Global burden of metabolic diseases, 1990-2021

Zhang H 1 , Zhou XD 2 , Shapiro MD 3 , Lip GYH 4 , Tilg H 5 , Valenti L 6 Show all authors , Somers VK 7 , Byrne CD 8 , Targher G 9 , Yang W 10 , Viveiros O 11 , Opio CK 12 , Mantzoros CS 13 , Ryan JD 14 , Kok KYY 15 , Jumaev NA 16 , Perera N 17 , Robertson AG 18 , Abu-Abeid A 19 , Misra A 20 , Wong YJ 21 , Ruiz-Úcar E 22 , Ospanov O 23 , Kızılkaya MC 24 , Luo F 25 , Méndez-Sánchez N 26 , Zuluaga M 27 , Lonardo A 28 , Al Momani H 29 , Toro-Huamanchumo CJ 30 , Adams L 31 , Al-Busafi SA 32 , Sharara AI 33 , Chan WK 34 , Abbas SI 35 , Sookoian S 36 , Treeprasertsuk S 37 , Ocama P 38 , Alswat K 39 , Kong AP 40 , Ataya K 41 , Lim-Loo MC 42 , Oviedo RJ 43 , Szepietowski O 44 , Fouad Y 45 , Zhang H 46 , Abdelbaki TN 47 , Katsouras CS 48 , Prasad A 49 , Thaher O 50 , Ali A 51 , Molina GA 52 , Sung KC 53 , Chen QF 54 , Lesmana CRA 55 , Zheng MH 56

Affiliations 

  • 1 Department of Medical Record, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 2 Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 3 Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
  • 4 Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  • 5 Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
  • 6 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Precision Medicine, Biological Resource Center Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
  • 7 Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, USA
  • 8 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, University of Southampton, Southampton General Hospital, Southampton, UK
  • 9 Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
  • 10 Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 11 Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Amadora, Lisbon, Portugal
  • 12 Department of Medicine, Aga Khan University, Nairobi, Kenya
  • 13 Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
  • 14 Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
  • 15 Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei-Muara, Brunei
  • 16 Department Surgical Diseases, Tashkent Medical Academy, Almazar, Tashkent, Uzbekistan
  • 17 Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
  • 18 Department of Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
  • 19 Division of Surgery, Tel Aviv Sourasky Medical Center affiliated to Tel Aviv University, Tel Aviv, Israel
  • 20 Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, New Delhi, India
  • 21 Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore; Duke-NUS Medical School, Singapore
  • 22 Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
  • 23 Surgical Disease and Bariatric Surgery, Astana Medical University, Astana, Aqmola, Kazakhstan
  • 24 Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Türkiye
  • 25 Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
  • 26 Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
  • 27 Department of Surgery, Universidad del Valle, Cali, Valle del Cauca, Colombia
  • 28 Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • 29 Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
  • 30 Universidad San Ignacio de Loyola, Lima, Peru; OBEMET Center for Obesity and Metabolic Health, Lima, Peru; Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia
  • 31 Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia
  • 32 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  • 33 Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical center, Beirut, Lebanon
  • 34 Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 35 Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates
  • 36 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Faculty of Health Science, Maimónides University, Buenos Aires, Argentina; Clinical and Molecular Hepatology, Translational Health Research Center (CENITRES), Maimónides University, Buenos Aires, Argentina
  • 37 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 38 Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
  • 39 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 40 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
  • 41 Department of Bariatric Surgery, University of Montreal, Montreal, Quebec, Canada
  • 42 Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines
  • 43 Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, USA
  • 44 Department of Surgery, Ashford and St Peter's Hospital, Chertsey, Surrey, United Kingdom
  • 45 Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
  • 46 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 47 Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
  • 48 First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
  • 49 Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
  • 50 Department of Surgery, Marien Hospital Herne, University Hospital of the Ruhr-University of Bochum, Herne, NRW, Germany
  • 51 Metabolic and Bariatric, Fatimah Hospital, Tehran, Iran
  • 52 Department of Surgery, USFQ (Universidad San Francisco), Quito, Pichincha, Ecuador
  • 53 Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  • 54 Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 55 Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia; Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia; Gastrointestinal Cancer Center, Mochtar Riyadi Comprehensive Cancer Center (MRCCC) Siloam Semanggi Hospital, Jakarta, Indonesia
  • 56 MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang, China. Electronic address: zhengmh@wmu.edu.cn
Metabolism, 2024 Nov;160:155999.
PMID: 39151887 DOI: 10.1016/j.metabol.2024.155999

Abstract

BACKGROUND: Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hypercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global health burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) data enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, highlighting regional, temporal and differences by sex.

METHODS: Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD). Age-standardized DALYs (mortality) per 100,000 population and annual percentage change (APC) between 1990 and 2021 were estimated for trend analyses. Estimates are reported with uncertainty intervals (UI).

RESULTS: In 2021, among five common metabolic diseases, hypertension had the greatest burden (226 million [95 % UI: 190-259] DALYs), whilst T2DM (75 million [95 % UI: 63-90] DALYs) conferred much greater disability than MASLD (3.67 million [95 % UI: 2.90-4.61]). The highest absolute burden continues to be found in the most populous countries of the world, particularly India, China, and the United States, whilst the highest relative burden was mostly concentrated in Oceania Island states. The burden of these metabolic diseases has continued to increase over the past three decades but has varied in the rate of increase (1.6-fold to 3-fold increase). The burden of T2DM (0.42 % [95 % UI: 0.34-0.51]) and obesity (0.26 % [95 % UI: 0.17-0.34]) has increased at an accelerated rate, while the rate of increase for the burden of hypertension (-0.30 % [95 % UI: -0.34 to -0.25]) and hypercholesterolemia (-0.33 % [95 % UI: -0.37 to -0.30]) is slowing. There is no significant change in MASLD over time (0.05 % [95 % UI: -0.06 to 0.17]).

CONCLUSION: In the 21st century, common metabolic diseases are presenting a significant global health challenge. There is a concerning surge in DALYs and mortality associated with these conditions, underscoring the necessity for a coordinated global health initiative to stem the tide of these debilitating diseases and improve population health outcomes worldwide.

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

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