Global, regional, and national burden of iodine deficiency for women of reproductive age, 1990-2021: a systematic analysis based on the Global Burden of Disease Study 2021.
Taotao Wang, Jingmin Tong, Yuzhou Liu, Yanqiu Liu, Hui Xu, Yang Liu
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Abstract
Objective: This study aims to assess the global, regional, and national burden of iodine deficiency among women of reproductive age (WRA) from 1990 to 2021.
Methods: Utilizing data from the Global Burden of Disease Study 2021, this study reports age-standardized rates per 100,000 population and average annual percentage changes (AAPCs) in incidence, prevalence, and years lived with disability (YLD) of iodine deficiency among WRA, facilitating a comparative analysis of the burden across regions and nations. Moreover, Joinpoint analysis was utilized to assess temporal trends, the slope index and concentration index of inequality were used to assess the health inequality across countries. The Bayesian age-period-cohort model was employed to forecast the burden up to 2044.
Results: A notable upward trend in the age-standardized incidence rate (ASIR) of iodine deficiency among WRA was observed globally from 1990 to 2021, and this trend is projected to remain relatively stable between 2021 and 2030. The global ASIR increase from 171.3 per 100,000 population (95% CI 122.8, 228.2) in 1990 to 193.6 (95% CI 141.7, 253.2) in 2021 with an AAPC at 0.36 (95% CI 0.26, 0.47). Moreover, the global age-standardized prevalence rate (ASPR) and age-standardized YLD rate (ASYR) demonstrated decreased trend with the AAPC of -0.31 (-0.35, -0.27) and -1.05 (-1.19, -0.92), respectively. In 2021, countries with low sociodemographic index (SDI) exhibited the highest iodine deficiency burden. The highest burden of iodine deficiency was observed in Central Sub-Saharan Africa, while East Asia exhibited the highest increase in ASIR, ASPR and ASYR. Women of 20-24 years showed the highest increase in the age specific incidence rate globally. The significant absolute and relative health inequality was also observed and the gap has been narrowed.
Conclusions: Over the past three decades, there has been an overall upward trend in the ASIR of iodine deficiency among WRA globally. Health inequalities related to iodine deficiency was still prominent across countries. Iodine deficiency among WRA remains a significant public health issue. It is crucial to prioritize the development of effective, targeted strategies and implement monitoring mechanisms to enhance the iodine levels among WRA.
目的：本研究旨在评估1990年至2021年全球、地区和国家育龄妇女（WRA）碘缺乏症负担。方法：利用2021年全球疾病负担研究的数据，本研究报告了WRA中每10万人的年龄标准化率和碘缺乏症发病率、患病率和残疾年数（YLD）的平均年百分比变化（AAPCs），促进了各地区和国家负担的比较分析。此外，利用Joinpoint分析来评估时间趋势，利用斜率指数和不平等集中指数来评估各国之间的健康不平等。采用贝叶斯年龄-时期-队列模型预测到2044年的负担。结果：从1990年到2021年，全球WRA中碘缺乏症的年龄标准化发病率（ASIR）呈显著上升趋势，预计这一趋势在2021年至2030年期间保持相对稳定。全球ASIR从1990年的每10万人171.3 （95% CI 122.8, 228.2）增加到2021年的193.6 (95% CI 141.7, 253.2)， AAPC为0.36 （95% CI 0.26, 0.47）。此外，全球年龄标准化患病率（ASPR）和年龄标准化YLD率（ASYR）呈下降趋势，AAPC分别为-0.31（-0.35,-0.27）和-1.05（-1.19,-0.92）。2021年，社会人口指数（SDI）较低的国家碘缺乏负担最重。撒哈拉以南非洲中部的缺碘负担最重，而东亚的ASIR、ASPR和ASYR的增加幅度最大。在全球范围内，20-24岁的女性在特定年龄的发病率中增幅最大。还观察到严重的绝对和相对健康不平等，差距已经缩小。结论：在过去的三十年中，全球WRA中碘缺乏症的ASIR总体呈上升趋势。与缺碘有关的保健不平等现象在各国仍然很突出。世界粮食计划署缺碘仍然是一个重大的公共卫生问题。至关重要的是优先制定有效的、有针对性的战略，并实施监测机制，以提高WRA之间的碘水平。
期刊介绍：
No subject pertains more to human life than nutrition. The aim of Frontiers in Nutrition is to integrate major scientific disciplines in this vast field in order to address the most relevant and pertinent questions and developments. Our ambition is to create an integrated podium based on original research, clinical trials, and contemporary reviews to build a reputable knowledge forum in the domains of human health, dietary behaviors, agronomy & 21st century food science. Through the recognized open-access Frontiers platform we welcome manuscripts to our dedicated sections relating to different areas in the field of nutrition with a focus on human health.
Specialty sections in Frontiers in Nutrition include, for example, Clinical Nutrition, Nutrition & Sustainable Diets, Nutrition and Food Science Technology, Nutrition Methodology, Sport & Exercise Nutrition, Food Chemistry, and Nutritional Immunology. Based on the publication of rigorous scientific research, we thrive to achieve a visible impact on the global nutrition agenda addressing the grand challenges of our time, including obesity, malnutrition, hunger, food waste, sustainability and consumer health.
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