1990-2019年中国成年人归因于糖尿病的心血管疾病负担研究  

Burden of Cardiovascular Diseases Attributable to Diabetes among Chinese Adults from 1990 to 2019

作　　者：梁栋[1,2,3] 杨成琳 林晓茹 赵洋 欧阳江[6] 林修全[2,7] LIANG Dong;YANG Chenglin;LIN Xiaoru;ZHAO Yang;OUYANG Jiang;LIN Xiuquan(School of Health Management,Fujian Medical University,Fuzhou 350122,China;School of Public Health,Fujian Medical University,Fuzhou 350122,China;Nursing Humanities Research Center,Fujian Medical University,Fuzhou 350122,China;George Institute for Global Health,University of New South Wales,Sydney 2050,Australia;School of Population and Global Health,University of Melbourne,Melbourne 3010,Australia;School of Public Health,Changsha Medical University,Changsha 410219,China;Department for Chronic and Noncommunicable Disease Control and Prevention,Fujian Provincial Center for Disease Control and Prevention,Fuzhou 350012,China)

机构地区：[1]福建医科大学卫生管理学院,福建省福州市350122 [2]福建医科大学公共卫生学院,福建省福州市350122 [3]福建医科大学护理人文研究中心,福建省福州市350122 [4]新南威尔士大学乔治全球健康研究院,澳大利亚悉尼2050 [5]墨尔本大学人口与全球健康学院,澳大利亚墨尔本3010 [6]长沙医学院公共卫生学院,湖南省长沙市410219 [7]福建省疾病预防控制中心慢性病防治研究室,福建省福州市350012

出　　处：《中国全科医学》2024年第11期1380-1386,1394,共8页Chinese General Practice

基　　金：福建省自然科学基金资助项目(2018J01121);福建省卫生健康科技计划项目(2020GGA026);福建省高校人文社会科学研究基地护理人文研究中心2023年开放课题(LLRW-202301);2023年卫生健康政策创新研究项目(2023B01)。

摘　　要：背景在全球老龄化不断深化的背景下,慢性病患者不断增加,多病共存现象愈加严重。在普遍认知中,心血管疾病与2型糖尿病大多属于老年病,但随着居民生活节奏与饮食等行为方式的改变,很多疾病呈现年轻化趋势。现也有研究表明,与一般人群相比,年轻时患糖尿病的患者的心血管疾病风险及死亡率会相对增加。目的探究1990—2019年中国成年人归因于糖尿病的心血管疾病负担情况,为共病预防提供依据。方法基于2019年全球疾病负担研究(GBD)数据,主要采用死亡率、伤残调整寿命年(DALY)率和计算获取的年估计变化百分比(EAPC)等指标评估我国心血管疾病(包括缺血性心脏病、脑卒中和外周动脉疾病3类)归因于糖尿病的疾病负担情况,并对年龄段(25~49岁、50~69岁、≥70岁)及性别进行分层分析,最后对疾病负担的时间趋势进行分析。结果中国25岁及以上人群归因于糖尿病的心血管疾病死亡数从1990年的29.805万例上升到2019年的70.034万例。男性归因于糖尿病的心血管疾病标化死亡率较1990年升高,而女性标化死亡率有所降低,且男性标化死亡率始终高于女性。2019年归因于糖尿病的心血管疾病DALY为1358.585万人年,按年龄划分的死亡率和DALY率随年龄增长而增加。女性标化DALY率下降趋势较男性明显(女性:EAPC=-0.32%,95%CI=-0.49%~-0.11%;男性:EAPC=-0.01%,95%CI=-0.26%~0.29%)。2019年归因于糖尿病的缺血性心脏病、外周动脉疾病患者3个年龄段的死亡率和DALY率较1990年大部分上升,而2019年归因于糖尿病的脑卒中患者3个年龄段的死亡率较1990年下降。1990—2019年心血管疾病中3类心血管疾病归因于糖尿病的标化DALY率占比呈波动性变化,但在2019年归因于糖尿病的3类心血管疾病标化DALY率占比均高于1990年。结论1990—2019年我国成年人归因于糖尿病的心血管疾病的死亡率和DALY率总体呈现上升趋势,人�Background Against the backdrop of global aging,the number of patients with chronic diseases is increasing,and the multimorbidity is becoming more severe.Traditionally,cardiovascular diseases and type 2 diabetes are mostly considered diseases of the elderly.However,with changes in lifestyle patterns such as the pace of life and diet,many diseases are showing a trend of rejuvenation.Recent studies have also shown that individuals who develop diabetes at a young age have an increased relative risk of developing cardiovascular diseases and higher mortality rates compared to the general population.Objective To investigate the burden of cardiovascular diseases attributed to diabetes among Chinese adults from 1990 to 2019,so as to provide evidence for comorbidity prevention.Methods Based on the 2019 Global Burden of Disease(GBD)study data,indicators such as mortality rates,disability-adjusted life years(DALY)rates,and estimated annual percentage change(EAPC)were used to assess the burden of cardiovascular diseases in China(including ischemic heart disease,stroke,and peripheral arterial disease)attributed to diabetes.The analysis was stratified by age group(25-49 years,50-69 years,≥70 years)and gender,and the temporal trends in disease burden were finally analyzed.Results The number of cardiovascular disease deaths attributable to diabetes increased from 298050 in 1990 to 700340 in 2019 among people aged 25 years and older in China.The age-standardized mortality rate for CVD attributed to diabetes increased for males compared to 1990,while it decreased for females,with males consistently having higher rates than females.In 2019,the DALY for CVD attributed to diabetes was 13585850 person-years.The age-specific mortality rate and DALY rate increased with age.The downward trend in standardized DALY rate was more pronounced in females(EAPC=-0.32%,95%CI=-0.49%to-0.11%)than in males(EAPC=-0.01%,95%CI=-0.26%to 0.29%).The mortality and DALY rates for ischemic heart disease and peripheral arterial disease attributed to diabete

关 键 词：心血管疾病 糖尿病 成年人 疾病负担 死亡率 伤残调整寿命年 

分 类 号：R54[医药卫生—心血管疾病]