Temporal trends in mortality of tuberculosis attributable to high fasting plasma glucose in China from 1990 to 2019: a joinpoint regression and age-period-cohort analysis

Chao Wang; Xueli Yang; Honglu Zhang; Yanzhuo Zhang; Jianfeng Tao; Xu Jiang; Chengai Wu

doi:10.3389/fpubh.2023.1225931

Temporal trends in mortality of tuberculosis attributable to high fasting plasma glucose in China from 1990 to 2019: a joinpoint regression and age-period-cohort analysis

Front Public Health. 2023 Jul 27:11:1225931. doi: 10.3389/fpubh.2023.1225931. eCollection 2023.

Authors

Chao Wang¹, Xueli Yang², Honglu Zhang², Yanzhuo Zhang¹, Jianfeng Tao¹, Xu Jiang³, Chengai Wu¹

Affiliations

¹ National Center for Orthopaedics, Beijing Research Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
² Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.
³ Department of Orthopaedics, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.

Abstract

Background: Nowadays, high fasting plasma glucose (HFPG) has been identified as the important risk factor contributing to the increased burden of diseases. But there remains a lack of research on tuberculosis (TB) mortality specifically attributable to HFPG. Thus, this study aims to explore the long-term trends in HFPG-related TB mortality in China from 1990 to 2019.

Methods: Data on HFPG-related TB mortality were obtained from the Global Burden of Disease (GBD) Study 2019. Analyzing the data using joinpoint regression and age-period-cohort methods adjusting for age, period, and cohort allowed us to assess the trends in TB mortality due to HFPG.

Results: The age-standardized mortality rates (ASMRs) of TB attributable to HFPG exhibited a downward trend in China from 1990 to 2019, with an average annual percentage change (AAPC) of -7.0 (95% CI, -7.5 to -6.6). Similar trends were found for male (AAPC of -6.5 [95% CI, -7.0 to -6.0]) and female (AAPC of -8.2 [95% CI, -8.5 to -7.9]), respectively. Local drifts curve with a U-shaped pattern reflected the AAPC of TB mortality due to HFPG across age groups. The greatest decline was observed in the age group of 60-64 years. The mortality rates related to HFPG first increased and then decreased with increasing age, peaking in the 55-59 age group. Our analysis of the period and cohort effects found that the rate ratios of TB mortality due to HFPG have decreased over the past three decades, more prominently in women. It is noteworthy that while both genders have seen a decline in HFPG-attributable TB mortality and risk, men have a higher risk and slightly less significant decline than women.

Conclusion: The present study shows that HFPG-related ASMRs and risk of TB in China decreased over the last 30 years, with similar trends observed in both men and women. In order to attain the recommended level set by the WHO, the effective strategies for glycemic control and management still needed to be implemented strictly to further decrease the burden of TB.

Keywords: Global Burden of Disease; age-period-cohort analysis; high fasting plasma glucose; joinpoint regression; mortality; tuberculosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Glucose*
China / epidemiology
Cohort Studies
Fasting
Female
Humans
Male
Middle Aged
Tuberculosis* / epidemiology

Substances

Blood Glucose