Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China.
J Glob Health. 2024 Nov 8;14:04200. doi: 10.7189/jogh.14.04200.
High body mass index (BMI) has gradually become an increased risk factor for the global burden of diseases (GBD). As the disease burden and the number of elders globally increase, it is crucial for policymakers to realise the associations between high BMI and disease burden worldwide in a timely manner and to develop effective interventions for different countries and ages.
We used the GBD 2019 database to analyse the deaths and disability-adjusted life-years (DALYs) in the disease burden associated with high BMI and indicated the health inequality at the global, regional, and national levels. We applied the slope index of inequality and concentration index, two standard metrics of absolute and relative gradient inequality recommended by the World Health Organization (WHO), to quantify the distributive inequalities in the burden of diseases associated with high BMI. These rates were reported per 100 000 population as crude incidence rates, death rates, and DALYs rates. All the estimates were generated with a 95% uncertainty interval (UIs).
Globally, we revealed that an estimated age-standardised mortality rate associated with high BMI is 6.26 million (95% UIs = 3.99, 8.91). The age-standardised DALYs rate is 19.32 million (95% UIs = 12.77, 26.40), and the global population attributable fraction was 9% (95% UIs = 5, 12) in 2019. The largest number of high-BMI-related deaths in women mainly concentrated in the age group of 65-79 years, whereas the largest number in men was in the age group of 60-69 years. The age-standardised DALYs rate of diseases associated with high BMI was larger in the high-middle and middle socio-demographic index (SDI) (population attributable fraction (PAF) = 11 and PAF = 9) regions than those with high SDI (PAF = 1) and low SDI (PAF = 5) regions.
In this study, our results showed that the disease burden of global deaths and DALYs associated with high BMI has substantially increased between 1990-2019. Furthermore, we demonstrated that countries with higher SDI development levels shoulders higher burden of diseases associated with high BMI. Future policies to prevent and reduce the burden should be developed and implemented based on country-specific development status.
高身体质量指数（BMI）逐渐成为全球疾病负担（GBD）的一个危险因素。随着全球疾病负担和老年人数量的增加，政策制定者及时了解全球范围内高 BMI 与疾病负担之间的关联，并为不同国家和年龄段制定有效的干预措施至关重要。
我们使用 GBD 2019 数据库分析了与高 BMI 相关的疾病负担的死亡人数和伤残调整生命年（DALYs），并指出了全球、区域和国家各级的健康不平等情况。我们应用了不平等斜率指数和集中指数这两个世界卫生组织（WHO）推荐的衡量绝对和相对梯度不平等的标准指标，来量化与高 BMI 相关的疾病负担的分布不平等情况。这些比率以每 100000 人口的粗发病率、死亡率和 DALYs 率报告。所有估计均使用 95%置信区间（UI）生成。
在全球范围内，我们发现与高 BMI 相关的年龄标准化死亡率估计为 626 万（95%UI=399，891）。年龄标准化 DALYs 率为 1932 万（95%UI=1277，2640），全球归因分数为 9%（95%UI=5，12）。2019 年，女性中与高 BMI 相关的死亡人数最多，主要集中在 65-79 岁年龄组，而男性中死亡人数最多的年龄组为 60-69 岁。高-中社会人口指数（SDI）（归因分数（PAF）=11 和 PAF=9）地区与高 SDI（PAF=1）和低 SDI（PAF=5）地区相比，高 BMI 相关疾病的年龄标准化 DALYs 率更大。
在这项研究中，我们的结果表明，1990-2019 年期间，全球与高 BMI 相关的死亡人数和 DALYs 的疾病负担大幅增加。此外，我们表明，SDI 发展水平较高的国家承担着与高 BMI 相关的更高的疾病负担。未来应根据各国的发展状况制定和实施预防和减少负担的政策。
