Burden of disease attributable to high body mass index: an analysis of data from the Global Burden of Disease Study 2021.

Background: Obesity represents a major global health challenge with important clinical implications. Despite its recognized importance, the global disease burden attributable to high body mass index (BMI) remains less well understood. Methods: We systematically analyzed global deaths and disability-adjusted life years (DALYs) attributable to high BMI using the methodology and analytical approaches of the Global Burden of Disease Study (GBD) 2021. High BMI was defined as a BMI over 25 kg/m2 for individuals aged ≥20 years. The Socio-Demographic Index (SDI) was used as a composite measure to assess the level of socio-economic development across different regions. Subgroup analyses considered age, sex, year, geographical location, and SDI. Findings: From 1990 to 2021, the global deaths and DALYs attributable to high BMI increased more than 2.5-fold for females and males. However, the age-standardized death rates remained stable for females and increased by 15.0% for males. Similarly, the age-standardized DALY rates increased by 21.7% for females and 31.2% for males. In 2021, the six leading causes of high BMI-attributable DALYs were diabetes mellitus, ischemic heart disease, hypertensive heart disease, chronic kidney disease, low back pain and stroke. From 1990 to 2021, low-middle SDI countries exhibited the highest annual percentage changes in age-standardized DALY rates, whereas high SDI countries showed the lowest. Interpretation: The worldwide health burden attributable to high BMI has grown significantly between 1990 and 2021. The increasing global rates of high BMI and the associated disease burden highlight the urgent need for regular surveillance and monitoring of BMI. Funding: National Natural Science Foundation of China and National Key R&D Program of China.

Temporal and spatial convergence: the major depressive disorder burden attributed to intimate partner violence against women.

Background: There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.Method: This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.Results: In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.Conclusions: The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.

Vulnerability to different biological stages of the burden of experiencing intimate partner violence leading to major depressive disorder in women. Women in their reproductive years and during the menopausal transition were more vulnerable.Intimate partner violence-induced depressive disorder is trending younger, with an increasing burden on girls aged 15­19 over the past 30 years.The burden of major depressive disorder attributed to intimate partner violence varies increasingly across countries.

Burden of biliary tract carcinoma in China (1990-2021): Findings from the 2021 Global Burden of Disease Study.

Biliary tract carcinoma (BTC) is a group of malignant tumors that originate in the digestive system and occurs with a high incidence in China. Few consistent and comparable assessments of BTC disease burden have been conducted at national or subnational levels, and little is known about the demographic, temporal, and geographic patterns of epidemiological characteristics and disease burden of BTC in China. The incidence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs) due to premature death and years lived with disability (YLDs) of BTC were comprehensively examined by age, sex, and calendar year in the Chinese population, using the methodological framework and analytical strategies used for the 2021 Global Burden of Disease study. All-age incidence increased from 17,077 to 51,720 between 1990 and 2021, and the age-standardized incidence rate rose by 13.62%; all-age deaths increased from 17,251 to 37,833, but the age-standardized mortality rate fell by nearly one-fifth. The DALYs rose by 89.57% while the age-standardized DALY rate fell by 23.24%. Variations of the tendencies in BTC burden were found between sexes and age groups. Data for each provincial region indicate that coastal eastern provincial regions have higher incidence and YLD levels, whereas northern provincial regions have higher mortality, DALY, and YLL levels. The proportions of DALYs attributable to high body mass index (BMI) illustrate the growing attribution obesity has made, and high BMI usually puts more burden on northern provincial regions. These results provide evidence to support precise, targeted, and customed public health strategies aimed at enhancing biliary tract health among the Chinese population.

Chronic obstructive pulmonary disease attributable to air pollution in the South Asian countries: global burden of disease study 1990 - 2019.

This study investigates the burden of COPD attributable to air pollution in South Asia using data from the Global Burden of Disease Study from 1990 to 2019. Method Data for this study were obtained from the Global Burden of Disease Study 2019. The burden was measured in terms of death, disability-adjusted life years (DALYs), and Years of life lost (YLLs). Results Since 1990, several countries in South Asia registered substantial declines in mortality rates attributed to COPD, ranging from -37.47% in Pakistan to -66.25% in Bangladesh. Similar trends were observed for DALYs and YLLs as well, which have potentially contributed to a considerable decrease in mortality rates at the regional level (-43.13%) compared to a 32.59% decline in Low SDI and 56.87% decline globally. Conclusion Despite significant declines since 1990, the burden of COPD attributable to air pollution reductions in the South Asian region's rates remains alarmingly high.

Spatiotemporal trends in the burden of colorectal cancer incidence and risk factors at country level from 1990 to 2019.

BACKGROUND AND AIM: Worldwide, the incidence of colorectal cancer (CRC) continues to rise and remains a major public health concern. This study aimed to analyze the temporal and spatial trends in CRC incidence and related risk factors at the country level. METHODS: Data on CRC and related risk factors were obtained from the Global Burden of Disease Study (GBD) 2019 study. Temporal trends were evaluated using estimated annual percentage change while spatial trends were analyzed using spatial autocorrelation and autoregression. Additionally, linear mixed-effects models were employed to identify risk factors linked to CRC incidence. RESULTS: Globally, from 1990 to 2019, the incidence cases of CRC increased by 157.23%. At the national level, the incidence of CRC increased in most countries, with the highest increases of age-standardized incidence rate (ASIR) in Equatorial Guinea, Vietnam, and China. In both 1990 and 2019, global spatial clustering of CRC ASIR highlighted hotspots in Europe, characterized by elevated CRC ASIR levels. A comparative analysis of risk factors between hotspot countries and others indicated that gender and alcohol use exerted greater influence in hotspots than elsewhere. CONCLUSION: Although from 1990 to 2019, the highest growth in ASIR of CRC has been observed in African, Asian, and Latin American countries, the hotspots are still concentrated in Europe. In the identified hotspots, gender and alcohol use exert a more significant impact on CRC incidence compared with other countries. Thus, we should pay attention to countries where the CRC incidence is increasing and these risk factors.

Burden of disease in Germany attributed to ambient particulate matter pollution : Findings from the Global Burden of Disease Study 2019.

INTRODUCTION: Ambient fine particulate matter pollution with a diameter less than 2.5 micrometers (PM2.5) is a significant risk factor for chronic noncommunicable diseases (NCDs), leading to a substantial disease burden, decreased quality of life, and deaths globally. This study aimed to investigate the disease and mortality burdens attributed to PM2.5 in Germany in 2019. METHODS: Data from the Global Burden of Disease (GBD) Study 2019 were used to investigate disability-adjusted life-years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), and deaths attributed to ambient PM2.5 pollution in Germany. RESULTS: In 2019, ambient PM2.5 pollution in Germany was associated with significant health impacts, contributing to 27,040 deaths (2.82% of total deaths), 568,784 DALYs (2.09% of total DALYs), 135,725 YLDs (1.09% of total YLDs), and 433,058 YLLs (2.92% of total YLLs). The analysis further revealed that cardiometabolic and respiratory conditions, such as ischemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and diabetes mellitus, were the leading causes of mortality and disease burden associated with ambient PM2.5 pollution in Germany from 1990-2019. Comparative assessments between 1990 and 2019 underscored ambient PM2.5 as a consistent prominent risk factor, ranking closely with traditional factors like smoking, arterial hypertension, and alcohol use contributing to deaths, DALYs, YLDs, and YLLs. CONCLUSION: Ambient PM2.5 pollution is one of the major health risk factors contributing significantly to the burden of disease and mortality in Germany, emphasizing the urgent need for targeted interventions to address its substantial contribution to chronic NCDs.

Global, regional, and national burden of bullying related mental disorders of adolescent from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019.

Few studies have assessed the burden of mental disorders in adolescents related to bullying victimization at the global, regional, and national levels. We analyzed adolescent mental disorder disability-adjusted life years (DALYs) attributed to bullying in 204 countries, following the Global Burden of Disease study 2019 framework. The DALYs rate of adolescent for bullying-related mental disorders global increased from 110.45 (95 % uncertainty intervals (UI): 40.76, 218.62) per 100,000 in 1990 to 138.92 (95 % UI: 54.37, 268.19) per 100,000 in 2019. The largest increase in DALYs rates were obvious in low-SDI and high-SDI regions. In 2019, the DALYs rate of adolescents with bullying-related anxiety disorders was 1.4 times higher than those depressive disorders; the DALYs rate of adolescents with bullying-related mental disorder in females was 1.3 times higher than that of male, and older adolescent (15-19 years old) was 1.4 times higher than younger adolescent (10-14 years old). High-income North America had the fastest increase in DALYs rates of mental disorders related to bullying. In general, a positive correlation was observed between bullying DALY rate of adolescent and SDIs at the regional and national levels. Our study highlights significant disparities in adolescent mental health burden from bullying. Governments must implement adaptive policies to address diverse needs effectively.

Temperature-Driven Dengue Transmission in a Changing Climate: Patterns, Trends, and Future Projections.

Dengue is a rapidly spreading mosquito-borne infectious disease that is sensitive to climate factors and poses a major public health concern worldwide. We analyzed dengue incidence trends and the relationship between annual mean minimum temperatures (AMMTs) and dengue incidence rates from 1990 to 2019 in 122 countries using the Global Burden of Disease and TerraClimate data sets. We also projected global dengue incidence rates under different carbon emission scenarios using temperature data from the Coupled Model Intercomparison Project Phase 6 (CMIP6) data set. Our results reveal a significant increase in global dengue cases from 1990 to 2019 and a positive correlation between temperature and dengue incidence. The association between AMMT and dengue incidence strengthened at temperatures exceeding 21°C. Central and eastern sub-Saharan Africa, as well as Oceania, were identified as the regions most sensitive to dengue; males and individuals aged 15-19 or 70-84 years were the most susceptible to dengue under rising temperatures. Our projections suggest that global dengue incidence will substantially increase by 2050 and 2100. By 2100, regions including Africa, the Arabian Peninsula, the southern United States, southern China, and island countries in the Pacific and Indian Oceans are projected to become year-round dengue-endemic under a high-emission climate scenario. Our findings underscore the importance of implementing effective measures to mitigate the impact of climate change on dengue transmission. Identifying high-risk areas and susceptible populations, along with understanding the projected expansion of dengue-endemic regions, will provide valuable guidance for targeted interventions to address this growing global health challenge in the face of changing climatic conditions.

Worldwide burden of liver cancer across childhood and adolescence, 2000-2021: a systematic analysis of the Global Burden of Disease Study 2021.

Background: Liver cancer is a significant contributor to the global disease burden, of which hepatoblastomas are the most common liver tumors in children, with 90% of cases occurring within the first 5 years of life. It is important for pediatricians and subspecialists in pediatric gastroenterology and hepatology to have knowledge of the epidemiology and incidence trends of pediatric hepatic cancer, despite its rarity. In the present study, we first provide estimates of the incidence and mortality burden of hepatoblastoma and liver cancer from 2000 to 2021 in the childhood and adolescence. Methods: Liver cancer burden and its attributable risk factors were estimated using data from the Global Burden of Disease Study (GBD) 2021. Percentage change was estimated to show the trend of liver cancer estimates from 2000 to 2021. The age-standardized rate (ASR) and estimated annual percentage change (EAPC) were utilized for measuring hepatoblastomas incidence and deaths rate trends. In accordance with the GBD framework, 95% uncertainty intervals (UIs) for all estimates by averaging the data from 1000 draws, with the lower and upper bounds of the 95% UIs. Findings: Globally, from 2000 to 2021 in the age 5-19 years group, the incidence cases and deaths cases due to liver cancer decreased from 2449.2 (95% UI: 2235.9-2689.8) to 1692.9 (95% UI: 1482.0-1992.5) and 2248.5 (95% UI: 2053.7-2474.9) to 1516.6 (95% UI: 1322.1-1797.9), respectively. Meanwhile, from 2000 to 2021 in the age 20-24 years group, the incidence cases and deaths cases due to liver cancer decreased from 1453.5 (95% UI: 1327.8-1609.4) to 1285.1 (95% UI: 1159.2-1447.2) and 1432.3 (95% UI: 1307.6-1585.7) to 1195.5 (95% UI: 1066.1-1355.2), respectively. In addition, the prevalence of liver cancer decreased from 41.9% (95% UI: 18.7%-64.7%) to 26.4% (95% UI: 14.2%-39.1%) in the age 5-19 years group, and 46.6% (95% UI: 42.8%-51.5%) to 36.5% (95% UI: 33.1%-40.9%) in the age 20-24 years. From 2000 to 2021, in the age group of 5-19 years, the proportion of liver cancer incidence due to hepatitis B has decreased from 42.2% to 37.9%, while the proportion due to hepatitis C has increased from 1.1% to 1.6%. Additionally, there has been an increase in the proportion of NASH-induced liver cancer incidence from 5.2% to 9.4%, and alcohol use induced liver cancer incidence has also increased from 0.5% to 0.7% over the same period. Globally, from 2000 to 2021, the incidence cases and deaths cases due to hepatoblastoma decreased from 6131.8 (95% UI: 5234.8-6961.9) to 4045.6 (95% UI: 3250-4995.8) and 4059.2 (95% UI: 3494.5-4621.2) to 2416 (95% UI: 1940.2-3022.5), respectively. There was some variation in age-related sex-specific patterns, the highest number of hepatoblastoma incidence cases occurred in children between 2 and 4 years old and females in the age range of 12 months to 9 years had a higher number of new cases. Importantly, the incidence of hepatoblastoma was started to increase sharply after the age of 1 month. Interpretation: The results of the present study are significant for liver health policy and practice in childhood and adolescence. Differentiated intervention and outreach strategies based on age and gender would be necessary to reduce the impact of liver cancer. Early screening and interventions for hepatoblastoma is important especially in the population of under 9 years old. Funding: This study was supported by the National Key R&D Program of China (grant numbers 2023YFC2307000), National Natural Science Foundation of China [grant numbers 82170571 and 81974068], China Postdoctoral Science Foundation (grant numbers 2023M741283).

Change in the global burden of depression from 1990-2019 and its prediction for 2030.

OBJECTIVE: Depression is a global health challenge, but only a few studies have fully assessed and predicted the disease burden. This study described the trend of global depression burden from 1990 to 2019 through age-standardized incidence rate (ASIR), age-standardized disability-adjusted life rate (ASDR), and predicted the number of cases of depression during 2020-2030. METHODS: Linear regression analysis was used to calculate the estimated annual percentage change (EAPC) in the age-standardized rates. The trends of global depression burden from 1990 to 2019 were analyzed by age, sex, and socio-demographic index (SDI) across various regions. Finally, we used the Bayesian age-period-cohort (BAPC) model to predict the disease burden in the coming 10 years. RESULTS: Globally, the ASIR of depression decreased from 3681.24 per 100,000 population in 1990 to 3588.25 per 100,000 population in 2019 and the EAPC was -0.29%. ASDR also decreased, following a similar trend as the ASIR. The highest ASDR was observed in adults aged 60-64 years. The burden of depressive illness was higher in women, with the greatest increase in incidence in low SDI areas. BAPC predicted that the worldwide ASIR and ASDR of depression would stabilize from 2020 to 2030, with an increasing number of cases. By 2030, the ASIR was estimated to be 2519.88 per 100,000 men and 3835.11 per 100,000 women. CONCLUSION: From 1990 to 2019, the global burden of depression remained significant, especially among women. It is important to address depression in older people, and it is therefore necessary to develop measures for prevention.

Temporal trends in prevalence of liver cancer and etiology-specific liver cancer from 1990 to 2019.

BACKGROUND: Liver cancer (LC) remains a major cause of cancer death worldwide. Grasping prevalence trends is key to informing strategies for control and prevention. We analyzed the global, regional and national trends in LC prevalence and its major causes from 1990 to 2019. METHODS: We obtained LC age-standardized prevalence rate (ASPR) estimates from the Global Burden of Disease study 2019 and assessed trends using Joinpoint regression. LC cases were categorized into those due to hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol use, nonalcoholic steatohepatitis (NASH) and other causes. RESULTS: While the ASPR of LC has shown a global decrease, there are specific regions where an increase in ASPR has been observed, with the highest rates in America. HBV remained the leading cause of LC (41.45 %) but significant increases occurred for HCV, alcohol use and NASH. Prevalence correlated with socioeconomic development. High-income countries had higher LC rates from HCV and alcohol but lower HBV-related LC. In high-income nations, LC prevalence climbs; the converse holds in middle- and low-income countries. CONCLUSIONS: Despite a global ASPR decrease, LC due to HCV, NASH, and alcohol is rising. Prevention strategies must prioritize HBV vaccination, HCV treatment, and alcohol regulation. IMPACT: The study informs targeted LC control policies and emphasizes the importance of continued monitoring and regional cooperation to combat LC.

Impact of hypertensive heart disease, risk factors, and age-period-cohort models across 204 nations and regions from 1990 to 2019: a global perspective from the 2019 global burden of disease study.

Background: Hypertensive heart disease (HHD) is a major global public health issue resulting from hypertension-induced end-organ damage. The aim of this study was to examine the global impact, risk factors, and age-period-cohort (APC) model of HHD from 1990 to 2019. Methods: Data from the 2019 Global Burden of Disease were used to assess age-adjusted HHD prevalence, disability-adjusted life years (DALYs), mortality rates, and contributions of HHD risk factors with 95% uncertainty intervals (UIs). APC models were used to analyze global age, period, and cohort mortality trends for HHD. Results: In 2019, 18.6 million prevalent HHD cases led to 1.16 million fatalities and 21.51 million DALYs. Age-adjusted rates were 233.8 (95%UI = 170.5-312.9) per 100,000 individuals for prevalence, 15.2 (11.2-16.7) for mortality, and 268.2 (204.6-298.1) for DALYs. Regionally, the Cook Islands (703.1), Jordan (561.6), and Kuwait (514.9) had the highest age-standardized incidence of HHD in 2019. There were significant increases in HHD prevalence in Andean Latin America (16.7%), western sub-Saharan Africa (5.6%), and eastern sub-Saharan Africa (4.6%). Mortality rate varied widely among countries. Risk factors like elevated systolic blood pressure and high body mass index significant influenced DALY rates, especially in females. The APC model revealed an association between mortality rates and age, with a decreasing mortality risk over time and improved survival rates for a later birth cohort. Conclusions: Despite the reduction in prevalence, HHD remains a significant public health issue, particularly in nations with low sociodemographic indices. To alleviate the impact of HHD, prevention efforts should concentrate on the management of hypertension, weight loss, and lifestyle improvement.

Global burden of thyroid cancer from 1990 to 2021: a systematic analysis from the Global Burden of Disease Study 2021.

Thyroid cancer (TC) is a significant global healthcare burden. However, the lack of comprehensive data has impeded our understanding of its global impact. We aimed to examine the burden of TC and its trends at the global, regional, and national levels using data stratified by sociodemographic index (SDI), sex, and age. Data on TC, including incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2021, were obtained from the Global Burden of Disease Study 2021. Estimated annual percentage changes (EAPCs) were calculated to assess the incidence rate, mortality, and DALYs trends. The incidence, mortality, and DALYs of TC in 2021 were 249,538 (95% uncertainty interval: 223,290-274,638), 44,799 (39,925-48,541), and 646,741 (599,119-717,357), respectively. The age-standardized incidence rate (ASIR) in 2021 was 2.914 (2.607-3.213), with an EAPC of 1.25 (1.14-1.37) compared to 1990. In 2021, the age-standardized death rate (ASDR) was 0.53 (0.47-0.575) and age-standardized DALYs rate was 14.571 (12.783-16.115). Compared with 1990, the EAPCs of ASDR and age-standardized DALYs rate showed decreasing trends, at - 0.24 (- 0.27 to - 0.21) and - 0.14 (- 0.17 to - 0.11), respectively. Low SDI regions showed the highest ASDR and age-standardized DALYs rate, at 0.642 (0.516-0.799) and 17.976 (14.18-23.06), respectively. Low-middle SDI regions had the highest EAPCs for ASDR and age-standardized DALYs rate, at 0.74 (0.71-0.78) and 0.67 (0.63-0.7), respectively. Females exhibited decreasing trend in ASDR and age-standardized DALYs rate, with EAPCs of - 0.58 (- 0.61 to - 0.55) and - 0.45 (- 0.47 to - 0.42), respectively. In contrast, males showed an increasing trend in ASDR and age-standardized DALYs rate, with EAPCs of 0.41 (0.35-0.46) for both. In high-income regions, most countries with decreased annual changes in deaths experience increasing age-related deaths. Over the past few decades, a notable increase in TC incidence and decreased mortality has been observed globally. Regions characterized by lower SDI, male sex, and an aging population exhibited no improvement in TC mortality. Effective resource allocation, meticulous control of risk factors, and tailored interventions are crucial for addressing these issues.

Global, regional, and national burden of female cancers in women of child-bearing age, 1990-2021: analysis of data from the global burden of disease study 2021.

Background: The global status of women's health is underestimated, particularly the burden on women of child-bearing age (WCBA). We aim to investigate the pattern and trend of female cancers among WCBA from 1990 to 2021. Methods: We retrieved data from the Global Burden of Disease Study (GBD) 2021 on the incidence and disability-adjusted life-years (DALYs) of four major female cancers (breast, cervical, uterine, and ovarian cancer) among WCBA (15-49 years) in 204 countries and territories from 1990 to 2021. Estimated annual percentage changes (EAPC) in the age-standardised incidence and DALY rates of female cancers, by age and socio-demographic index (SDI), were calculated to quantify the temporal trends. Spearman correlation analysis was used to examine the correlation between age-standardised rates and SDI. Findings: In 2021, an estimated 1,013,475 new cases of overall female cancers were reported globally, with a significant increase in age-standardised incidence rate (EAPC 0.16%), and a decrease in age-standardised DALY rate (-0.73%) from 1990 to 2021. Annual increase trends of age-standardised incidence rate were observed in all cancers, except for that in cervical cancer. Contrary, the age-standardised DALY rate decreased in all cancers. Breast and cervical cancers were prevalent among WCBA worldwide, followed by ovarian and uterine cancers, with regional disparities in the burden of four female cancers. In addition, the age-standardised incidence rates of breast, ovarian, and uterine cancers basically showed a consistent upward trend with increasing SDI, while both the age-standardised incidence and DALY rates in cervical cancer exhibited downward trends with SDI. Age-specific rates of female cancers increased with age in 2021, with the most significant changes observed in younger age groups, except for uterine cancer. Interpretation: The rising global incidence of female cancers, coupled with regional variations in DALYs, underscores the urgent need for innovative prevention and healthcare strategies to mitigate the burden among WCBA worldwide. Funding: This study was supported by the Science Foundation for Young Scholars of Sichuan Provincial People's Hospital (NO. 2022QN44 and NO. 2022QN18); the Key R&D Projects of Sichuan Provincial Department of Science and Technology (NO. 2023YFS0196); the National Natural Science Foundation of China (No. 82303701).

Epidemiological trends of subarachnoid hemorrhage at global, regional, and national level: a trend analysis study from 1990 to 2021.

BACKGROUND: Subarachnoid hemorrhage (SAH) is a subtype of hemorrhagic stroke characterized by high mortality and low rates of full recovery. This study aimed to investigate the epidemiological characteristics of SAH between 1990 and 2021. METHODS: Data on SAH incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2021 were obtained from the Global Burden of Disease Study (GBD) 2021. Estimated annual percentage changes (EAPCs) were calculated to evaluate changes in the age-standardized rate (ASR) of incidence and mortality, as well as trends in SAH burden. The relationship between disease burden and sociodemographic index (SDI) was also analyzed. RESULTS: In 2021, the incidence of SAH was found to be 37.09% higher than that in 1990; however, the age-standardized incidence rates (ASIRs) showed a decreased [EAPC: -1.52; 95% uncertainty interval (UI) -1.66 to -1.37]. Furthermore, both the number and rates of deaths and DALYs decreased over time. It was observed that females had lower rates compared to males. Among all regions, the high-income Asia Pacific region exhibited the highest ASIR (14.09/100,000; 95% UI 12.30/100,000 - 16.39/100,000) in 2021, with an EPAC for ASIR < 0 indicating decreasing trend over time for SAH ASIR. Oceania recorded the highest age-standardized mortality rates (ASMRs) and age-standardized DALYs rates among all regions in 2021 at values of respectively 8.61 (95% UI 6.03 - 11.95) and 285.62 (95% UI 209.42 - 379.65). The burden associated with SAH primarily affected individuals aged between 50 - 69 years old. Metabolic risks particularly elevated systolic blood pressure were identified as the main risk factors contributing towards increased disease burden associated with SAH when compared against environmental or occupational behavioral risks evaluated within the GBD framework. CONCLUSIONS: The burden of SAH varies by gender, age group, and geographical region. Although the ASRs have shown a decline over time, the burden of SAH remains significant, especially in regions with middle and low-middle SDI levels. High systolic blood pressure stands out as a key risk factor for SAH. More specific supportive measures are necessary to alleviate the global burden of SAH.

Trends in the burden and determinants of HIV in the Asia-Pacific region (1990-2019): An age-period-cohort analysis of the 2019 Global Burden of Disease Study.

Although the burden of the human immunodeficiency virus (HIV) in the Asia-Pacific region is increasingly severe, comprehensive evidence of the burden of HIV is scarce. We aimed to report the burden of HIV in people aged 15-79 years from 1990 to 2019 using data from the Global Burden of Disease Study (GBD) 2019. We analyzed rates of age-standardized disability-adjusted life years (ASDR), age-standardized mortality (ASMR), and age-standardized incidence (ASIR) in our age-period-cohort analysis by sociodemographic index (SDI). According to HIV reports in 2019 from 29 countries in the Asia-Pacific region, the low SDI group in Papua New Guinea had the highest ASDR, ASMR, and ASIR. From 1990 to 2019, the ASDR, ASIR, and ASMR of persons with acquired immune deficiency syndrome (AIDS) increased in 21 (72%) of the 29 countries in the Asia-Pacific region. During the same period, the disability-adjusted life years (DALYs) of AIDS patients in the low SDI group in the region grew the fastest, particularly in Nepal. The incidence of HIV among individuals aged 20-30 years in the low-middle SDI group was higher than that of those in the other age groups. In 2019, unsafe sex was the main cause of HIV-related ASDR in the region's 29 countries, followed by drug use. The severity of the burden of HIV/AIDS in the Asia-Pacific region is increasing, especially among low SDI groups. Specific public health policies should be formulated based on the socioeconomic development level of each country to alleviate the burden of HIV/AIDS.

Pre-COVID life expectancy, mortality, and burden of diseases for adults 70 years and older in Australia: a systematic analysis for the Global Burden of Disease 2019 Study.

Background: The Australian population aged 70 and above is increasing and imposing new challenges for policy makers and providers to deliver accessible, appropriate and affordable health care. We examine pre-COVID patterns of health loss between 1990 and 2019 to inform policies and practices. Methods: Using the standardised methodology framework and analytical strategies from GBD 2019 methodologies, we estimated mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), life expectancy at age 70 and above (LE-70), and healthy life expectancy (HALE-70) in Australia comparing them globally and with high socio-demographic index (SDI) groups. Findings: DALY rates have been improving steadily over the past 30 years among Australians aged 70 and above. Decreases in DALY rates were primarily attributed to a fall in YLLs attributable to cardiovascular diseases (60%) and chronic respiratory disorders (30.2%) and transport injuries (56.9%), while the non-fatal burden remained stable from 1990 to 2019. According to the DALY rates, the top five leading causes are ischemic heart disease, Alzheimer's disease, COPD, stroke, and falls, where falls exhibited the largest increase since 1990. Interpretation: This study provides an in-depth report on the main causes of mortality and disability in Australia's population aged 70 and above. It sheds light on the shifts in burden over three decades, emphasising the need for the Australian health system to enhance its readiness in addressing the escalating demands of an ageing population. These findings establish pre-COVID baseline estimates for Australia's population aged 70 and above, informing healthcare preparedness. Funding: Bill & Melinda Gates Foundation.

The global burden of cataracts and its attributable risk factors in 204 countries and territories: a systematic analysis of the global burden of disease study.

Introduction: The global distribution and trends in the attributable burden of cataract risk have rarely been systematically explored. To guide the development of targeted and accurate cataract screening and treatment strategies, we analyzed the burden of cataract disease attributable to known risk factors. Method: This study utilized detailed cataract data from the Global Burden of Disease e 2019, and we analyzed disability-adjusted life years (DALYs) e each risk factor from 1990 to 2019. Additionally, we calculated estimated annual percentage changes (EAPCs) during the study period. Results: The results revealed that from 1990-2019, the global age-standardized DALYs of e attributable to particulate matter pollution, smoking, high fasting glucose plasma and high BMI showed steady downward trends (1990-2009: EAPC = -0.21 [-0.57 -0.14]); 2000-2009: EAPC = -0.95 [-1.01 -0.89]; 2010-2019: EAPC = -1.41 [-1.8 -1.02]). The age-standardized DALYs and mortality caused by each risk factor were highest in the low-middle sociodemographic index (SDI) region (EAPC = -1.77[(-2.19--1.34)]). The overall disease burden of cataracts is lower in males than in females. When analyzing the EAPCs of cataract disease burden for each risk factor individually, we found that the age-standardized disability-adjusted life years caused by particulate matter pollution and smoking decreased (PMP1990-2009: EAPC = -0.53 [-0.9--0.16]; 2000-2009: EAPC = -1.39 [-1.45--1.32]; 2010-2019: EAPC = -2.27 [-2.75--1.79]; smoking 2000 to 2009: EAPC = -1.51 [-1.6--1.43], 2009 to 2019: EAPC = -1.34 [-1.68--1])), while high fasting plasma glucose and high body mass index increased annually (HFPG1990 to 1999: EAPC = 1.27 [0.89-1.65], 2000 to 2009: EAPC = 1.02 [0.82-1.22], 2010-2019: EAPC = 0.44 [0.19-0.68]; HBMI 1990 to 1999: EAPC = 1.65 [1.37-1.94], 2000 to 2009: EAPC = 1.56 [1.43-1.68], 2010-2019: EAPC = 1.47 [1.18-1.77]). Disscussion: The burden of cataracts caused by ambient particulate matter and smoking is increasing in low, low-middle SDI areas, and specific and effective measures are urgently needed. The results of this study suggest that reducing particulate matter pollution, quitting smoking, controlling blood glucose, and lowering BMI could play important roles in reducing the occurrence of cataracts, especially in older people.

Global pattern, trend, and cross-country inequality of early musculoskeletal disorders from 1990 to 2019, with projection from 2020 to 2050.

BACKGROUND: This study aims to estimate the burden, trends, forecasts, and disparities of early musculoskeletal (MSK) disorders among individuals ages 15 to 39 years. METHODS: The global prevalence, years lived with disabilities (YLDs), disability-adjusted life years (DALYs), projection, and inequality were estimated for early MSK diseases, including rheumatoid arthritis (RA), osteoarthritis (OA), low back pain (LBP), neck pain (NP), gout, and other MSK diseases (OMSKDs). FINDINGS: More adolescents and young adults were expected to develop MSK disorders by 2050. Across five age groups, the rates of prevalence, YLDs, and DALYs for RA, NP, LBP, gout, and OMSKDs sharply increased from ages 15-19 to 35-39; however, these were negligible for OA before age 30 but increased notably at ages 30-34, rising at least 6-fold by 35-39. The disease burden of gout, LBP, and OA attributable to high BMI and gout attributable to kidney dysfunction increased, while the contribution of smoking to LBP and RA and occupational ergonomic factors to LBP decreased. Between 1990 and 2019, the slope index of inequality increased for six MSK disorders, and the relative concentration index increased for gout, NP, OA, and OMSKDs but decreased for LBP and RA. CONCLUSIONS: Multilevel interventions should be initiated to prevent disease burden related to RA, NP, LBP, gout, and OMSKDs among individuals ages 15-19 and to OA among individuals ages 30-34 to tightly control high BMI and kidney dysfunction. FUNDING: The Global Burden of Disease study is funded by the Bill and Melinda Gates Foundation. The project is funded by the Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).