Global burden of disease attributable to metabolic risk factors in adolescents and young adults aged 15-39, 1990-2021

Zhou XD 1 , Chen QF 2 , Targher G 3 , Byrne CD 4 , Mantzoros CS 5 , Zhang H 6 Show all authors , Lonardo A 7 , Lip GYH 8 , Porta G 9 , Misra A 10 , Robertson AG 11 , Luo F 12 , Alisi A 13 , Yang W 14 , El-Shabrawi M 15 , Al Momani H 16 , Somers VK 17 , Katsouras CS 18 , Méndez-Sánchez N 19 , Lefere S 20 , Szepietowski O 21 , Sung KC 22 , Hui Ng NB 23 , Valenti L 24 , Lee WS 25 , Pik-Shan Kong A 26 , Kızılkaya MC 27 , Ocama P 28 , Ali A 29 , Viveiros O 30 , Ryan JD 31 , Toro-Huamanchumo CJ 32 , Perera N 33 , Ataya K 34 , Yen Kok KY 35 , Gracia-Sancho J 36 , Sharara AI 37 , Prasad A 38 , Oviedo RJ 39 , Ospanov O 40 , Ruiz-Úcar E 41 , Alswat K 42 , Abbas SI 43 , Abdelbaki TN 44 , Wong YJ 45 , Fouad Y 46 , Shapiro MD 47 , Bacopoulou F 48 , Sookoian S 49 , Kehar M 50 , Chan WK 51 , Treeprasertsuk S 52 , Adams L 53 , Turan S 54 , Zuluaga M 55 , Pirola CJ 56 , Thaher O 57 , Molina GA 58 , Jumaev NA 59 , Al-Busafi SA 60 , Opio CK 61 , Lim-Loo MC 62 , Adithya Lesmana CR 63 , Kamani L 64 , Zheng MH 65

Affiliations 

  • 1 Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 2 Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 3 Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
  • 4 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK
  • 5 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
  • 6 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 7 Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • 8 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
  • 9 Pediatric Hepatology, Transplant Unit, Hospital Infantil Menino Jesus and Hospital Sirio Libanes, San Paulo, Brazil
  • 10 Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, New Delhi, India
  • 11 Department of Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
  • 12 Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
  • 13 Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
  • 14 Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 15 Department of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt
  • 16 Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
  • 17 Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, USA
  • 18 First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
  • 19 Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
  • 20 Hepatology Research Unit, Department Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium; Liver Research Center Ghent, Ghent University, Ghent, Belgium
  • 21 Department of Surgery, Ashford and St Peter's Hospital, Chertsey, Surrey, UK
  • 22 Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
  • 23 Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 24 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
  • 25 Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
  • 26 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
  • 27 Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Turkey
  • 28 Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
  • 29 Metabolic and Bariatric, Fatimah Hospital, Tehran, Iran
  • 30 Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Amadora, Lisbon, Portugal
  • 31 Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
  • 32 Universidad San Ignacio de Loyola, Lima, Peru
  • 33 Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
  • 34 Department of Bariatric Surgery, University of Montreal, Montreal, Quebec, Canada
  • 35 Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei-Muara, Brunei
  • 36 Liver Vascular Biology Laboratory, IDIBAPS Biomedical Research Institute - Hospital Clínic de Barcelona & CIBEREHD, Barcelona, Spain; Department of Visceral Surgery and Medicine, Inselspital - University of Bern, Bern, Switzerland
  • 37 Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  • 38 Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
  • 39 Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, United States
  • 40 Surgical Disease and Bariatric Surgery, Astana Medical University, Astana, Aqmola, Kazakhstan
  • 41 Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
  • 42 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 43 Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates
  • 44 Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
  • 45 Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore; Duke-NUS Medical School, Singapore
  • 46 Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
  • 47 Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  • 48 Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, Aghia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; University Research Institute of Maternal and Child Health & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • 49 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
  • 50 Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Eastern Ontario, Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
  • 51 Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 52 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 53 Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia
  • 54 Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
  • 55 Departament of Surgery, Universidad del Valle, Cali, Valle del Cauca, Colombia, USA
  • 56 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Systems Biology of Complex Diseases, Centro de Investigación Traslacional en Salud, Universidad Maimónides, Buenos Aires, Argentina
  • 57 Department of Surgery, Marien Hospital Herne, University Hospital of the Ruhr-University of Bochum, Herne, NRW, Germany
  • 58 Department of Surgery, USFQ (Universidad San Francisco), Quito, Pichincha, Ecuador
  • 59 Department Surgical Diseases, Tashkent Medical Academy, Tashkent, Almazar, Uzbekistan
  • 60 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  • 61 Department of Medicine, Aga Khan University, Nairobi, Kenya
  • 62 Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines
  • 63 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
  • 64 Department of Gastroenterology, Liaquat National Hospital, Karachi, Pakistan
  • 65 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, China. Electronic address: zhengmh@wmu.edu.cn
Clin Nutr, 2024 Nov 14;43(12):391-404.
PMID: 39579593 DOI: 10.1016/j.clnu.2024.11.016

Abstract

BACKGROUND: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally.

AIMS: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15-39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database.

METHODS: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults. The estimated annual percentage changes (EAPC) of DALYs were utilized to depict the trends from 1990 to 2021.

RESULTS: From 1990 to 2021, the DALY rates attributable to all metabolic risk factors showed a globally significant upward trend, with EAPC reaching 33.0 % (27.4-38.7). Compared to females, males had a heavier burden and a more significant increase in deaths and DALYs attributable to metabolic risk factors. High BMI and high FPG have become the top two metabolic risk factors in 2021, with summary exposure variables (SEV) rising by 84.2 % and 53.6 %, respectively. Low-middle socio-demographic index (SDI), middle SDI, and high SDI regions experienced upward regional trends in DALY rates, while low SDI regions remained stable. Among 204 countries and territories, 101 (49.5 %) showed a significant increase in DALY rates, as indicated by the EAPC.

CONCLUSIONS: There is a substantial global burden attributable to metabolic risk factors in adolescents and young adults in 2021, especially high BMI and high FPG. This calls for further investigation and intervention to address this emerging trend.

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

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