1990-2019年江苏省居民缺血性心脏病及其危险因素疾病负担变化趋势

王巍巍; 俞浩; 洪忻; 杨华凤; 周海茸; 戚圣香; 周金意

doi:10.16462/j.cnki.zhjbkz.2023.10.006

1990-2019年江苏省居民缺血性心脏病及其危险因素疾病负担变化趋势

doi: 10.16462/j.cnki.zhjbkz.2023.10.006

1.
南京市疾病预防控制中心慢性非传染病防制科，南京 210003
2.
江苏省疾病预防控制中心慢性非传染病防制所，南京 210009

基金项目:

南京市医学科技发展项目 ZKX21054

南京市医学科技发展项目 ZKX18049

详细信息

通讯作者:
周金意，E-mail: zhoujinyi74@sina.com

中图分类号: R181.2;R541.4
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- 被引次数: 0
出版历程
- 收稿日期: 2022-04-02
- 修回日期: 2022-08-03
- 网络出版日期: 2023-10-23
- 刊出日期: 2023-10-10

Trends of burden on ischemic heart disease and related risk factors among residents in Jiangsu Province, 1990-2019

1.
Department of Chronic and Non-communicable Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China
2.
Department of Chronic and Non-communicable Disease Control and Prevention, Jiangsu Center for Disease Control and Prevention, Nanjing 210009, China

Funds:

Nanjing Municipal Medical Science and Technique Development Foundation, China ZKX21054

Nanjing Municipal Medical Science and Technique Development Foundation, China ZKX18049

More Information

Corresponding author: ZHOU Jinyi, E-mail: zhoujinyi74@sina.com

摘要

摘要: 目的探讨1990-2019年江苏省居民缺血性心脏病(ischemic heart disease，IHD)及其危险因素疾病负担变化趋势。方法基于2019年全球疾病负担(global burden of disease, GBD)研究，利用早死损失寿命年(years of life lost, YLL)、伤残损失寿命年(years lived with disability, YLD)、伤残调整寿命年(disability-adjusted of life years, DALY)和人群归因分值(population attributable fraction, PAF)分析1990-2019年江苏省人群IHD疾病负担和归因疾病负担变化趋势，并采用分解法将年龄相关DALY分解为人口增长、年龄构成、年龄别患病率和疾病严重程度4个因素。结果 1990-2019年江苏省居民IHD患病数、死亡数和DALY均呈增长趋势；标化YLL率和DALY率呈下降趋势，2010-2019年年均降幅高于1990-2010年。2019年江苏省IHD DALY较1990年增长了75.78%；归因于年龄别患病率、年龄构成、人口增长和疾病严重程度增长率依次为52.06%、46.12%、23.52%和-45.92%。2019年，IHD 26种危险因素归因DALY占IHD总DALY的92.75%；其中环境/职业、行为和代谢危险因素比例分别为38.21%、68.03%和79.07%。2019年IHD归因标化DALY率前5位的危险因素分别为高收缩压、高低密度脂蛋白胆固醇、烟草、室外颗粒物污染和钠摄入过多。近30年间室外颗粒物污染、高BMI、红肉摄入过多、加工肉摄入过多和饮酒5个危险因素年均变化率(annual rate of change, ARC)呈上升趋势，ARC分别为1.29%、1.76%、0.36%、0.32%和4.19%。2010-2019年有10种IHD危险因素的标化DALY率顺位上升，8种危险因素的顺位下降。结论 1990-2019年江苏省居民IHD疾病负担总体增加，人口老龄化和年龄别患病率是江苏省IHD DALY增长的主要原因。加强对高血压、高血脂和肥胖的预防和控制，戒烟限酒、减少红肉和加工肉摄入水平，改善室外空气污染是今后江苏省IHD防治的重点。
- 缺血性心脏病 /
- 疾病负担 /
- 危险因素 /
- 变化趋势
Abstract: Objective To examine the trend of burden on ischemic heart disease (IHD) and related risk factors among residents in Jiangsu Province from 1990 to 2019. Methods Based on open access data from the Global Burden of Disease (GBD) 2019 Study, years of life lost (YLD), years lived with disability (YLL), disability-adjusted of life years (DALY), and population attributable fraction (PAF) were used to describe the temporal trend burden of IHD and its attributable risk factors from 1990 to 2019. A decomposition method established by Das Gupta P was applied to quantify the burden related to population growth, population age, age-specific prevalence, and the severity of the disease. Results The burden of IHD, in number of prevalence, deaths, and DALYs showed increasing trends from 1990 to 2019. During the same period, age-standardized rates of IHD YLL and DALY showed decreased trends, and the annual decreased rates of change of both YLL and DALY were much higher from 2010 to 2019 than those from 1990 to 2010. The DALY of IHD in 2019 increased by 75.78% compared with 1990, the proportions attributable to age-specific prevalence, population growth, population age and the severity of the disease were 52.06%, 46.12%, 23.52%, and -45.92, respectively. In 2019, DALY attributable to the 26 modifiable risk factors accounted for 92.75% of the total IHD DALY, and the proportion of environmental/occupational, behavioral and metabolic risk factors was 38.21%, 68.03% and 79.07%, respectively. The top five of age-standardized attributable DALY rate in 2019 were high blood pressure, high LDL cholesterol, tobacco, ambient particulate matter pollution, and diet high in sodium. From 1990 to 2019, DALYs attributed to ambient particulate matter pollution (ARC=1.29%), high body-mass index (ARC=1.76%), diet high in red meat (ARC=0.36%), diet high in processed meat (ARC=0.32%), and alcohol use (ARC=4.19%) exhibited the greatest increase. From 2010 to 2019, the age-standardized DALY rate ranking for 10 risk factors for IHD increased, and the age-standardized DALY rate ranking for 8 risk factors decreased. Conclusions The burden of IHD continues to increase in Jiangsu residents. Population age and age-specific prevalence are responsible for the considerable increase in the burden of IHD among Jiangsu residents. It is important to strengthen programs on prevention and control for hypertension, dyslipidemia and obesity. Behavior risk factors such as smoking, drinking and unreasonable diet habits should be reduced. Outdoor environment should be improved.
- Ischemic heart disease /
- Burden of disease /
- Risk factors /
- Variation trend

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图 1 1990-2019年江苏省IHD疾病负担变化分解的时间趋势

IHD，缺血性心脏病。DALY，伤残调整寿命年。

Figure 1. Temporal trend of the change decomposition on IHD disease burden in Jiangsu Province, 1990-2019

IHD, ischemic heart disease. DALY, disability-adjusted life years.

下载: 全尺寸图片幻灯片

图 2 1990-2019年江苏省IHD危险因素的归因标化DALY率变化情况

IHD，缺血性心脏病。
a: 变化趋势有统计学意义。

Figure 2. Changes of attributed standardized DALY rate of IHD risk factors in Jiangsu Province, 1990-2019

IHD, ischemic heart disease.
a: The change trend was statistically significant.

下载: 全尺寸图片幻灯片

表 1 1990-2019年江苏省IHD疾病负担变化趋势(95% UI)

Table 1. Trends of disease burden of IHD in Jiangsu Province, 1990-2019 (95% UI)

年份Year	患病人数/万例 Number of prevalence cases/10 000	死亡人数/万例 Number of death cases/10 000	YLL/万人年 YLL/10 000	YLD/万人年 YLD/10 000	DALY/万人年 DALY/10 000
1990	119.07(102.20~139.46)	2.76(2.36~3.35)	57.27(48.48~67.99)	4.84(3.18~6.84)	62.11(52.89~72.91)
2010	216.79(186.86~252.00)	5.55(4.77~6.53)	92.88(79.82~110.31)	8.53(12.19~5.63)	101.41(88.23~119.21)
2019	294.52(254.52~342.24)	6.49(5.30~8.20)	97.60(78.14~122.88)	11.58(7.70~16.49)	109.18(89.19~134.02)
ARC(%)
1990-2010	3.00(2.77~3.34) ^①	3.49(2.85~3.82) ^①	2.42(1.93~2.58) ^①	2.83(2.62~3.04) ^①	2.45(1.89~2.71) ^①
2010-2019	3.40(3.36~3.58) ^①	1.74(1.32~2.14) ^①	0.55(0.10~0.77) ^①	3.40(3.18~3.66) ^①	0.82(0.43~1.12) ^①
1990-2019	3.12(2.96~3.34) ^①	2.95(2.42~3.40) ^①	1.84(1.32~2.21) ^①	3.01(2.78~3.23) ^①	1.95(1.49~2.32) ^①
注：IHD，缺血性心脏病；UI，不确定区间；YLL，早死损失寿命年；YLD，伤残损失寿命年；DALY，伤残调整寿命年。 ①代表变化趋势有统计学意义。 Notes: IHD, ischemic heart disease; UI, indeterminate interval; YLL, years of life loss; YLD, years lived with disability; DALY, disability-adjusted life years. ① Statistically significant of trend.

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表 2 1990-2019年江苏省IHD年龄标化疾病负担变化趋势(/100 000 95% UI)

Table 2. Trends of age-standardized disease burden of IHD in Jiangsu Province, 1990-2019 (/100 000 95% UI)

年份Year	标化患病率 Age-standardized prevalence rate	标化死亡率 Age-standardized death rate	标化YLL率 Age-standardized YLL rate	标化YLD率 Age-standardized YLD rate	标化DALY率 Age-standardized DALY rate
1990	2 205.25(1 907.24~2 555.63)	69.12(59.16~86.45)	1 118.69(955.00~1 342.11)	90.97(60.75~128.82)	1 209.66(1 042.66~1 433.36)
2010	2 174.57(1 882.57~2 508.16)	71.53(61.44~83.85)	1 012.18(873.04~1 192.09)	85.05(56.73~121.15)	1 097.23(958.51~1 282.99)
2019	2 186.40(1 894.99~2 524.22)	54.40(44.49~68.57)	773.47(623.92~972.18)	86.05(57.56~122.45)	859.52(706.54~1 053.70)
ARC(%)
1990-2010	-0.07(-0.21~0.03)	0.17(-0.52~0.61)	-0.50(-1.14~-0.28) ^①	-0.34(-0.52~-0.27) ^①	-0.49(-1.01~-0.13) ^①
2010-2019	0.06(-0.12~0.15)	-3.04(-3.57~-2.65) ^①	-2.99(-3.49~-2.66) ^①	0.13(-0.34~0.42)	-2.71(-3.33~-2.39) ^①
1990-2019	-0.03(-0.12~0.04)	-0.83(-1.30~-0.52) ^①	-1.27(-1.78~-0.91) ^①	-0.19(-0.43~-0.09) ^①	-1.18(-1.63~-0.75) ^①
注：IHD，缺血性心脏病；UI，不确定区间；YLL，早死损失寿命年；YLD，伤残损失寿命年；DALY，伤残调整寿命年。 ①代表变化趋势有统计学意义。 Notes: IHD, ischemic heart disease; UI, indeterminate interval; YLL, years of life loss; YLD, years lived with disability; DALY, disability-adjusted life years. ① Statistically significant of trend.

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