Xue Hua, Zeng Yuqi, Zou Xinyang, Li Yongkun
Department of Neurology, Shengli Clinical Medical College of Fujian Medical University, Fujian, China.
Department of Neurology, Fuzhou University Affiliated Provincial Hospital, Fujian, China.
Diabetes Metab Res Rev. 2025 Sep;41(6):e70071. doi: 10.1002/dmrr.70071.
The role of high fasting plasma glucose (HFPG) in ischaemic stroke (IS) has become increasingly prominent. Our study aimed to assess the global and regional distribution of the burden of IS attributable to HFPG (IS-HFPG) and to predict the disease burden of IS-HFPG to 2041.
This study extracted the data on the burden of IS-HFPG, including the number and age-standardized rate of deaths and disability-adjusted life years (DALYs) from the Global Burden of Disease Study (GBD) 2021. Joinpoint analysis was used to assess trends in IS-HFPG burden between 1990 and 2021. Further analyses were stratified by region, sex, and age groups.
In 2021, the number of deaths and DALYs related to IS-HFPG reached 0.65 million and 12.37 million, respectively. From 1990 to 2021, the global age-standardized mortality rate (ASMR) and DALY (ASDR) for IS-HFPG declined, with an Average Annual Percentage Change (AAPC) of -0.96 (95% CI: -1.06, -0.86) and -0.72 (95% CI: -0.81, -0.62), respectively. Regionally, the ASMR and ASDR were highest in High-middle SDI and lowest in High SDI. ASMR were higher for males than for females, with rates of 9.43 per 100,000 (95% UI: 7.31, 11.75) and 7.07 per 100,000 (95% UI: 5.35, 8.96), respectively. Age-stratified analysis indicates that the elderly population, particularly those over 70 years old, bears the heaviest burden.
Our research indicates that the global ASMR and ASDR attributable to IS-HFPG has a declining trend. However, developing regions confront a burden of mortality and disability associated with IS-HFPG. Notably, male and the elderly are the primary demographics affected by IS-HFPG. Our study underscores the necessity for regions to formulate targeted prevention and treatment strategies that address the specific needs of diverse populations, particularly in low- and middle-income countries.
空腹血糖升高（HFPG）在缺血性卒中（IS）中的作用日益突出。我们的研究旨在评估归因于HFPG的IS（IS-HFPG）负担的全球和区域分布，并预测到2041年IS-HFPG的疾病负担。
本研究从《2021年全球疾病负担研究》（GBD 2021）中提取了IS-HFPG负担的数据，包括死亡人数、年龄标准化死亡率以及伤残调整生命年（DALYs）。采用Joinpoint分析评估1990年至2021年期间IS-HFPG负担的趋势。进一步按地区、性别和年龄组进行分层分析。
2021年，与IS-HFPG相关的死亡人数和DALYs分别达到65万和1237万。从1990年到2021年，IS-HFPG的全球年龄标准化死亡率（ASMR）和伤残调整生命年率（ASDR）呈下降趋势，平均年变化百分比（AAPC）分别为-0.96（95%CI：-1.06，-0.86）和-0.72（95%CI：-0.81，-0.62）。在区域层面，ASMR和ASDR在高中等社会人口指数地区最高，在高社会人口指数地区最低。男性的ASMR高于女性，分别为每10万人9.43例（95%UI：7.31，11.75）和每10万人7.07例（95%UI：5.35，8.96）。年龄分层分析表明，老年人群，尤其是70岁以上的人群，负担最重。
我们的研究表明，归因于IS-HFPG的全球ASMR和ASDR呈下降趋势。然而，发展中地区面临着与IS-HFPG相关的死亡和残疾负担。值得注意的是，男性和老年人是受IS-HFPG影响的主要人群。我们的研究强调各地区有必要制定针对性的预防和治疗策略，以满足不同人群的特定需求，特别是在低收入和中等收入国家。
