ABSTRACT
Objective To analyze the burden of chronic kidney disease (CKD) attributable to metabolic factors in Jiangsu Province from 1990 to 2019, and to provide evidence for the formation and implementation of intervention policies. Methods Using data from Jiangsu Province from the 2019 Global Burden of Disease Study (GBD 2019), mortality and disability-adjusted life-years (DALYs) were selected as indicators for analysis and standardized with the age structure of the world standard population. The effects of three metabolic factors including high systolic blood pressure (SBP), high fasting glycaemic index (FPG) and high body mass index (BMI) on the disease burden of CKD were analyzed, and the attributable disease burden by gender and age was compared. Results The rank of the three attributable risk factors was high SBP, high FPG, and high BMI. Standardized mortality rates attributable to high SBP, high FPG, and high BMI all showed an overall upward trend from 1990 to 2019, with annual average percent changes (AAPCs) of 0.3%, 0.0%, and 2.8%, respectively. Age-standardized DALYs attributed to high SBP and high BMI showed increasing trends, with the AAPCs of 0.5% and 3.1% (both P＜0.05), respectively. There was no statistical significance of high FPG (P > 0.05). Mortality and disease burden attributed to high SBP both showed upward trends with increasing age. Age-standardized mortality and age-standardized DALYs attributed to high FPG peaked at 45-49 and 50-54 age-group, respectively. Both age-standardized mortality and age-standardized DALYs attributed to high BMI peaked at ages 60-64 age-group. Conclusion The trends of mortality and DALYs attributed to the three risk factors can reflect the changes of population structure and lifestyle in Jiangsu Province in the past 30 years to a certain extent. Early screening of population at high risk of CKD and targeted provision of health policies can reduce the mortality and disease burden of CKD.
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Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
ABSTRACT
Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
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Objective To investigate the long-term effects of regular exercise during pregnancy on overweight and obese gravidas. Methods This study was based on a previous randomized controlled trial (RCT) regarding Effect of Regular Exercise Commenced in Early Pregnancy on the Incidence of Gestational Diabetes Mellitus in Overweight and Obese Pregnant Women conducted at Peking University First Hospital from December 2014 to July 2016. Totally 265 women whose prepregnant body mass index (BMI) ≥24.0 kg/m2 were enrolled in the RCT and were randomly assigned to exercise group (n=132) and control group (n=133). This study was a follow-up of all the participants at one year after delivery from March 2016 to August 2017. Body weight, body fat, fasting and 2 h glucose level in 75 g oral glucose tolerance test (OGTT), insulin resistance index and lipid profiles were compared. We also evaluated their physical activities with International Physical Activity Questionnaire (IPAQ), their dietary habits with modified Adult Dietary Behavior Assessment Scale and depression condition with Postpartum Depression Screen Scale (PDSS). Two independent samples t-test, Mann-Whitney U test and Chi-square test were used for statistical analysis. ResuLts The overall follow-up rate was 51.7% (137/265), while 64.4% (85/132) in the exercise group and 39.1% (52/133) in the control group. No significant difference in body weight loss [2.3 ( － 6.0 to 5.0) vs 1.0 ( － 1.3 to 4.7) kg], body fat percentage [(38.04±4.54)% vs (37.51±4.90) %], 2 h glucose level in 75 g OGTT [(7.30±2.80) vs (7.32±1.61) mmol/L], abnormal glucose tolerance ratio [30.0% (9/30) vs 28.8% (17/59)] or insulin resistance index (2.92±1.77 vs 2.86±1.92) was found between the control and exercise group (t or Z= － 0.940, 0.312, 3.415, 0.005, 1.743, all P>0.05). However, the fasting blood glucose in 75 g OGTT was higher in the control group [(5.53±0.92) vs (5.28±0.43) mmol/L, t=9.268, P=0.003]. The two groups showed no significant difference (exercise group vs control group) in physical activity level [219 (99-504) vs 195 (99-351)], total score of dietary habits [79.00 (72.50-87.50) vs 76.00 (70.00-82.00)] or PDSS score of depression [55.00 (41.00-77.00) vs 70.00 (46.25-84.75)] at follow-up (Z=－0.808, －1.822, －1.620, all P>0.05). Moreover, there was no significant difference in the level of serum triglyceride [(1.25±1.04) vs (1.42±0.85) mmol/L], total cholesterol [(4.56±0.71) vs (4.40±0.67) mmol/L], high density lipoprotein-cholesterol [(1.32±0.29) vs (1.22±0.21) mmol/L] or low density lipoprotein-cholesterol [(2.67±0.56) vs (2.55±0.52) mmol/L] between the exercise and control group (t=0.001, 0.020, 3.255, 0.303, all P>0.05). ConcLusions Regular exercise during pregnancy has no long-term effect on maternal health in the absence of continuing lifestyle intervention after delivery. Therefore, postpartum follow-up and continued education on healthy lifestyle should be emphasized.