1990—2021年中国中老年人群2型糖尿病疾病负担趋势分析

Analysis of disease burden of type 2 diabetes among middle-aged and older adults in China from 1990 to 2021

目的分析1990—2021年我国中老年人群2型糖尿病(type 2 diabetes mellitus,T2DM)的变化趋势,评价近年来T2DM预防策略,为中老年人T2DM的防控措施改进提供理论依据。方法对全球疾病负担研究2021数据库中我国55岁及以上人群T2DM发病率、患病率、死亡率以及伤残调整寿命年(disability adjusted life years,DALYs)数据进行标准化,线图描述各指标的变化趋势,Joinpoint回归模型定量分析变化情况,以年度变化百分比(annual percent change,APC)和平均年度变化百分比(average annual percent change,AAPC)作为观察指标。结果1990—2021年我国55岁及以上人群T2DM的疾病负担仍然较重,发病率、患病率和DALYs率保持上升趋势(AAPC分别为0.39、1.08和0.39,P<0.001),死亡率整体下降(AAPC=-0.16,P<0.001)。女性以及55~74岁人群的发病率较高,随年龄增长中老年人T2DM死亡率升高。结论应加强对中老年人群T2DM健康管理和健康教育,倡导积极健康的生活方式,个人、家庭、社会、政府多方联动,降低我国中老年人群T2DM的疾病负担。

Objective To analyze the change trend of type 2 diabetes mellitus(T2DM)in middle-aged older adults in China from 1990 to 2021,evaluate the prevention strategies of T2DM in recent years,and provide theoretical basis for the improvement of prevention and control measures of T2DM in middle-aged older adults.Methods The data of T2DM incidence,prevalence,mortality and disability adjusted life years(DALYs)in Chinese population aged above 55 from the Global Burden of Disease Study 2021 database were standardized.The trend of each index was described by line graph,and the changes were quantitatively analyzed by Joinpoint regression model.APC and AAPC were used as observational indicators.Results From 1990 to 2021,the disease burden of T2DM in Chinese elderly(over 55 years old)was still relatively heavy,and the incidence,prevalence and DALYs rates maintained an increasing trend(AAPC=0.39,1.08 and 0.39,respectively,P<0.001).The mortality rate decreased overall(AAPC=-0.16,P<0.001).The incidence is higher in female and people aged 55-74 years,and T2DM mortality increases with age in the elderly.Conclusions The health management and health education of the elderly with T2DM should be strengthened,active and healthy lifestyle should be advocated,so as to reduce the disease burden of the middle-aged and older adults with T2DM in China.