全球糖尿病负担的社会经济差异:1990—2019年时间趋势的分析  

Socio-economic disparity in the global burden of diabetes mellitus:an analysis for 2019 with time trends since 1990

作　　者：吴秀强 戴小华[1] 杨珍[1] 谢志勤 陈诗涵 王泽权 易林霞 WU Xiu-qiang;DAI Xiao-hua;YANG Zhen;XIE Zhi-qin;CHEN Shi-han;WANG Ze-quan;YI Lin-xia(The First Affiliated Hospital and School of Nursing of Nanchang University,Nanchang,Jiangxi 330000,China;不详)

机构地区：[1]南昌大学第一附属医院,江西南昌330000 [2]南昌大学护理学院

出　　处：《现代预防医学》2024年第2期210-215,共6页Modern Preventive Medicine

基　　金：江西省科技厅重点研发项目(20192BBGL70016);江西省教育厅科学技术研究项目(GJJ190047)。

摘　　要：目的利用伤残调整生命年(DALYs)评估糖尿病引起的疾病负担在全球社会经济群体中不平等差异。方法收集来自GBD数据库的1990—2019年因糖尿病导致的DALYs数、年龄标准化DALYs率和来自《2021—22年人类发展报告》的国家人类发展指数(HDI)数据。分析了年龄标准化DALYs率与HDI之间的关系,了解糖尿病疾病负担的社会经济差异。计算年度变化百分比(APC)和平均年度变化百分比(AAPC)评估近几十年期间糖尿病负担的时间变化趋势。结果从1990—2019年,全球因糖尿病导致的DALYs数从2.83千万增长至6.99千万,增幅为146.85%,其中中低收入国家增长最快(206.49%)。年龄标准化DALYs率与HDI呈负相关(r=-0.480,P<0.001)。HDI中等的国家因糖尿病而表现出较高的DALYs率。从1990—2019年,年龄标准化DALYs率年均增长0.78%(AAPC=0.78%,95%CI为0.74%~0.81%),年龄标准化死亡率的年均增长为0.46%(AAPC=0.46%,95%CI:0.41%~0.51%)。结论在过去几十年中,全球糖尿病负担大大增加,其中,中低收入国家增长最快。在发展中国家,糖尿病年龄标准化负担更高。虽然观察到糖尿病负担增长速度变慢,但疾病负担增长的持续存在表明应该为发展中国家提供更多的糖尿病预防方案和保健服务。Objective To use disability-adjusted life years(DALYs)to assess unequal differences in the burden of disease due to diabetes across global socioeconomic groups.Methods Number of DALYs due to diabetes,age-standardized DALYs rates from the GBD database,1990-2019,and national Human Development Index(HDI)data from the Human Development Report 2021-2022 were collected.The relationship between age-standardized DALY rates and HDI was analyzed to understand socioeconomic differences in diabetes disease burden.Calculation of Annual Percentage Change(APC)and Average Annual Percentage Change(AAPC)to assess temporal trends in the burden of diabetes disease during recent decades.Results From 1990-2019,the number of DALYs due to diabetes globally increased from 28.3 million to 69.9 million,an increase of 146.85%,with the fastest growth(206.49%)in Lower middle-income countries.The age-standardized DALYs rates were negatively correlated with HDI(r=-0.480,P<0.001).Countries with medium HDI exhibit higher DALYs rates due to diabetes mellitus.From 1990-2019,the average annual increase in the rate of age-standardized DALYs was 0.78%(AAPC=0.78%,95%CI=0.74%to 0.81%),and the average annual increase in the age-standardized mortality rate was 0.46%(AAPC=0.46%,95%CI=0.41%~0.51%).Conclusion The global burden of diabetes disease has increased substantially over the last few decades,with the fastest growth in Lower middle-income countries.The age-standardized burden was higher in developing countries.Although a slower increase in the burden of diabetes was observed,the persistence of the increase in the burden of disease suggests that more diabetes prevention programs and health-care services should be made available to developing countries.

关 键 词：糖尿病 疾病负担 社会经济差异 时间趋势 

分 类 号：R587.1[医药卫生—内分泌]