1999年至2020年美国糖尿病人群脑血管疾病死亡率趋势和差异:CDC WONDER分析

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM
Allahdad Khan, Waseef Ullah, Moeen Ikram, Rameez Qasim, Umama Alam, Maheen Sheraz, Ayesha Khan, Kainat Kanwal, Peter Collins, Raheel Ahmed
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引用次数: 0

摘要

糖尿病(DM)显著增加脑血管疾病(CeVD)的风险,CeVD是导致死亡和长期残疾的主要原因。尽管医疗保健有所改善,但美国糖尿病人群中cevd相关死亡率的差异仍然存在。方法利用CDC WONDER数据库对1999年至2020年年龄≥45岁的糖尿病患者进行回顾性分析,评估与CeVD相关的死亡率趋势。使用ICD-10代码I60-I69 (CeVD)和E10-E14 (DM)确定死亡。计算年龄调整死亡率(AAMRs),并使用Joinpoint回归分析趋势,按年龄、种族/民族、地理、城市化和死亡地点分层。结果糖尿病患者cevd相关死亡689,846例。AAMR由1999年的36.9下降到2020年的29.3,年均变化百分比(AAPC)为- 1.41%。然而,从2018年到2020年,APC急剧上升(14.87%),表明正在发生令人担忧的逆转。粗死亡率最高的是75-84岁年龄组,最低的是45-54岁年龄组。黑人和西班牙裔人口、农村居民和美国南部的人死亡率最高。东北亚和亚洲人口最低,反映了在获得护理和预防服务方面的持续差异。虽然糖尿病患者CeVD死亡率在过去二十年中有所下降,但最近的逆转凸显了新出现的挑战,可能是由于医疗保健中断和社会经济差距。这些发现强调需要有针对性的公共卫生干预措施,以解决不公平现象,改善高危人群的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Mortality Trends and Disparities in Cerebrovascular Disease Among Diabetic Population in the United States From 1999 to 2020: A CDC WONDER Analysis

Mortality Trends and Disparities in Cerebrovascular Disease Among Diabetic Population in the United States From 1999 to 2020: A CDC WONDER Analysis

Background

Diabetes mellitus (DM) significantly increases the risk of cerebrovascular disease (CeVD), a major cause of mortality and long-term disability. Despite improvements in healthcare, disparities in CeVD-related mortality among diabetic populations in the United States persist.

Methods

We conducted a retrospective analysis using the CDC WONDER database from 1999 to 2020 to assess mortality trends related to CeVD among adults aged ≥ 45 years with DM. Deaths were identified using ICD-10 codes I60–I69 (CeVD) and E10–E14 (DM). Age-adjusted mortality rates (AAMRs) were calculated, and trends were analysed using Joinpoint regression, stratified by age, race/ethnicity, geography, urbanisation, and place of death.

Results

A total of 689,846 CeVD-related deaths occurred in diabetic individuals. AAMR decreased from 36.9 in 1999 to 29.3 in 2020, with an average annual percentage change (AAPC) of −1.41%. However, a sharp rise was observed from 2018 to 2020 (APC 14.87%), indicating a concerning reversal in progress. The highest crude mortality rates were in the 75–84 age group, and the lowest in the 45–54 group. Black and Hispanic populations, rural residents, and those in the Southern United States had the highest mortality rates. The Northeast and Asian populations had the lowest, reflecting persistent disparities in access to care and preventive services.

Conclusion

While CeVD mortality in diabetics declined over two decades, the recent reversal highlights emerging challenges, possibly due to healthcare disruptions and socioeconomic disparities. These findings underscore the need for targeted public health interventions to address inequities and improve outcomes in high-risk populations.

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来源期刊
Endocrinology, Diabetes and Metabolism
Endocrinology, Diabetes and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.00
自引率
0.00%
发文量
66
审稿时长
6 weeks
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