Yang Junting, Deng Siwei, Zhao Houyu, Sun Feng, Zou Xiaotong, Ji Linong, Zhan Siyan
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100871, China.
Health Data Sci. 2024 Dec 17;4:0210. doi: 10.34133/hds.0210. eCollection 2024.
Early-onset type 2 diabetes (T2D) is an increasingly serious public health issue, particularly in China. This study aimed to analyze the characteristics of disease burden, secular trend, and attributable risk factors of early-onset T2D in China. Using data from the Global Burden of Disease (GBD) 2021, we analyzed the age-standardized rate (ASR) of incidence, disability-adjusted life years (DALYs), and mortality rates of T2D among individuals aged 15 to 39 years in China from 1990 to 2021. Joinpoint regression analysis was employed to analyze secular trend, calculating the average annual percent change (AAPC). We also examined changes in the proportion of early-onset T2D within the total T2D burden and its attributable risk factors. From 1990 to 2021, the ASR of incidence of early-onset T2D in China increased from 140.20 [95% uncertainty interval (UI): 89.14 to 204.74] to 315.97 (95% UI: 226.75 to 417.55) per 100,000, with an AAPC of 2.67% (95% CI: 2.60% to 2.75%, < 0.001). DALYs rose from 116.29 (95% UI: 78.51 to 167.05) to 267.47 (95% UI: 171.08 to 387.38) per 100,000, with an AAPC of 2.75% (95% CI: 2.64% to 2.87%, < 0.001). Mortality rates slightly decreased from 0.30 (95% UI: 0.24 to 0.38) to 0.28 (95% UI: 0.23 to 0.34) per 100,000, with an AAPC of -0.22% (95% CI: -0.33% to -0.11%, < 0.001). The 15 to 19 years age group showed the fastest increase in incidence (AAPC: 4.08%, 95% CI: 3.93% to 4.29%, < 0.001). The burden was consistently higher and increased more rapidly among males compared to females. The proportion of early-onset T2D within the total T2D burden fluctuated but remained higher than global levels. In 2021, high body mass index (BMI) was the primary attributable risk factor for DALYs of early-onset T2D (59.85%, 95% UI: 33.54% to 76.65%), and its contribution increased substantially from 40.08% (95% UI: 20.71% to 55.79%) in 1990, followed by ambient particulate matter pollution (14.77%, 95% UI: 8.24% to 21.24%) and diet high in red meat (9.33%, 95% UI: -1.42% to 20.06%). The disease burden of early-onset T2D in China is rapidly increasing, particularly among younger populations and males. Despite a slight decrease in mortality rates, the continued rapid increase in incidence and DALYs indicates a need for strengthened prevention and management strategies, especially interventions targeting younger age groups. High BMI and environmental pollution emerge as primary risk factors and should be prioritized in future interventions.
早发型2型糖尿病（T2D）是一个日益严重的公共卫生问题，在中国尤为如此。本研究旨在分析中国早发型T2D的疾病负担特征、长期趋势及可归因风险因素。利用全球疾病负担（GBD）2021的数据，我们分析了1990年至2021年中国15至39岁人群中T2D的年龄标准化发病率（ASR）、伤残调整生命年（DALYs）和死亡率。采用Joinpoint回归分析来分析长期趋势，计算平均年度百分比变化（AAPC）。我们还研究了早发型T2D在总T2D负担中的比例变化及其可归因风险因素。1990年至2021年，中国早发型T2D的发病率ASR从每10万人140.20[95%不确定区间（UI）：89.14至204.74]增至315.97（95%UI：226.75至417.55），AAPC为2.67%（95%CI：2.60%至2.75%，<0.001）。DALYs从每10万人116.29（95%UI：78.51至167.05）增至267.47（95%UI：171.08至387.38），AAPC为2.75%（95%CI：2.64%至2.87%，<0.001）。死亡率从每10万人0.30（95%UI：0.24至0.38）略有下降至0.28（95%UI：0.23至0.34），AAPC为-0.22%（95%CI：-0.33%至-0.11%，<0.001）。15至19岁年龄组的发病率增长最快（AAPC：4.08%，95%CI：3.93%至4.29%，<0.001）。男性的负担始终高于女性，且增长更快。早发型T2D在总T2D负担中的比例有所波动，但仍高于全球水平。2021年，高体重指数（BMI）是早发型T2D的DALYs的主要可归因风险因素（59.85%，95%UI：33.54%至76.65%），其贡献从1990年的40.08%（95%UI：20.71%至55.79%）大幅增加，其次是环境细颗粒物污染（14.77%，95%UI：8.24%至21.24%）和红肉含量高的饮食（9.33%，95%UI：-1.42%至20.06%）。中国早发型T2D的疾病负担正在迅速增加，尤其是在年轻人群和男性中。尽管死亡率略有下降，但发病率和DALYs的持续快速增长表明需要加强预防和管理策略，特别是针对年轻年龄组的干预措施。高BMI和环境污染成为主要风险因素，应在未来干预中予以优先考虑。
