2011与2017年南京≥25岁居民归因于高血糖相关慢性病疾病负担分析

Disease burden attributable to hyperglycemia among Nanjing city residents aged 25 years and older in 2011 and 2017

目的分析2011与2017年江苏省南京市≥25岁居民归因于高血糖的疾病负担和期望寿命损失情况。方法利用南京市慢性病及其危险因素监测、南京市死因监测和2016全球疾病负担(GBD)资料,采用人群归因分值(PAF)估算高血糖(FPG)导致相关慢性病(包括糖尿病、缺血性心脏病、脑血管疾病、慢性肾病)死亡和寿命损失的变化。结果2017年南京市因高血糖导致的死亡占全部死亡的9.22%,相比于2011年(5.85%),南京市高血糖导致死亡的PAF增长42.77%;2017年归因于高血糖的死亡例数由2011年2024例上升为3778例,标化死亡率由2011年45.06/10万上升为50.16/10万,过早死亡损失寿命年(YLL)由2011年35346人年上升为57556人年,标化YLL率由800.69/10万上升为845.34/10万;2017年高血糖对南京人群造成的疾病负担主要是糖尿病,造成的主要死亡是脑血管疾病;去除高血糖暴露对期望寿命的影响后,2017年南京市≥25岁居民期望寿命为59.19岁,较全死因期望寿命提高1.03岁,其中男性提高0.91岁,女性提高1.15岁。结论高血糖是影响南京市居民死亡和期望寿命的重要危险因素之一,应加强高血糖及相关疾病的预防控制。

Objective To analyze disease burden and years of life lost(YLL) due to premature mortality attributable to hyperglycemia among 25 years and older residents of Nanjing city in 2011 and 2017. Methods The data of the study were extracted from Nanjing Chronic Disease and Risk Factor Surveillance(2011 and 2017), Nanjing Mortality Registry(2011 and 2017) and the 2016 Global Burden of Disease Study(GBD). Population attributable fractions(PAF) of mortality and YLL due to hyperglycemia-related non-communicable diseases(including diabetes, ischemic heart disease, cerebrovascular diseases,and chronic kidney disease) in 2011 and 2017 were estimated. Results For the residents surveyed, the total number of deaths attributed to hyperglycemia increased from 2 024(accounting for 5.85% of all causes of death) in 2011 to 3 778(9.22% of all causes of death) in 2017, with an increased PAF of 42.77% for hyperglycemia-related mortality. Between 2011 and 2017 for the mortality attributable to hyperglycemia-related diseases, there were increases in age-standardized death rate(from 45.06/100 000 to 50.16/100 000), YLLs(from 35 346 to 57 556 person-years), and age-standardized YLL rate(from 800.69/100 000 to 845.34/100 000). In 2017, the disease burden attributable to hyperglycemia was mainly caused by diabetes and the mortality attributed to hyperglycemia-related diseases was cerebrovascular disease. For the population of25 years and above in 2017, the hyperglycemia-related disease eliminated life expectancy was 59.19 years, 1.03 years(0.91 and 1.15 for the male and the female population) higher than the life expectancy without the death cause elimination.Conclusion Hyperglycemia is an important adverse factor for mortality and life expectancy among 25 years old and above residents in Nanjing city, suggesting that intervention on hyperglycemia and its related diseases should be promoted in the population.