1990-2021年全球与中国2型糖尿病疾病负担及归因危险因素分析OA
Analysis of burden of type 2 diabetes mellitus and its attributable risk factors in global and China from 1990 to 2021
目的 评估 1990-2021 年全球与中国 2 型糖尿病(T2DM)的疾病负担与风险因素变迁情况,并预测其未来变化趋势.方法 基于全球疾病负担2021数据库,采用年龄标准化发病率(ASIR)、年龄标准化患病率(ASPR)、年龄标准化伤残调整生命年(DALY)率(ASDR)、年龄标准化死亡率(ASMR)及其估计年度百分比变化(EAPC)对 1990-2021 年全球和中国T2DM疾病负担进行分析,自回归移动平均模型(ARIMA)预测疾病负担的变化趋势.结果 1990-2021年,全球T2DM ASIR[EAPC=1.74％,95％CI(1.72％,1.76％)]、ASPR[EAPC=2.12％,95％CI(2.08％,2.16％)]、ASMR[EAPC=0.21％,95％CI(0.15％,0.27％)]、ASDR[EAPC=1.04％,95％CI(1.00％,1.08％)]呈上升趋势;中国T2DM ASIR[EAPC=1.10％,95％CI(1.01％,1.19％)]、ASPR[EAPC=1.65％,95％CI(1.56％,1.75％)]、ASDR[EAPC=0.69％,95％CI(0.54％,0.84％)]呈上升趋势,而ASMR[EAPC=-0.22％,95％CI(-0.49％,0.04％)]无明显变化趋势.全球及中国老年群体T2DM患病率、DALY率和死亡率高于中青年,中国 15～24 岁人群发病率较高;全球及中国男性四项指标均高于女性.1990-2021 年,高空腹血糖、高BMI始终居于全球和中国T2DM死亡风险因素的前 2 位,环境颗粒污染物危险因素顺位上升幅度最高.预计到 2040 年,全球及中国T2DM ASIR分别上升至 385.85/10 万、305.10/10 万;ASPR分别上升至 8 619.18/10 万、7 509.98/10 万;ASDR分别上升至 975.50/10 万人年、636.63/10 万人年;全球ASMR上升至 18.83/10 万,而中国下降至 8.64/10 万.结论 男性、老年人群T2DM疾病负担较重,且T2DM发病呈年轻化趋势.高空腹血糖和高BMI是全球及中国患者死亡的重要风险因素.中国T2DM防治成效显著,但预测疾病负担形势仍严峻,需强化三级预防策略并严格控制相关风险因素.
Objective To assess the changes in the disease burden and risk factors of type 2 diabetes mellitus(T2DM)globally and in China from 1990 to 2021 and predict their future trends.Methods Based on the Global Burden of Disease 2021 database,the age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),age-standardized disability-adjusted life years(DALY)rate(ASDR),age-standardized mortality rate(ASMR),and their estimated annual percentage changes(EAPC)were used to analyze the disease burden of T2DM globally and in China from 1990 to 2021.The auto-regressive integrated moving average model(ARIMA)was applied to predict trends in disease burden.Results From 1990 to 2021,the global T2DM ASIR[EAPC=1.74％,95％CI(1.72％,1.76％)],ASPR[EAPC=2.12％,95％CI(2.08％,2.16％)],ASMR[EAPC=0.21％,95％CI(0.15％,0.27％)]and ASDR[EAPC=1.04％,95％CI(1.00％,1.08％)]showed increasing trends.In China,T2DM ASIR[EAPC=1.10％,95％CI(1.01％,1.19％)],ASPR[EAPC=1.65％,95％CI(1.56％,1.75％)],and ASDR[EAPC=0.69％,95％CI(0.54％,0.84％)]showed an upward trend,while ASMR[EAPC=-0.22％,95％CI(-0.49％,0.04％)]showed no significant change.The prevalence,DALY rate,and mortality of T2DM among the elderly were higher than those among young and middle-aged adults globally and in China,while the incidence rate among individuals aged 15 to 24 is notably elevated.Globally and in China,all four rates were higher in males than in females.From 1990 to 2021,high fasting plasma glucose and high body mass index(BMI)remained the top two risk factors for T2DM-related deaths globally and in China,while environmental particulate matter pollution showed the largest rise in ranking among risk factors.It is projected that by 2040,the global and China T2DM ASIR will rise to 385.85/100,000 and 305.10/100,000,respectively;ASPR to 8,619.18/100,000 and 7,509.98/100,000,respectively;ASDR to 975.50/100,000 person years and 636.63/100,000 person years,respectively;global ASMR will increase to 18.83/100,000,while China's ASMR will decrease to 8.64/100,000.Conclusion The disease burden of T2DM was heavier in males and the elderly,and the onset age tended to be younger among adolescents.High fasting plasma glucose and high BMI were important risk factors for T2DM-related deaths globally and in China.China has achieved notable results in prevention and control,but the predicted disease burden remains severe.It is necessary to strengthen the three-level prevention strategy and strictly control relevant risk factors.
魏鑫龙;朱莹;邓超;黄志刚
广东医科大学公共卫生学院(广东 东莞 523808)广东医科大学公共卫生学院(广东 东莞 523808)广东医科大学公共卫生学院(广东 东莞 523808)广东医科大学公共卫生学院(广东 东莞 523808)
医药卫生
2型糖尿病疾病负担风险因素ARIMA模型
Type 2 diabetes mellitusDisease burdenRisk factorsARIMA model
《医学新知》 2026 (1)
54-61,8
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