1975-2020年青海省居民糖尿病死亡趋势分析

Trend analysis of mortality of diabetes mellitus among residents in Qinghai province,China,1975-2020

目的分析青海省1975-2020年居民糖尿病死亡特征与变化趋势。方法利用青海省1975、2006、2015和2020年四次死因回顾性调查数据,按地区、性别、年龄分别计算糖尿病粗死亡率、标化死亡率、平均年度变化百分比(AAPC)、早死概率等指标。分别用χ^(2)检验和t检验进行率以及变化趋势的比较。结果青海省1975-2020年糖尿病死亡数占总死亡人数的比例由0.10%上升到2.55%(AAPC=7.64%,P<0.05),糖尿病粗死亡率从0.84/10万上升至15.66/10万(AAPC=6.77%,P<0.05),标化死亡率由1.74/10万上升到20.44/10万(AAPC=5.78%,P<0.05),糖尿病早死概率从0.05%上升至0.41%。女性死亡人数构成比和标化死亡率AAPC分别为8.28%和6.01%,均较男性上升明显(AAPC分别为7.10%和5.62%),差异有统计学意义(P<0.05)。从年龄分布看,糖尿病死亡率从40岁组开始上升,除1975年外,其余年份死亡率均随年龄增长而逐年升高,80岁以上达峰值。不同地区糖尿病标化死亡率总体呈上升趋势,牧区的上升趋势明显高于城市和农村地区,由0.93/10万上升到16.21/10万,不同年份城市、农村、牧区糖尿病标化死亡率AAPC分别为4.55%、5.06%和6.86%。结论青海省糖尿病死亡仍呈现上升趋势,牧区高于农村、城市,女性死亡增长较快,应持续实施全民健康干预措施,重点关注牧区、农村地区和女性居民,有效降低糖尿病死亡负担。

Objective To analyze the epidemiologic characteristics and changing trend of mortality of diabetes mellitus in residents in Qinghai province,China,from 1975 to 2020.Methods The crude mortality,standardized mortality,average annual percentage change(AAPC)and probability of premature death of diabetes mellitus were calculated by region,sex,and age based on the data of causes of death from four retrospective investigations in Qinghai province in 1975,2006,2015,and 2020.The chi-square test and t-test were used to compare the rates and AAPC,respectively.Results From 1975 to 2020,the proportion of deaths from diabetes mellitus in total deaths in Qinghai province increased from 0.10%to 2.55%(AAPC=7.64%,P<0.05);the crude mortality of diabetes mellitus increased from 0.84/100000 to 15.66/100000(AAPC=6.77%,P<0.05);the standardized mortality increased from 1.74/100000 to 20.44/100000(AAPC=5.78%,P<0.05);and the probability of premature death from diabetes mellitus increased from 0.05%to 0.41%.The AAPC values for the component ratio of mortality and standardized mortality in women were 8.28% and 6.01%,respectively,which were significantly higher than 7.10% and 5.62% in men,respectively(P<0.05).In age distribution,the mortality of diabetes mellitus began to increase from 40-year-olds,and increased with age,peaking over 80-year-olds,except for 1975.In different areas,the standardized mortality of diabetes mellitus also showed an upward trend in general,which was significantly more marked in pastoral areas(from 0.93/100000 to 16.21/100000)than in urban and rural areas.The AAPC values in different years for the standardized mortality of diabetes mellitus in urban,rural,and pastoral areas were 4.55%,5.06%,and 6.86%,respectively.Conclusion The mortality of diabetes mellitus in Qinghai province is still on the rise,which is more marked in pastoral areas than in urban and rural areas,with a rapid increase in women.It is necessary to implement national health intervention continuously,focus on pastoral areas,rural areas and female residents,and effectively reduce the mortality burden of diabetes mellitus.