Objectives: Stroke has become the leading cause of death and disability among adults in China. This study aims to analyze the disease burden based on gender and age and the risk factors for stroke subtypes in China 2019, and to provide reference for targeted stroke prevention and control.
Methods: Based on 2019 data of the Global Burden of Disease (GBD), the gender and age in patients with different stroke subtypes (ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage) in China 2019 was described by using disability-adjusted life years (DALY), and attributable burden of related risk factors was analyzed.
Results: In 2019, the burden of intracranial hemorrhage was the heaviest one in China, resulting in 22.210 6 million person years of DALY, following by ischemic stroke and subarachnoid hemorrhage, resulting in 21.393 9 and 2.344 7 million person years of DALY, respectively. Among them, except the 0-14 age group, the disease burden of different subtypes of stroke in men was higher than that in women. The disease burden of ischemic stroke was increased with age in both men and women, with the heaviest disease burden in ≥70 years group. The disease burden of intracranial hemorrhage and subarachnoid hemorrhage was the heaviest in males aged 50-69 years old, and in females aged ≥70 years and 50-69 years, respectively. Metabolic factors were the main risk factors in all ages of different stroke subtypes, and the most important risk factor was high systolic blood pressure. Other risk factors were different between men and women. Smoking, high body mass index, high low-density lipoprotein, and outdoor particulate matter pollution were the main risk factors for stroke in men, while high body mass index, outdoor particulate matter pollution, and high fasting blood glucose were the main risk factors of stroke in women. The main risk were different among different age groups.
Conclusions: The burden and attributable risk factors for different stroke subtypes are discrepancy in different gender and age groups. Targeted interventions should be conducted in the future to reduce the burden of stroke.
目的: 脑卒中已成为中国成人致死和致残的首要原因。本研究旨在分析2019年中国脑卒中及其亚型不同性别和年龄别的疾病负担及其相关危险因素，为针对性预防提供科学依据。方法: 利用2019年全球疾病负担(Global Burden of Disease 2019，GBD2019)公开数据，采用伤残调整生命年(disability-adjusted life years，DALY)对2019年中国不同卒中亚型(缺血性脑卒中、颅内出血、蛛网膜下腔出血)的性别和年龄别疾病负担进行描述性分析，并探讨其相关危险因素归因负担。结果: 2019年中国脑卒中亚型中以颅内出血疾病负担最重，所致DALY为2 221.06万人年，其次为缺血性脑卒中和蛛网膜下腔出血，所致DALY分别为2 139.39和234.47万人年。其中，除0~14岁年龄组外，其他各年龄组不同脑卒中亚型的疾病负担男性均高于女性；缺血性脑卒中的疾病负担在男性和女性中均随着年龄的增加而增加，70岁及以上年龄组疾病负担最重；而对于颅内出血及蛛网膜下腔出血，男性均为50~69岁组疾病负担最重，女性分别是50~69岁及70岁及以上组最重。不同脑卒中亚型中各年龄段的归因危险均以代谢因素为主，其中最主要的危险因素均为高收缩压；男性和女性的其他归因危险因素有所不同，男性以吸烟、高体重指数、高低密度脂蛋白及室外颗粒物污染为主，女性则以高体重指数、室外颗粒物污染、高空腹血糖为主；不同年龄组间主要归因危险因素也有差异。结论: 2019年中国脑卒中疾病负担较重，不同性别、不同年龄组的疾病负担及归因危险因素不同，今后应针对不同人群的主要归因危险因素进行干预，以减轻脑卒中疾病负担。.
Keywords: disability-adjusted life years; disease burden; risk factors; stroke.