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一项关于中国归因于代谢风险因素的阿尔茨海默病和其他痴呆症的全球疾病负担研究(GBD 2021)及到2045年的预测。

A GBD 2021 study of Alzheimer's disease and other dementias attributable to metabolic risk factors and forecasts to 2045 in China.

作者信息

Zhu Meng'en, Bi Zhimin, Zhou Shaoqiong, Li Wei

机构信息

Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Nephrology, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan University, Wuhan, China.

出版信息

Front Public Health. 2025 Apr 1;13:1575906. doi: 10.3389/fpubh.2025.1575906. eCollection 2025.

Abstract

BACKGROUND AND AIMS

High fasting plasma glucose (FPG) and body mass index (BMI) are recognized as significant metabolic risk factors for Alzheimer's disease (AD) and other dementias. This study assesses the burden of AD and other dementias attributable to these risks in China using Global Burden of Disease (GBD) 2021 data.

METHODS

We estimated deaths, disability-adjusted life-years (DALYs), years lived with disability (YLDs), and age-standardized rates of mortality (ASMR), DALYs (ASDR), and YLDs (ASYR) by age and sex. Temporal trends were analyzed via the average annual percentage change (AAPC), and Bayesian age-period-cohort (BAPC) models were applied to evaluate the effects of age, period, and cohort.

RESULTS

In 2021, China recorded 76,239.36 deaths (95% UI: 2,528.26-259,225.86) from AD and other dementias due to metabolic risks, a 4.7-fold increase from 1990. Females experienced more metabolic risk-related deaths [51,844.08 (95% UI, 1,457.44, 177,037.05)] than males. The ASMR, ASDR, and ASYR showed continuous increases from 1990 to 2021, with AAPC values of 1.03, 1.31, and 1.98%, respectively. A significant increasing trend was observed across age groups from 40 to 95 years, with percentages above 0. Females presented relatively higher risks than males after 1997-2001 and within the birth cohort groups of 1957-1966. The disease burden due to HBMI is expected to rise, while that due to HFPG will decline, notable sex will persist until 2045.

CONCLUSION

Monitoring trends is crucial for interventions to reduce the future disease burden, particularly among women and older populations in China, to guide healthcare resource allocation effectively.

摘要

背景与目的

空腹血糖(FPG)升高和体重指数(BMI)被认为是阿尔茨海默病(AD)和其他痴呆症的重要代谢风险因素。本研究利用《2021年全球疾病负担(GBD)》数据评估中国这些风险因素所致的AD和其他痴呆症负担。

方法

我们按年龄和性别估算了死亡人数、伤残调整生命年(DALYs)、带病生存年数(YLDs)以及年龄标准化死亡率(ASMR)、DALYs率(ASDR)和YLDs率(ASYR)。通过平均年度百分比变化(AAPC)分析时间趋势,并应用贝叶斯年龄-时期-队列(BAPC)模型评估年龄、时期和队列的影响。

结果

2021年,中国因代谢风险因素导致76239.36例AD和其他痴呆症死亡(95%不确定区间:2528.26 - 259,225.86),较1990年增长了4.7倍。女性因代谢风险相关死亡人数[51844.08(95%不确定区间,1457.44,177037.05)]多于男性。1990年至2021年,ASMR、ASDR和ASYR持续上升,AAPC值分别为1.03%、1.31%和1.98%。40至95岁各年龄组均呈现显著上升趋势,百分比均高于0。1997 - 2001年后以及1957 - 1966年出生队列组中,女性的风险相对高于男性。预计高BMI所致疾病负担将上升,而高FPG所致疾病负担将下降,显著的性别差异将持续到2045年。

结论

监测趋势对于采取干预措施以减轻未来疾病负担至关重要,尤其是在中国的女性和老年人群中,从而有效指导医疗资源的分配。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ff/11998917/cc00c679f6b9/fpubh-13-1575906-g001.jpg

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