Background: High fasting plasma glucose (HFPG) is the leading risk factor contributing to the increase of stroke burden in the past three decades. However, the global distribution of stroke burden specifically attributable to HFPG was not studied in depth. Therefore, we analyzed the HFPG-attributable burden in stroke and its subtypes in 204 countries and territories from 1990 to 2019.
Methods: Detailed data on stroke burden attributable to HFPG were obtained from the Global Burden of Disease Study 2019. The numbers and age-standardized rates of stroke disability-adjusted life years (DALYs), deaths, years lived with disability, and years of life lost between 1990 and 2019 were estimated by age, sex, and region.
Results: In 2019, the age-standardized rate of DALYs (ASDR) of HFPG-attributable stroke was 354.95 per 100 000 population, among which 49.0% was from ischemic stroke, 44.3% from intracerebral hemorrhage, and 6.6% from subarachnoid hemorrhage. The ASDRs of HFPG-attributable stroke in lower sociodemographic index (SDI) regions surpassed those in higher SDI regions in the past three decades. Generally, the population aged over 50 years old accounted for 92% of stroke DALYs attributable to HFPG, and males are more susceptible to HFPG-attributable stroke than females across their lifetime.
Conclusions: Successful key population initiatives targeting HFPG may mitigate the stroke disease burden. Given the soaring population-attributable fractions of HFPG for stroke burden worldwide, each country should assess its disease burden and determine targeted prevention and control strategies.
背景: 在过去30年中, 空腹血糖升高(HFPG)是导致卒中负担增加的主要危险因素。然而, HFPG导致的卒中负担的全球分布并未得到深入研究。因此, 我们分析了从1990年到2019年204个国家和地区卒中及其亚型的HFPG归因负担。 方法: 从2019年全球疾病负担研究中获得可归因于HFPG的中风负担的详细数据。按年龄、性别和地区估计1990年至2019年期间中风残疾调整寿命年(DALY)、死亡数、残疾生存年数和寿命损失年的数量和年龄标化率。 结果: 2019年HFPG归因性卒中的DALY年龄标化率(ASDR)为354.95/10万, 其中缺血性卒中占49.0%, 脑出血占44.3%, 蛛网膜下腔出血占6.6%。在过去的30年里, 社会人口统计指数(SDI)较低地区HFPG归因性卒中的ASDR超过了SDI较高地区。一般来说, 50岁以上的人群占HFPG导致的卒中DALY的92%, 男性在一生中比女性更容易患HFPG所致的中风。 结论: 针对HFPG的关键人群预防计划可能会减轻中风疾病的负担。鉴于世界范围内卒中负担可归因于HFPG的人口比例飙升, 每个国家都应评估其疾病负担, 并确定有针对性的预防和控制战略。.
Keywords: disability-adjusted life years; global burden of disease; high fasting plasma glucose; stroke; 伤残调整寿命年; 全球疾病负担; 卒中; 高空腹血糖.
© 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.