1990-2021年全球与中国老年2型糖尿病的疾病负担调查与未来趋势预测  

Investigation and Future Trend Prediction of Disease Burden of Elderly Type 2 Diabetes Mellitus Globally and in China from 1990 to 2021

作　　者：赵晓晓 柯立鑫 荀杨芹 王海博 高武霖 乔天慈 卢笑晖[1] 武继彪[2] 卢存存 ZHAO Xiaoxiao;KE Lixin;XUN Yangqin;WANG Haibo;GAO Wulin;QIAO Tianci;LU Xiaohui;WU Jibiao;LU Cuncun(Affiliated Hospital of Shandong University of TCM,Jinan 250014,China;Shandong University of TCM,Jinan 250399,China;Department of Pediatrics,University of Groningen,University Medical Center Groningen,Groningen 9713GZ,Netherlands;School of Population Medicine and Public Health,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Critical Care Medicine,Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou 730000,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]山东中医药大学附属医院,山东省济南市250014 [2]山东中医药大学,山东省济南市250399 [3]格罗宁根大学医学中心儿科学实验室,荷兰格罗宁根9713GZ [4]中国医学科学院北京协和医学院群医学与公共卫生学院,北京市100730 [5]甘肃中医药大学附属医院重症医学科,甘肃省兰州市730000 [6]中国中医科学院中医临床基础医学研究所,北京市100700

出　　处：《中国全科医学》2025年第16期2050-2058,共9页Chinese General Practice

基　　金：山东省自然科学基金青年项目(NO.ZR2022QH123)。

摘　　要：背景老年2型糖尿病(T2DM)已成为全球性及中国国内影响人口健康的重大公共卫生难题,明确与之相关的疾病负担迫在眉睫。目的分析1990—2021年全球与中国老年T2DM的疾病负担并预测未来趋势,为公共卫生和医疗决策提供参考。方法从全球疾病负担(GBD)数据库2021,提取并整理1990—2021年全球与中国60岁及以上T2DM患者的发病和死亡负担数据。以GBD 2021标准人口为基础,估算60岁及以上T2DM群体的年龄标准化发病率和死亡率。利用Joinpoint回归计算平均年度变化百分比(AAPC)评估疾病负担的趋势变化。基于年龄和性别进行亚组分析,利用分解分析方法探讨老龄化、人口增长和流行病学改变3个因素对疾病负担改变的相对影响。使用贝叶斯模型预测2022—2035年的发病数和死亡数。结果2021年全球与中国老年T2DM的发病数分别为6047049例和800764例,与1990年相比,分别增加178.68%和220.28%。1990—2021年全球年龄标准化发病率整体呈上升趋势(AAPC=1.21%,P<0.001),但中国的整体上升趋势却无统计学意义(AAPC=0.29%,P=0.189)。2021年全球与中国老年T2DM的死亡数分别为1304150例和149972例,与1990年相比,分别增加164.68%和197.98%。1990—2021年全球年龄标准化死亡率整体呈上升趋势(AAPC=0.32%,P<0.001),但中国的趋势却相对平稳(AAPC=0.01%,P=0.922)。此外,全球与中国在1990年和2021年的发病数和死亡数均为女性高于男性,且60~64岁组在2021年的发病数中占比最高,70~74岁组在死亡数中占比最高。分解分析发现人口增长是全球和中国老年T2DM发病数和死亡数增加的主要影响因素。预测分析表明2022—2035年全球老年T2DM的发病数和死亡数以及中国的死亡数将继续呈上升趋势。结论全球和中国老年T2DM的发病和死亡负担依然沉重,迫切需要进一步加强和制订更加有效的公共卫生政策和临床防控策略,从而为降低老年T2DM的基本负担发�Background Type 2 diabetes mellitus(T2DM)among the elderly has become a significant public health problem both globally and in China,affecting population health.It is extremely urgent to clarify the related disease burden.Objective To assess the disease burden of T2DM among the elderly population globally and in China from 1990 to 2021,project future trends,and offer insights to inform public health and medical decision-makings.Methods Data on incidence and mortality burdens of individuals aged 60 years and above with T2DM in China and around the world were extracted from the global Burden of Disease(GBD)2021 database.Age-standardized incidence and mortality rates were estimated based on the GBD 2021 standard population.Joinpoint regression was utilized to calculate the average annual percentage change(AAPC)for assessing disease burden trends.Subgroup analyses were performed based on age and sex,and decomposition analysis was performed to examine how aging,population growth,and epidemiological changes impacted disease burden.Bayesian models were employed to forecast prevalence and mortality between 2022 and 2035.Results In 2021,the global incidence of T2DM stood at 6047049,while in China,it reached 800764,representing increases of 178.68%and 220.28%,respectively,compared to the incidence in 1990.Over the period from 1990 to 2021,the global age-standardized incidence rate exhibited a significant overall upward trend(AAPC=1.21%,P<0.001),whereas the trend in China was not statistically significant(AAPC=0.29%,P=0.189).The number of deaths among elderly T2DM patients in 2021 in the global and Chinese populations was 1304150 and 149972,respectively,marking increases of 164.68%and 197.98%compared to the number of deaths in 1990.Throughout the same period,the global age-standardized mortality rate displayed a consistent upward trend(AAPC=0.32%,P<0.001),while the trend in China remained relatively stable(AAPC=0.01%,P=0.922).Notably,the number of incidence and mortality for female in 1990 and 2021,globally and in China,exc

关 键 词：2型糖尿病 老年人 疾病负担 流行病学特征 预测分析 

分 类 号：R587.1[医药卫生—内分泌]