Global Stroke Burden from Metabolic Risks Across Demographics: Findings from the 2021 Global Burden of Disease Study

medRxiv - Public and Global Health Pub Date : 2024-08-07 DOI:10.1101/2024.08.06.24311583

Song Xue, Guoqing Wu

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Abstract

Background: Stroke is the second leading cause of death and the primary cause of disability worldwide. Metabolic risks are major contributors to stroke. The global trends in metabolic risk-related stroke from 1990 to 2019, and the differences in mortality and DALYs across various demographic factors, remain unclear. Methods: All analyses were based on rates derived from the GBD2021 results (https://vizhub.healthdata.org/gbd-results/). Data were stratified by gender, region, and age. Joinpoint software was used to perform regression analysis of the average annual percent change (AAPC) and its 95% confidence interval to analyze trends from 1990 to 2019. Excel, PowerPoint, and R software were used for plotting and analysis, with p<0.05 considered statistically significant. Results: From 1990 to 2019, the average annual percent change (AAPC) for age-standardized rates (ASR) of DALYs was -1.70% (-1.81%, -1.58%), and for mortality, the AAPC was -1.57% (-1.68%, -1.46%). As the SDI increased, both the ASR of DALYs and mortality in 2019 showed a significant decline. The AAPC from 1990 to 2019 also exhibited a downward trend with increasing SDI levels. The DALYs and mortality rates of metabolic risk-related stroke predominantly affected individuals aged 75 and above, with a lesser impact on those under 55. For both genders, the 10-55 and 50-74 age groups had the highest DALYs and mortality rates due to metabolic-related intracerebral hemorrhage. For those aged 75-84 and over 85, ischemic stroke was the leading subtype of metabolic-related stroke contributing to DALYs and mortality rates. Conclusion: This is the first retrospective study on metabolic risk-related stroke on a global scale, summarizing its temporal trends and demographic distribution characteristics. Effective public health strategies are needed to address these disparities and continue reducing the global burden of metabolic risk-related strokes.

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不同人口结构的代谢风险造成的全球脑卒中负担：2021年全球疾病负担研究的结果

背景：中风是全球第二大死亡原因，也是导致残疾的主要原因。代谢风险是导致中风的主要因素。从 1990 年到 2019 年，代谢风险相关中风的全球趋势以及各种人口因素在死亡率和残疾调整寿命年数方面的差异仍不清楚：所有分析均基于 GBD2021 结果得出的比率（https://vizhub.healthdata.org/gbd-results/）。数据按性别、地区和年龄分层。使用Joinpoint软件对年均百分比变化（AAPC）及其95%置信区间进行回归分析，以分析1990年至2019年的趋势。使用 Excel、PowerPoint 和 R 软件进行绘图和分析，p<0.05 为具有统计学意义：从 1990 年到 2019 年，残疾调整寿命年数（DALYs）的年龄标准化率（ASR）的年均百分比变化（AAPC）为-1.70%（-1.81%，-1.58%），死亡率的年均百分比变化（AAPC）为-1.57%（-1.68%，-1.46%）。随着 SDI 的增加，2019 年的残疾调整寿命年数和死亡率的 ASR 都出现了显著下降。从 1990 年到 2019 年，随着 SDI 水平的增加，AAPC 也呈下降趋势。代谢风险相关中风的残疾调整寿命年数和死亡率主要影响 75 岁及以上人群，对 55 岁以下人群的影响较小。就男女而言，10-55 岁和 50-74 岁年龄组因代谢相关脑内出血造成的残疾调整寿命年数和死亡率最高。对于 75-84 岁和 85 岁以上的人群，缺血性中风是导致残疾调整寿命年数和死亡率的代谢相关中风的主要亚型：这是首次在全球范围内对代谢风险相关中风进行回顾性研究，总结了其时间趋势和人口分布特征。需要有效的公共卫生策略来解决这些差异，并继续减轻代谢风险相关中风的全球负担。

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medRxiv - Public and Global Health

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