1990~2019年我国15岁以上居民中2型糖尿病归因于饮食因素的疾病负担研究

Disease Burden of Type 2 Diabetes Mellitus Attributable to Dietary Factors in Chinese Residents Aged 15 and Above From 1990 to 2019

目的:分析1990~2019年我国15岁以上居民中2型糖尿病归因于饮食因素的疾病负担情况及变化趋势。方法:利用全球疾病负担研究2019(GBD 2019)数据,采用Joinpoint模型评估分析我国15岁以上居民中2型糖尿病归因于七种饮食因素的疾病负担的时间变化趋势。结果:1990~2019年,我国15岁以上居民中2型糖尿病归因于饮食因素的疾病负担构成比为26.13%~26.79%,粗伤残调整寿命年(DALY)率和标化DALY率上升了100.19%和6.61%,其中粗伤残损失寿命年(YLD)率和标化YLD率上升了117.92%和18.91%,粗过早死亡损失寿命年(YLL)率上升了72.59%,而标化YLL率下降了11.17%;除标化YLL率外,男性上升幅度均大于女性;归因于饮食因素的粗DALY率、粗YLD率和粗YLL率随年龄增加逐渐上升,男性高于女性。1990年,我国15岁以上居民中2型糖尿病归因于各饮食因素的疾病负担从高到低依次为水果摄入量低、红肉摄入量高、全谷物摄入量低、含糖饮料摄入量高、膳食纤维摄入量低、坚果和种子类摄入量低、加工肉类摄入量高,2019年则依次为红肉摄入量高、全谷物摄入量低、水果摄入量低、加工肉类摄入量高、含糖饮料摄入量高、膳食纤维摄入量低、坚果和种子类摄入量低。与1990年相比,2019年我国15岁以上居民中2型糖尿病归因于各饮食因素的粗DALY率、粗YLD率和粗YLL率均呈上升趋势;年龄标化后,加工肉类和红肉摄入量高的DALY率、YLD率和YLL率均呈上升趋势,而水果摄入量低、含糖饮料摄入量高、膳食纤维摄入量低、坚果和种子类摄入量低的DALY率、YLD率和YLL率均呈下降趋势,全谷物类摄入量低的DALY率和YLD率上升,而YLL率下降。结论:2型糖尿病归因于饮食因素的疾病负担总体呈增加趋势,尤其是红肉和加工肉类摄入量高;含糖饮料摄入量高及全谷物、水果、膳食纤维、坚果和种子类摄入量低经年龄调整后有下降趋势,但依然是目前防控2型糖尿病饮食干预策略的重要内容。同时,男性和高龄人群是通过饮食干预来防控2型糖尿病的重点人群。

Objectives:To analyze the disease burden and trends of type 2 diabetes mellitus(T2DM)attributable to dietary factors in Chinese residents aged 15 and above from 1990 to 2019.Methods:The Joinpoint model was used to analyze the trend of changes in disease burden of T2DM attributed to seven dietary factors in China based on the data of the Global Burden of Disease Study 2019(GBD 2019).Results:From 1990 to 2019,the composition rate of T2DM attributed to dietary factors was 26.13%-26.79%,and the crude disability-adjusted life years(DALY)rate and standardized DALY rate increased by 100.19% and 6.61% respectively,the crude years lived with disability(YLD)rate and standardized YLD rate increased by 117.92% and 18.91%,and the crude years of life lost(YLL)rate increased by 72.59%,while the standardized YLL rate decreased by 11.17%.Except for the standardized YLL rate,the growth margins of all rates were greater for males than for females.The rates of crude DALY,crude YLD and crude YLL attributed to dietary factors increased with age and were higher in males than in females.In 1990,dietary factors contributing to T2DM in descending order were low in fruit,high in red meat,low in whole grains,high in sugary beverages,low in dietary fiber,low in nuts and seeds,and high in processed meat.In 2019,dietary factors contributing to T2DM in descending order were high in red meat,low in whole grains,low in fruit,high in processed meat,high in sugary beverages,low in dietary fiber,low in nuts and seeds.Compared with 1990,crude rates attributed to all dietary factors showed an increasing trend.DALY rate,YLD rate and YLL rate of high processed meat and high red meat showed an increasing trend after age standardization,while those of low fruit,high sugary beverage,low dietary fiber,low nuts and seeds showed a decreasing trend.DALY and YLD rates of low whole grain group increased while its YLL rate decreased.Conclusions:The disease burden of T2DM due to dietary factors increased in general,especially due to high red meat and high processed meat consumption,as well as low intake of whole grain,fruit,increased consumption of sugary drinks,low consumption of dietary fiber,nuts and seeds.It is important to apply related dietary intervention strategies for the prevention and control of T2DM.At the same time,males and aged people are the key population,who might benefit more from the dietary intervention for prevention and control of T2DM.