1990—2019年中国、印度高BMI所致缺血性心脏病的年龄-时期-队列分析

Trends of ischemic heart disease mortality attributable to high BMI during 1990—2019 in China and India:an age-period-cohort analysis

目的:分析1990—2019年中国、印度高体质指数(BMI)的缺血性心脏病死亡情况的长期趋势,为缺血性心脏病的防控提供科学建议。方法:基于全球疾病负担研究项目(GBD2019),运用R软件的年龄-时期-队列(APC)模型分析工具包分析高BMI所致的缺血性心脏病死亡率的年龄、时期、队列效应。结果:1990—2019年中、印两国由高BMI所致的缺血性心脏病的标化死亡率均呈现上升趋势。APC模型显示,1990—2019年两国高BMI所致的缺血性心脏病死亡率的纵向年龄曲线均有随着年龄增长而增加的趋势,中国的死亡率高峰为80~84岁(男女分别为140.84/10万、132.16/10万),印度的死亡率高峰为75~79岁(男女分别为187.29/10万、157.34/10万)。随着时期的推移,中印两国死亡风险增加,中国男性相对危险度(RR)从0.88增至1.93,中国女性RR从0.92增至1.11;印度男性从0.73增至1.47,印度女性从0.76增至1.41。除中国女性外,越晚的出生队列死亡风险越大,中国男性RR从0.27增至4.06;印度男性从0.27增至2.31,印度女性从0.33增至2.12。结论:由于年龄、时期、队列的影响,近30年来,中、印两国由高BMI导致的缺血性心脏病的死亡率不断增加,需要加强缺血性心脏病患者的体重控制和健康教育以期降低该疾病造成的死亡负担。

Objective:To analyze the long-term trend of mortality risk of ischemic heart disease(IHD)attributable to high body mass index(BMI)in China and India from 1990 to 2019,and provide scientific suggestions for the prevention and control of IHD.Methods:Based on the global burden of disease 2019,the R software-based ageperiod-cohort(APC)model analysis was used to evaluate the age,period,and cohort effects of mortality risk of IHD attributable to high BMI.Results:From 1990 to 2019,the age-standardized mortality rate of IHD attributable to high BMI in China and India showed an increasing trend.The APC model showed that the longitudinal age curve of the mortality rate of IHD attributable to high BMI in both countries from 1990 to 2019 had a trend of increasing with age,and the peak mortality rate in China was 80-84 years old(140.84/100000 and 132.16/100000) for male and female,respectively,and the peak mortality rate in India was 75-79 years old(187.29/100000,157.34/100000) for male and female,respectively.Over time,the risk of death increased in China and India,with relative risk(RR)for Chinese male increasing from 0.88 to 1.93,0.92 to 1.11 in Chinese female,0.73 to 1.47 in Indian male,and 0.76 to 1.41 in Indian female.With the exception of Chinese female,the later the risk of death in the birth cohort was greater,with RR increasing from 0.27 to 4.06 in Chinese male,0.27 to 2.31 in Indian male,and 0.33 to 2.12 in Indian female.Conclusion:Due to the effects of age,period and cohort,the mortality of IHD attributable to high BMI in China and India have been increasing,and it is necessary to strengthen the weight control of patients with IHD and raise the health awareness of the population through health education in order to reduce the mortality burden caused by IHD.