1990—2019年中国归因于高盐饮食的慢性肾病疾病负担研究及趋势预测  

Study and trend forecast on the burden of chronic kidney disease attributed to high salt diet in China from 1990 to 2019

作　　者：张凯 杨丽[1] 彭瑞 叶晓雯 ZHANG Kai;YANG Li;PENG Rui;YE Xiao-wen(School of Public Health,Weifang Medical College,Weifang,Shandong 261053,China)

机构地区：[1]潍坊医学院公共卫生学院,山东潍坊261053

出　　处：《现代预防医学》2023年第15期2737-2743,共7页Modern Preventive Medicine

基　　金：山东省自然基金(ZR2014AQ020);山东省中医药科技发展计划项目(2017-204);山东省社会科规划文化旅游研究专项(20CLYJ72)。

摘　　要：目的 分析1990—2019年中国因高盐饮食导致慢性肾病(chronic kidney disease,CKD)的疾病负担,并对未来10年的疾病负担进行预测,以期为慢性肾病的防治提供对策建议。方法 基于2019年全球疾病负担研究(global disease burden 2019,GBD 2019)的数据,采用死亡数、死亡率、伤残调整寿命年(disability adjusted life year,DALY)、DALY率分析1990—2019年中国归因于高盐饮食的慢性肾病疾病负担情况。采用人群归因分值(population attributable fraction,PAF),描述高盐饮食对人群的危害程度。通过Joinpoint模型,采用年平均变化百分率(average annual percent age rate change,AAPC),分析比较中国与全球及不同社会人口学指数(social demographic index,SDI)地区之间的疾病负担差异。运用ARIMA模型,对中国2020—2029年归因于高盐饮食的慢性肾病的死亡率与DALY率进行预测分析。结果 2019年中国15岁及其以上人群,15.06%的慢性肾病死亡归因于高盐饮食。与1990年相比,2019年中国因高盐饮食导致慢性肾病疾病负担的死亡人数增加到2.96万例,DALY增加到92.21万人年;死亡率从1.26/10万增加到2.09/10万,相对增加65.87%;DALY率从44.63/10万增加到64.83/10万,相对增加45.26%;人群归因分值略微下降。男性的死亡人数、死亡率、DALY、DALY率均高于女性,且呈现逐年增长的趋势。2019年中国的死亡率和DALY率均高于全球,且上升趋势高于大部分SDI地区,AAPC分别为1.74(95%CI:1.61~1.87)、1.37 (95%CI:0.99~1.75)。ARIMA模型预测显示,在未来十年,死亡率继续增加,DALY率则略微下降。1990—2019年在慢性肾病的归因顺位中,高盐饮食一直是排名前五的危险因素。结论 1990—2019年中国归因于高盐饮食的慢性肾病疾病负担较为沉重,高于全球与各个SDI地区,呈现逐年增长的趋势。并且在未来的10年中,死亡率会继续增加。研究发现男性、老年人群慢性肾病归因于高盐饮食的负担高于女性。因Objective To analyze the disease burden of chronic kidney disease(CKD) caused by high-salt diet in China from1990 to 2019,and to predict the disease burden in the next 10 years,so as to provide countermeasures and suggestions for the prevention and treatment of chronic kidney disease.Methods Based on the data of the Global Burden of Disease study in2019(GBD2019),mortality,disability-adjusted life years(DALY),and DALY rate were used to analyze the burden of CKD attributed to high-salt diet in China from 1990 to 2019.The population attribution score(PAF) was used to describe the harm of high-salt diet to the population.Based on the Join point model,the average annual percentage of change(AAPC) was used to analyze and compare the differences of disease burden among China,the whole world,and different social demographic in-dex(SDI) regions.The ARIMA model was used to predict the mortality and DALY rate of CKD attributed to high-salt diet in China from 2020 to 2029.Results In 2019,15.06% of chronic kidney disease deaths in Chinese people aged 15 and above were attributed to high-salt diet.Compared with 1990,in 2019,the number of deaths caused by the burden of CKD caused by high-salt diet in China increased to 29 600,DALY increased to 922 100 person-years,and the mortality rate increased from 1.26/100 000 to 2.09/100 000 with a relative increase of 65.87%.The DALY rate increased from 44.63/100 000 to64.83/100 000 with a relative increase of 45.26%,and the population attribution score decreased slightly.The death toll,mortality,DALY,and DALY rates of males were higher than those of females,showing an increasing trend year by year.In2019,the mortality rate and DALY rate in China were higher than those in the whole world,and the rising trend was higher than that in most SDI regions,with AAPC of 1.74(95%CI:1.61-1.87) and 1.37(95%CI:0.99-1.75),respectively.The ARIMA model predicted that the mortality rate would continue to increase over the next decade,while the DALY rate would de-cline slightly.From 1990 to 2019,high-salt

关 键 词：高盐饮食 慢性肾病 疾病负担 Joinpoint模型 ARIMA模型 

分 类 号：R692[医药卫生—泌尿科学] R155[医药卫生—外科学]