Global, Regional and National burden of dementia attributable to metabolic dysregulation from 1990 to 2021, with projections of burden to 2050: An analysis of the global burden of disease study 2021

IF 4.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews Pub Date : 2026-08-01 Epub Date: 2026-09-23 DOI:10.1016/j.dsx.2026.103486

Kaichen Wang, Meijin Song, Jing Lu, Dongxu Li, Huijing Cui, Ying Zhang, Li Jiang, Tong Wu, Yibin Zhang, Hanying Xu, Qiaoying Li, Jian Wang, Hongmei Nan, Peng Xu

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引用次数: 0

Abstract

Background and aims

We quantified dementia burden attributable to high fasting plasma glucose (FPG) and high body mass index (BMI), projected trends to 2050, and examined metabolic traits using Mendelian randomization (MR).

Methods

Global Burden of Disease (GBD) 2021 data from 204 countries and territories were analyzed by age, sex, and Socio-demographic Index. Future burden was projected using time-series and Bayesian age-period-cohort models. Two-sample MR used European-ancestry genetic summary data with inverse-variance weighted estimates and sensitivity analyses.

Results

Metabolic-attributable dementia burden increased, with a steeper rise for high BMI than high FPG. Genetically predicted hypertension was associated most clearly with vascular dementia (odds ratio 2.72, 95% confidence interval 1.66–4.45; P = 0.0001) and was supported by the weighted-median estimator. Genetically predicted high-density lipoprotein cholesterol (HDL-C) showed only a nominal association with Alzheimer disease (odds ratio 1.09, 95% confidence interval 1.00–1.19; P = 0.0459) that was not consistently supported across MR methods. Mediation analyses were not significant.

Conclusions

Metabolic-attributable dementia burden is increasing globally. High BMI was a prominent contributor in GBD analyses, whereas MR most strongly supported hypertension and vascular dementia. The HDL-C finding is exploratory, and MR does not directly validate the BMI or FPG burden estimates.

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1990年至2021年由代谢失调引起的全球、区域和国家痴呆负担，以及到2050年的负担预测：2021年全球疾病负担研究分析

背景和目的：我们量化了由高空腹血糖（FPG）和高体重指数（BMI）引起的痴呆负担，预测了到2050年的趋势，并使用孟德尔随机化（MR）检查了代谢特征。方法：对来自204个国家和地区的全球疾病负担（GBD） 2021数据进行年龄、性别和社会人口指数分析。使用时间序列和贝叶斯年龄-时期-队列模型预测未来的负担。双样本MR使用欧洲血统遗传汇总数据，进行反方差加权估计和敏感性分析。结果：代谢引起的痴呆负担增加，高BMI比高FPG增加得更快。遗传预测高血压与血管性痴呆最明显相关（优势比2.72,95%可信区间1.66-4.45;P = 0.0001），并得到加权中位数估计的支持。遗传预测的高密度脂蛋白胆固醇（HDL-C）与阿尔茨海默病仅显示名义上的关联（优势比1.09,95%置信区间1.00-1.19;P = 0.0459），这在磁共振方法中并不一致得到支持。中介分析不显著。结论：全球范围内代谢归因痴呆负担正在增加。高BMI是GBD分析的重要因素，而MR最有力地支持高血压和血管性痴呆。HDL-C的发现是探索性的，MR并不能直接验证BMI或FPG负担的估计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & Metabolic Syndrome-Clinical Research & Reviews ENDOCRINOLOGY & METABOLISM-

CiteScore

22.90

自引率

2.00%

发文量

248

审稿时长

51 days

期刊介绍： Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care. Types of Publications: Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.