Zhongguo quanke yixue (Mar 2024)
Analysis and Prediction of the Disease Burden of Type 2 Diabetes Attributable to High Body Mass Index in China from 1990 to 2019
Abstract
Background China ranks first in the world in terms of the number of diabetes patients. In recent years, the prevalence and mortality of diabetes have been rising, threatening people's health and placing a heavy burden on the people of China. As the prevalence of obesity continues to rise, the burden of diabetes is expected to continue to rise, and diabetes has become a public health problem that cannot be ignored in China. Objective To describe and analyze the disease burden of type 2 diabetes attributable to high BMI and its trend in China from 1990 to 2019, and predict the disease burden of type 2 diabetes attributable to high BMI in China from 2020 to 2024, so as to provide a basis for the scientific prevention and control of type 2 diabetes in China. Methods In May 2023, data on the burden of disease indicators of type 2 diabetes such as disability-adjusted life years (DALYs) , DALYs rate, standardized DALYs rate, death toll, mortality rate and standardized mortality rate of type 2 diabetes in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) , and the trend was analyzed by annual percentage change (APC) and average annual percentage change (AAPC) using the Joinpoint Regression Model. An autoregressive moving average (ARIMA) model of DALYs rate and mortality rate of type 2 diabetes attributable to high BMI was constructed based on the data from 1990 to 2016 (training set) , and evaluated using the data from 2017 to 2019 (test set) . The relative error between the predicted value and the actual value, the mean absolute error (MAE) , mean absolute percentage error (MAPE) , mean square error (MSE) and root mean square error (RMSE) of the model were used to determine the model prediction effect, and the optimal model was selected to predict the burden of type 2 diabetes attributable to high BMI in China from 2020 to 2024. Results From 1990 to 2019, the burden of disease showed an overall upward trend (AAPC of standardized DALYs rate=2.85%, AAPC of standardized mortality=2.32%, both P<0.05) , the standardized DALYs rate increased from 80.21/100 000 to 181.54/100 000, and the standardized mortality rate increased from 1.25/100 000 to 2.39/100 000. The standardized DALYs rate and standardized mortality rate of both men and women showed a rapid upward trend, with standardized DALYs rate increasing by 173% for males and 89% for females compared to 2019, as well as the standardized mortality rate increasing by 146% for males and 58% for females. The DALYs rate and mortality rate increased significantly with age, with DALYs rates increasing rapidly after age 30 years, with peaks basically maintained in the 65-69 (337.47/100 000 in 1990, 711.09/100 000 in 2019) and 70-74 age groups (323.64/100 000 in 1990, 730.47/100 000 in 2019) , and the population mortality rate increased rapidly after the age of 45 years and the peak was maintained above the age of 95 years (12.78/100 000 in 1990 and 33.29/100 000 in 2019) . The DALYs and mortality rates of type 2 diabetes attributable to high BMI in China was increasing at a higher rate compared to the world. There were four inflection points in 1990-2019, the standardized DALYs rate and standardized mortality rate increased the fastest in 2000-2004 and 1996-2004, respectively. The ARIMA model predicted that the standardized DALYs rate and standardized mortality rate of type 2 diabetes attributable to high BMI in China would continue to increase from 2020 to 2024, reaching 205.142/100 000 (95%CI=189.775/100 000-220.508/100 000) and 2.621/100 000 (95%CI=2.343/100 000-2.900/100 000) by 2024, respectively. Conclusion The disease burden of type 2 diabetes attributable to high BMI in China is generally on the rise, manifested by an increase in the disease burden and number of deaths attributable to DALYs, and the growth rate is higher than globally. The disease burden of type 2 diabetes attributable to high BMI in men was progressively higher than that in women. The DALYs rate and mortality rate of type 2 diabetes attributable to high BMI were trending towards younger age groups. The ARIMA model indicated that the disease burden of type 2 diabetes attributable to high BMI was expected to continue to rise. In order to reduce the disease burden of type 2 diabetes, health education should be strengthened for the key populations (male, middle-aged and elderly people) to improve the awareness of diabetes prevention and control, and weight management can be strengthened by promoting healthy diet and lifestyle habits.
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