中国高空腹血糖相关缺血性脑卒中疾病负担评估、趋势预测与重点人群防控策略:基于GBD 2021的公共卫生预警OA
Assessment of disease burden and trend prediction of ischemic stroke attributable to high fasting plasma glucose in China:prevention and control strategies for key populations—a public health early warning based on GBD 2021
目的 本研究基于2021年全球疾病负担研究(global burden of disease,GBD)数据,系统评估1990-2021年中国25岁以上人群归因于高空腹血糖(high fasting plasma glucose,HFPG)的缺血性脑卒中(ischemic stroke,IS)疾病负担,分析人群差异,并预测2022-2035年趋势.方法 数据来源于GBD 2021数据库,提取中国地区1990-2021年HFPG相关缺血性脑卒中的年龄标化死亡率(age-standardized mortality rate,ASMR)、年龄标化伤残调整生命年率(age-standardized disability-adjusted life years rate,ASDR)及人群亚组数据.采用Joinpoint回归分析时间趋势,贝叶斯年龄-时期-队列(bayesian age-period-cohort,BAPC)模型预测未来负担变化.结果 1990-2021年中国25岁以上人群HFPG相关缺血性脑卒中的ASMR和ASDR整体呈下降趋势,但2021年ASMR(19.76/10万)和ASDR(354.37/10万人年)仍显著高于全球水平(ASMR=14.69/10万;ASDR=266.36/10万人年).男性负担高于女性,25～44岁群体负担呈上升趋势,80岁以上人群下降趋势不显著.预测显示,2022-2035年中国ASMR和ASDR将持续下降,降幅预计高于全球,但绝对水平仍高于全球.结论 中国≥25岁人群HFPG相关缺血性脑卒中疾病负担虽整体下降,但防控形势仍严峻.需针对男性、老年及年轻高危人群制定精准干预策略,加强糖尿病管理与健康促进,以遏制疾病负担上升.对策 建议强化高危人群血糖筛查与基层规范管理,针对男性、老年及年轻高危人群制定精准干预策略,完善卒中救治——康复连续服务和医保保障,建立监测评估与预警体系,以遏制HFPG相关IS负担.
Objective To systematically assess the disease burden of ischemic stroke(IS)attributable to high fasting plasma glucose(HFPG)among Chinese adults aged 25 years and older from 1990 to 2021 based on 2021 Global Burden of Disease(GBD)data,and to analyze population disparities and project trends for 2022 to 2035,providing evidence for prevention and control strategies.Methods Data were extracted from the GBD 2021 database,including age-standardized mortality rate(ASMR),disability-adjusted life years per million(ASDR),and population subgroup data for HFPG-related IS in China from 1990 to 2021.Joinpoint regression model was used to analyze temporal trends,and Bayesian age-period-cohort(BAPC)model was employed to predict future burden changes.Results Overall,both the ASMR and ASDR for HFPG-related IS showed a declining trend from 1990 to 2021 among individuals aged 25 and older in China.However,in 2021,the ASMR(19.76 per 100 000)and ASDR(354.37 per 100 000 person-years)remained significantly higher than the global levels(ASMR=14.69 per 100 000;ASDR=266.36 per 100 000 person-years).The disease burden was higher in males than in females,with an increasing trend among those aged 25 to 44 years and a non-significant decline among those aged 80 years and older.Projections indicated that China's ASMR and ASDR will be in a continuous decline from 2022 to 2035,with a projected rate of decrease exceeding the global average,though absolute levels will still remain higher than the global average.Conclusion Although the overall burden of HFPG-related is among Chinese individuals aged≥25 years has decreased,the prevention and control situation remains severe.Countermeasures It is recommended to enhance blood glucose screening for high-risk populations and standardized primary care management.Precise intervention strategies should be formulated for males,the elderly,and other young high-risk groups.Additionally,it is essential to improve the continuum of stroke treatment,rehabilitation services,and medical insurance coverage,while establishing a monitoring,evaluation,and early warning system to curb the burden of hyperglycemia-related ischemic stroke.
周银娟;王文;魏海萍
兰州大学:第二临床医学院,甘肃兰州兰州大学:第二医院神经内科,甘肃兰州兰州大学:第二临床医学院,甘肃兰州
医药卫生
缺血性脑卒中风险因素全球疾病负担死亡率伤残调整生命年
ischemic strokerisk factorsglobal burden of diseasemortalitydisability-adjusted life years
《陆军军医大学学报》 2026 (2)
181-190,10
国家自然科学基金面上项目(82201441,82460245)甘肃省自然科学基金(22JR5RA1002)兰州大学第二医院"萃英科技创新"应用基础研究计划(CY2022-MS-A01)兰州大学第二医院本科生萃英科研培训计划(CYXZ2024-09,CYXZPT2025-35) Supported by the General Program of National Natural Science Foundation of China(82201441,82460245),the Natural Science Foundation of Gansu Province(22JR5RA1002),the Project of"Cuiying Science and Technology Innovation"Program for Applied Basic Research Plan of Lanzhou University Second Hospital(CY2022-MS-A01),and the Project of Cuiying Scientific Training Program for Undergraduates of Lanzhou University Second Hospital(CYXZ2024-09,CYXZPT2025-35).
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