Cao Yu, Chen Huiting, Liu Hui, Wu Hao, Gao Wei
School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China.
Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University, Nanchang, China.
Diabetes Metab J. 2025 Jul;49(4):848-861. doi: 10.4093/dmj.2024.0593. Epub 2025 Mar 11.
Type 2 diabetes mellitus (T2DM) is a major cause of declining renal function.
Temporal trends in T2DM-related chronic kidney disease (CKD-T2DM) incidence across 204 countries and territories from 1992 to 2021 were analyzed using data from the Global Burden of Disease 2021. The impact of macro-factors (demographic change, age, period, and birth cohort) on CKD-T2DM incidence trends was assessed using decomposition analyses and age-period- cohort modeling, highlighting opportunities to improve incidence and reduce regional disparities.
In 2021, global CKD-T2DM incidence cases reached 2.01 million, a 150.92% increase since 1992, with population growth and aging contributing to 80% of this rise. The age-standardized incidence rate (ASIR) ranged from 15.09 per 100,000 in low sociodemographic index (SDI) regions to 23.07 in high SDI regions. China, India, the United States, and Japan have the most incidence cases, accounted for 69% of incidence cases globally. With 175 countries showing an increasing ASIR trend. Unfavorable trend in ASIR increase were generally found in most high-middle and middle SDI countries, such as China and Mexico (net drift=0.15% and 1.17%, per year). Age-period-cohort analyses indicated a high incidence risk near age 80, with worsening risks for recent periods and birth cohorts, except in high SDI areas.
The CKD-T2DM incidence burden continues to rise globally, with significant variations between countries, posing major global health implications. CKD-T2DM is largely preventable and treatable, warranting greater attention in global health policy, particularly for older populations and in low and middle SDI regions.
2型糖尿病(T2DM)是肾功能下降的主要原因。
利用2021年全球疾病负担数据,分析了1992年至2021年期间204个国家和地区T2DM相关慢性肾脏病(CKD-T2DM)的发病时间趋势。使用分解分析和年龄-时期-队列模型评估宏观因素(人口结构变化、年龄、时期和出生队列)对CKD-T2DM发病趋势的影响,突出改善发病率和减少地区差异的机会。
2021年,全球CKD-T2DM发病病例达201万例,自1992年以来增长了150.92%,其中人口增长和老龄化占增长的80%。年龄标准化发病率(ASIR)范围从社会人口学指数(SDI)低的地区每10万人15.09例到SDI高的地区每10万人23.07例。中国、印度、美国和日本发病病例最多,占全球发病病例的69%。175个国家的ASIR呈上升趋势。大多数高中等和中等SDI国家,如中国和墨西哥,ASIR呈不利的上升趋势(净漂移分别为每年0.15%和1.17%)。年龄-时期-队列分析表明,80岁左右发病风险较高,除高SDI地区外,近期和出生队列的风险呈恶化趋势。
全球CKD-T2DM发病负担持续上升,国家间存在显著差异,对全球健康具有重大影响。CKD-T2DM在很大程度上是可预防和可治疗的,值得在全球卫生政策中给予更多关注,特别是针对老年人群以及低和中等SDI地区。