influencing the burden of disease, especially among the elderly and men. Policies should be used to promote the prevention of known risk factors and to strengthen health management for key populations.
目前，缺血性脑卒中在全球造成了严重的疾病负担，而空腹血糖升高是重要的危险因素之一。本研究旨在探讨 1990 年至 2019 年期间中国因空腹血糖导致的缺血性脑卒中疾病负担情况，评估年龄、时期和队列效应对缺血性脑卒中疾病负担变化趋势的影响，并预测 2020 年至 2030 年的疾病负担。
通过从全球疾病负担研究 2019 年（GBD 2019）数据库中筛选中国高危人群，获取缺血性脑卒中负担数据。采用 Joinpoint 回归模型计算年平均变化百分比（AAPC），评估 1990 年至 2019 年缺血性脑卒中负担的变化趋势。引入年龄-时期-队列模型，估计年龄、时期和队列效应对缺血性脑卒中负担的独立影响，并基于贝叶斯年龄-时期-队列模型预测 2020 年至 2030 年的缺血性脑卒中负担。
1990 年至 2019 年，中国因空腹血糖升高导致的缺血性脑卒中死亡人数持续增加，AAPC 为 3.61。年龄标准化发病率的变化趋势没有统计学意义。在年龄-时期-队列分析中，缺血性脑卒中负担的年龄效应在研究期间呈持续增加趋势。时期效应在研究期间呈整体有利趋势。男性的整体和队列效应呈整体增加趋势，而女性的队列效应在 1945 年出生队列呈下降趋势后呈下降趋势。
本研究发现，中国因空腹血糖升高导致的缺血性脑卒中在 1990 年至 2019 年期间总体呈波动趋势，近年来呈下降趋势，预测未来也将继续呈下降趋势。年龄和出生时期是影响疾病负担的主要因素，特别是在老年人和男性中。应采取政策促进已知危险因素的预防，并加强重点人群的健康管理。
