铅暴露对全球高血压CKD的影响：1990年至2021年基于YLDs/ ylls的研究结果和2035年的预测趋势

IF 6.1 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Ecotoxicology and Environmental Safety Pub Date : 2025-10-15 DOI:10.1016/j.ecoenv.2025.119192

Yujun He , Yaling Zheng , Weiwei Tang , Bowen Xing , Hui Xu , Jiujie He , Wei Mai , Xiaoyi Wang , Miao Zhou

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引用次数: 0

摘要

背景：高血压慢性肾脏疾病（CKD）是一个重大的全球健康挑战，铅暴露进一步加剧了这一疾病负担。然而，不同社会人口指数（SDI）背景下铅致高血压CKD的负担特征仍未完全阐明，这阻碍了有针对性的公共卫生策略的制定。目的：本研究旨在分析1990年至2021年与铅致高血压CKD相关的全球残疾年（YLDs）和生命损失年（YLLs）负担，以及到2035年的预测趋势。方法：从GBD Study 2021数据库中提取与铅归因高血压CKD相关的YLDs和YLLs数据，涵盖204个国家/地区（进一步分为21个GBD地区和5个SDI地区）。分析的指标包括病例数、年龄标准化率（ASR）、年龄和性别差异以及时间趋势。采用Pearson相关分析探讨SDI与疾病负担的关系，采用护理质量指数（Quality of Care Index， QCI）辅助解释与SDI的关系。进行了前沿分析，以评估各国负担水平的差异。采用自回归综合移动平均（ARIMA）模型预测未来趋势，采用贝叶斯年龄-时期-队列（BAPC）模型进行补充验证。结果：1990-2021年，全球铅归因高血压CKD的YLDs和YLLs呈上升趋势，且区域差异显著：老年人和男性负担较重；低SDI地区的疾病负担最高，高SDI地区的疾病负担最低；在21个GBD区域中，南亚的负担最重，而东欧和大洋洲的负担相对较低。SDI相关分析显示，负担与SDI之间存在显著相关性。前沿分析表明，各国疾病负担存在很大的异质性，并确定了相同SDI水平的高负担和低负担国家。预测分析表明，ARIMA和BAPC模型一致验证了2022 - 2035年yll的下降趋势。虽然两种模型的YLDs趋势存在差异，但总体结果表明，防治效果具有良好的前景。结论：控制铅暴露是减轻高血压慢性肾病疾病负担的关键措施。建议根据不同的SDI水平制定有针对性的干预战略，并借鉴处于疾病负担控制前沿的国家的经验，以促进全球公平减少疾病负担。

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Impact of lead exposure on global hypertensive CKD: YLDs/YLLs-based findings from 1990 to 2021 and projected trends to 2035

Background

Hypertensive Chronic kidney disease (CKD) constitutes a major global health challenge, and lead exposure further exacerbates this disease burden. However, the burden characteristics of lead-attributable hypertensive CKD across different Socio-Demographic Index (SDI) contexts remain incompletely elucidated—hindering the development of targeted public health strategies.

Objective

This study aims to analyze the global burden of Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) related to lead-attributable hypertensive CKD from 1990 to 2021, as well as the projected trends up to 2035..

Method

Data on YLDs and YLLs related to lead-attributable hypertensive CKD were extracted from the GBD Study 2021 database, covering 204 countries/regions (further categorized into 21 GBD regions and 5 SDI regions). The analyzed indicators included number of cases, age-standardized rate (ASR), age and sex disparities, and temporal trends. Pearson correlation analysis was used to explore the association between SDI and disease burden, while the Quality of Care Index (QCI) was employed to assist in explaining the relationship with SDI. Frontier analysis was conducted to assess differences in burden levels across countries. The Autoregressive Integrated Moving Average (ARIMA) model was used to predict future trends, with the Bayesian Age-Period-Cohort (BAPC) model employed for supplementary validation.

Results

From 1990–2021, global YLDs and YLLs of lead-attributable hypertensive CKD exhibited an upward trend, with significant regional disparities: the burden was heavier among the elderly and males; Low SDI regions had the highest disease burden, while High SDI regions had the lowest; among the 21 GBD regions, South Asia had the heaviest burden, whereas Eastern Europe and Oceania had relatively low burdens. SDI correlation analysis revealed a significant association between burden and SDI. Frontier analysis indicated substantial heterogeneity in disease burden across countries, and identified countries with high and low burdens at the same SDI level. Predictive analysis showed that the declining trend of YLLs from 2022 to 2035 was consistently validated by both the ARIMA and BAPC models. Although there were discrepancies in YLDs trends between the two models, the overall results suggested promising prospects for prevention and control effectiveness.

Conclusions

Controlling lead exposure is a key measure to reduce the disease burden of hypertensive CKD. It is recommended to develop targeted intervention strategies based on different SDI levels and draw lessons from countries at the forefront of disease burden control, so as to promote the equitable reduction of disease burden globally.

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来源期刊

Ecotoxicology and Environmental Safety 环境科学-毒理学

CiteScore

12.10

自引率

5.90%

发文量

1234

审稿时长

88 days

期刊介绍： Ecotoxicology and Environmental Safety is a multi-disciplinary journal that focuses on understanding the exposure and effects of environmental contamination on organisms including human health. The scope of the journal covers three main themes. The topics within these themes, indicated below, include (but are not limited to) the following: Ecotoxicology、Environmental Chemistry、Environmental Safety etc.