中国铅暴露所致心血管疾病负担：1990年至2019年数据的综合分析
Burden of cardiovascular disease attributable to lead exposure in China: a comprehensive analysis of data from 1990 to 2019.
作者信息
Zhao Jian, Yang Hui
机构信息
Department of Cardiology, The Second Affiliated Hospital of Shandong First Medical University Tai'an, Shandong, China.
Department of Pathology, The Second Affiliated Hospital of Shandong First Medical University Tai'an, Shandong, China.
出版信息
Am J Transl Res. 2024 Sep 15;16(9):4959-4966. doi: 10.62347/CJBO5822. eCollection 2024.
OBJECTIVE
To analyze the burden of cardiovascular disease (CVD) caused by lead pollution exposure in China from 1990 to 2019.
METHODS
Utilizing data from the Global Burden of Disease 2019 (GBD 2019), this research examines the changes in the number of CVD deaths, deaths rates, disability-adjusted life years (DALYs) and DALY rates, as well as their age-normalization rates, due to lead pollution exposure in China from 1990 to 2019. Joinpoint was used to estimate average annual percentage of change (AAPC) and reflect the time change trend of the burden of CVD caused by lead pollution exposure in China, the world and different socio-demographic index (SDI) regions.
RESULTS
The age-standardized mortality rate and age-standardized DALY rate showed a decreasing trend in China from 1990 to 2019, with an average annual decrease of -1.17% (95% confidence interval (CI): -3.49-3.14, P<0.05) and -1.90% (95% CI: -2.04-1.75, P<0.05), respectively. In 2019, age-standardized CVD mortality and DALY rates attributed to lead exposure in China were higher than those in the global, high-SDI, medium-high SDI and moderate SDI regions. In 2019, 5.94% of CVD deaths in China were caused by lead exposure. Compared to 1990, the number of attributable deaths and mortality increased by 0.73% and 0.44%, respectively, and the attributable DALY and DALY rates increased by 30.04% and 8.22%, respectively. From 1990 to 2019, the mortality rate and DALY rate of males were higher than those of females, and the mortality rate and DALY rate increased with the increase of age, reaching the highest in the age group of 70 years and above.
CONCLUSION
In 2019, the standardized death rate of CVD and the standardized DALY rate attributed to lead pollution exposure in China were higher than those in the global regions with high SDI, medium-high SDI and medium SDI. The findings highlight demographic disparities in CVD deaths and DALYs attributable to lead exposure, with males and the elderly identified as high-risk groups.
目的
分析1990年至2019年中国铅污染暴露所致心血管疾病（CVD）负担。
方法
利用2019年全球疾病负担（GBD 2019）的数据，本研究考察了1990年至2019年中国因铅污染暴露导致的CVD死亡人数、死亡率、伤残调整生命年（DALYs）和DALY率的变化，以及它们的年龄标准化率。采用Joinpoint估计年均变化百分比（AAPC），以反映中国、全球及不同社会人口指数（SDI）地区铅污染暴露所致CVD负担的时间变化趋势。
结果
1990年至2019年，中国年龄标准化死亡率和年龄标准化DALY率呈下降趋势，年均下降率分别为-1.17%（95%置信区间（CI）：-3.49-3.14，P<0.05）和-1.90%（95%CI：-2.04-1.75，P<0.05）。2019年，中国因铅暴露导致的年龄标准化CVD死亡率和DALY率高于全球、高SDI、中高SDI和中等SDI地区。2019年，中国5.94%的CVD死亡由铅暴露所致。与1990年相比，归因死亡人数和死亡率分别增加了0.73%和0.44%，归因DALY和DALY率分别增加了30.04%和8.22%。1990年至2019年，男性的死亡率和DALY率高于女性，且死亡率和DALY率随年龄增长而增加，在70岁及以上年龄组达到最高。
结论
2019年，中国因铅污染暴露导致的CVD标准化死亡率和标准化DALY率高于高SDI、中高SDI和中等SDI的全球地区。研究结果凸显了因铅暴露导致的CVD死亡和DALYs的人口统计学差异，男性和老年人被确定为高危人群。
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