美国年轻成年人中与2型糖尿病相关的死亡率上升：一项全国性分析。
Rising type 2 diabetes mellitus-related mortality among young adults in the United States: a nationwide analysis.
作者信息
Qamar Usama, Naeem Farhan, Asif Maaz, Qamar Waleed
机构信息
Department of Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905 USA.
Department of Medicine, King Edward Medical University, Lahore, Pakistan.
出版信息
J Diabetes Metab Disord. 2025 May 9;24(1):116. doi: 10.1007/s40200-025-01626-4. eCollection 2025 Jun.
BACKGROUND
Type 2 diabetes mellitus (T2DM) related mortality trends remain understudied among younger adults in the United States (US). This study aims to bridge this gap by using data from a large national database of mortality statistics.
METHODS
Death certificate data from 1999 to 2020 were extracted from the CDC WONDER database for all the fatalities among US adults aged 25 to 64 years, where T2DM was listed as the underlying or contributing cause of death. Age-adjusted mortality rates (AAMR) per 1 million persons were calculated, and temporal mortality trends were evaluated by computing annual percent change (APC) in AAMRs using the Joinpoint log-linear regression model.
RESULTS
A total of 272,155 T2DM-related deaths occurred among US adults aged 25-64 years from 1999 to 2020. The overall AAMR significantly increased from 37.6 in 1999 to 138.36 by 2020 with an APC of 4.8 ( < 0.01). Males had higher AAMR than females (80.13 vs. 51.20), and adults aged 55-64 years had a higher mortality rate than younger age groups. Among races, non-Hispanic American Indians/Alaska Natives had the highest AAMR (177.09). Mortality rates showed a significant upward trend across all genders, age groups, and racial subgroups. Nonmetropolitan areas had higher AAMR than metropolitan areas (83.08 vs. 61.97). AAMR varied substantially by state, with the highest AAMR in West Virginia (140.39) and the lowest in Massachusetts (23.06).
CONCLUSION
T2DM-related mortality has significantly increased among younger US adults over the last two decades. Higher mortality rates were observed among males, NH American Indians, and residents of rural areas and the Western regions.
GRAPHICAL ABSTRACT
Type 2 Diabetes Mellitus-related mortality among young adults aged 25-64 years in the United States from 1999 to 2020.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-025-01626-4.
背景
在美国，2型糖尿病（T2DM）相关的死亡率趋势在年轻成年人中仍未得到充分研究。本研究旨在通过使用来自一个大型国家死亡率统计数据库的数据来填补这一空白。
方法
从美国疾病控制与预防中心（CDC）的WONDER数据库中提取了1999年至2020年期间25至64岁美国成年人所有死亡病例的死亡证明数据，其中T2DM被列为根本死因或促成死因。计算了每100万人的年龄调整死亡率（AAMR），并使用Joinpoint对数线性回归模型通过计算AAMR的年度百分比变化（APC）来评估时间上的死亡率趋势。
结果
1999年至2020年期间，25至64岁的美国成年人中共有272,155例与T2DM相关的死亡。总体AAMR从1999年的37.6显著增加到2020年的138.36，APC为4.8（P<0.01）。男性的AAMR高于女性（80.13对51.20），55至64岁的成年人死亡率高于年轻年龄组。在各个种族中，非西班牙裔美国印第安人/阿拉斯加原住民的AAMR最高（177.09）。所有性别、年龄组和种族亚组的死亡率均呈显著上升趋势。非都市地区的AAMR高于都市地区（83.08对61.97）。AAMR因州而异，西弗吉尼亚州的AAMR最高（140.39），马萨诸塞州的最低（23.06）。
结论
在过去二十年中，美国年轻成年人中与T2DM相关的死亡率显著增加。在男性、非西班牙裔美国印第安人以及农村和西部地区居民中观察到较高的死亡率。
图形摘要
1999年至2020年美国25至64岁年轻成年人中2型糖尿病相关死亡率。
补充信息
在线版本包含可在10.1007/s40200-025-01626-4获取的补充材料。
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