Ding Yunfa, Deng Anxia, Qi Teng Fei, Yu Hao, Wu Liang Ping, Zhang Hongbin
Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asian, Department of Cardiology, the First Affiliated Hospital of Xinjiang Medical University, Clinical Medical Research Institute of Xinjiang Medical University, Urumqi, China.
Environ Health. 2025 Apr 22;24(1):23. doi: 10.1186/s12940-025-01155-w.
The purpose of this study was to quantify the global burden of ischemic heart disease associated with lead exposure, utilizing data from the Global Burden of Disease (GBD) Study, 2021.
Data on the burden of ischemic heart disease (IHD) associated with lead exposure were compiled globally from 1990 to 2021. These data were further stratified by dimensions including gender, age, GBD regions, and countries. Utilizing the Joinpoint regression model, we analyzed long-term trends in the burden of IHD disease associated with lead exposure and derived estimated annual percentage changes (EAPC). For future projections, we used an ARIMA model to predict potential trends in the burden of IHD disease associated with lead exposure over the next decade.
The study's findings reveal that in 2021, there were 590,370 deaths attributed to IHD (95% UI (Uncertainty interval (UI) is derived from the Bayesian school of statistical analysis used in the GBD studies. Unlike the frequency school of thought, which constructs confidence intervals (CI), the Bayesian school of thought views probability as a measure of confidence in an event, and in this approach the actual mean is viewed as a random variable dependent on the data and prior knowledge, with UI indicating that there is a specific probability (e.g., 95%) that the actual mean will fall within the interval.): -83,778 to 1,233,628) and 11,854,661 disability-adjusted life years (DALYs) (95% UI: -1,668,553 to 24,791,275) globally due to lead exposure, reflecting an increasing and then stabilizing trend from 1990 to 2021. Comparative analysis across study regions indicated a higher disease burden for IHD in regions with lower Socio-Demographic Index (SDI) values, contrasting with the lower burden in regions with higher SDI values. Furthermore, IHD mortality and DALYs peak in the 70-80 age cohort, with males exhibiting higher rates compared to females. Decadal projections indicate a downward trend in IHD mortality and DALYs for regions with higher SDI, in contrast to an anticipated upward trend in regions with lower SDI.
The global burden of ischemic heart disease associated with lead exposure is increasing, particularly in regions with low SDI values and within the elderly population. Considering the profound threat posed by lead exposure to the global burden of IHD, there is an imperative to consistently reinforce and execute robust prevention strategies to mitigate environmental lead exposure.
本研究旨在利用《2021年全球疾病负担研究》的数据，量化与铅暴露相关的缺血性心脏病的全球负担。
收集了1990年至2021年全球范围内与铅暴露相关的缺血性心脏病负担数据。这些数据进一步按性别、年龄、全球疾病负担（GBD）区域和国家等维度进行分层。利用Joinpoint回归模型，我们分析了与铅暴露相关的缺血性心脏病负担的长期趋势，并得出估计的年度百分比变化（EAPC）。对于未来预测，我们使用自回归积分移动平均（ARIMA）模型来预测未来十年与铅暴露相关的缺血性心脏病负担的潜在趋势。
该研究结果显示，2021年，全球因铅暴露导致590,370例缺血性心脏病死亡（95%不确定区间（UI）：-83,778至1,233,628）以及11,854,661伤残调整生命年（DALY）（95% UI：-1,668,553至24,791,275），反映出1990年至2021年呈先上升后稳定的趋势。跨研究区域的比较分析表明，社会人口指数（SDI）值较低的区域缺血性心脏病的疾病负担较高，而SDI值较高的区域负担较低。此外，缺血性心脏病死亡率和DALY在70至80岁年龄组达到峰值，男性患病率高于女性。十年预测表明，SDI较高的区域缺血性心脏病死亡率和DALY呈下降趋势，而SDI较低的区域预计呈上升趋势。
与铅暴露相关的缺血性心脏病的全球负担正在增加，特别是在SDI值较低的区域和老年人群中。鉴于铅暴露对全球缺血性心脏病负担构成的严重威胁，必须持续加强和实施强有力的预防策略，以减轻环境铅暴露。
