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The temporal trend of disease burden attributable to metabolic risk factors in China, 1990-2019: An analysis of the Global Burden of Disease study

Jin Y 1 , So H 1 , Cerin E 2 , Barnett A 2 , Mubarik S 3 , Hezam K 4 Show all authors , Feng X 5 , Wang Z 6 , Huang J 7 , Zhong C 7 , Hayat K 8 , Wang F 9 , Wu AM 10 , Xu S 11 , Zou Z 12 , Lim LL 1 , Cai J 13 , Song Y 14 , Tam LS 1 , Wu D 15

Affiliations 

  • 1 Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
  • 2 Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
  • 3 Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
  • 4 Nankai University School of Medicine, Tianjin, China
  • 5 Faculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, NSW, Australia
  • 6 Department of Family Medicine, McGill University, Montreal, QC, Canada
  • 7 Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  • 8 Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
  • 9 School of Public Health, Xuzhou Medical University, Xuzhou, China
  • 10 Department of Orthopaedics, Wenzhou Medical University, Wenzhou, China
  • 11 Department of Endocrinology, University of Science and Technology of China, Hefei, China
  • 12 Institute of Child and Adolescent Health, Peking University, Beijing, China
  • 13 Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
  • 14 School of the Environment, Yale University, New Haven, CT, United States
  • 15 Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
Front Nutr, 2022;9:1035439.
PMID: 36687675 DOI: 10.3389/fnut.2022.1035439

Abstract

BACKGROUND AND AIMS: The disease burden attributable to metabolic risk factors is rapidly increasing in China, especially in older people. The objective of this study was to (i) estimate the pattern and trend of six metabolic risk factors and attributable causes in China from 1990 to 2019, (ii) ascertain its association with societal development, and (iii) compare the disease burden among the Group of 20 (G20) countries.

METHODS: The main outcome measures were disability-adjusted life-years (DALYs) and mortality (deaths) attributable to high fasting plasma glucose (HFPG), high systolic blood pressure (HSBP), high low-density lipoprotein (HLDL) cholesterol, high body-mass index (HBMI), kidney dysfunction (KDF), and low bone mineral density (LBMD). The average annual percent change (AAPC) between 1990 and 2019 was analyzed using Joinpoint regression.

RESULTS: For all six metabolic risk factors, the rate of DALYs and death increased with age, accelerating for individuals older than 60 and 70 for DALYs and death, respectively. The AAPC value in rate of DALYs and death were higher in male patients than in female patients across 20 age groups. A double-peak pattern was observed for AAPC in the rate of DALYs and death, peaking at age 20-49 and at age 70-95 plus. The age-standardized rate of DALYs increased for HBMI and LBMD, decreased for HFPG, HSBP, KDF, and remained stable for HLDL from 1990 to 2019. In terms of age-standardized rate of DALYs, there was an increasing trend of neoplasms and neurological disorders attributable to HFPG; diabetes and kidney diseases, neurological disorders, sense organ diseases, musculoskeletal disorders, neoplasms, cardiovascular diseases, digestive diseases to HBMI; unintentional injuries to LBMD; and musculoskeletal disorders to KDF. Among 19 countries of Group 20, in 2019, the age-standardized rate of DALYs and death were ranked fourth to sixth for HFPG, HSBP, and HLDL, but ranked 10th to 15th for LBMD, KDF, and HBMI, despite the number of DALYs and death ranked first to second for six metabolic risk factors.

CONCLUSIONS: Population aging continuously accelerates the metabolic risk factor driven disease burden in China. Comprehensive and tight control of metabolic risk factors before 20 and 70 may help to mitigate the increasing disease burden and achieve healthy aging, respectively.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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