Evaluating the global impact of low physical activity on type 2 diabetes: Insights from the global burden of disease 2019 study.

AIM: We aimed to assess the global implications of low physical activity (LPA) on type 2 diabetes mellitus (T2DM) by utilizing data from the Global Burden of Disease (GBD) 2019. METHODS: The analysis was conducted by examining the age-standardized disability-adjusted life years (DALYs) rates over a 30-year period. To assess the trends, we utilized estimated annual percentage changes (EAPCs). RESULTS: The study revealed a notable increase in the burden of DALYs attributable to T2DM resulting from LPA, with an EAPC of 0.84 (95% confidence interval 0.78-0.89). Among the regions examined, Oceania showed the highest burden, whereas Eastern Europe exhibited the lowest burden. Specifically, within the Central Asia region, a considerable increase in T2DM-LPA DALYs was observed, with an EAPC of 3.18 (95% confidence interval 3.01-3.36). The burden associated with T2DM-LPA DALYs was found to be similar between genders and increased across all age groups, peaking in the 80-84 years. Furthermore, there was a clear association between the socio-demographic index (SDI) and the age-standardized DALYs rate. Regions categorized as low-middle and middle SDI experienced a substantial rise in burden. CONCLUSION: This study highlights a substantial increase in the T2DM-LPA DALYs in low-middle and middle SDI regions, as well as among individuals aged 80-84 years. These findings emphasize the importance of implementing comprehensive global health interventions that promote physical activity, particularly targeting high-risk populations and regions.

Spatiotemporal trends in the burden of aortic aneurysms caused by high sodium intake from 1990 to 2019: A global, regional, and national analysis.

BACKGROUND AND AIMS: This study, drawing on Global Burden of Disease (GBD) data, examines spatiotemporal trends in mortality and disability-adjusted life years (DALYs) linked to aortic aneurysm (AA) from high sodium intake. The aim is a comprehensive analysis globally, regionally, and nationally spanning 1990 to 2019. METHODS AND RESULTS: Quantifying AA deaths and DALYs due to high sodium intake, incorporating age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), revealed a global surge. Deaths rose by 86.09 %, DALYs by 74.02 % from 1990 to 2019. EAPC for ASMR and ASDR displayed negative trends (-0.72 and -0.77). High/middle-high Socio-demographic Index (SDI) regions bore higher burdens than lower SDI regions. Males consistently had higher burdens across SDI regions, with both genders showing a slight downward trend. Age-wise, AA deaths and DALYs rose with age, followed by decline. A positive correlation existed between SDI and global burden, inversely related to EAPC for ASMR and ASDR. CONCLUSION: AA burden from high sodium intake is pronounced in high SDI regions, necessitating targeted interventions. The global data highlights a significant increase in AA deaths and DALYs due to high sodium intake, urging prompt and effective control measures.

Global, regional, and national quality of care index of cervical and ovarian cancer: a systematic analysis for the global burden of disease study 1990-2019.

BACKGROUND AND OBJECTIVE: Cervical cancer is the most preventable and ovarian cancer is the most lethal gynecological cancer. However, in the world, there are disparities in health care performances resulting in differences in the burden of these cancers. The objective of this study was to compare the health-system quality of care and inequities for these cancers using the Quality of Care Index (QCI). MATERIAL AND METHODS: The 1990-2019 data of the Global Burden of Disease (GBD) was analyzed to extract rates of incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years of healthy life lost due to disability (YLD) of cervical and ovarian cancer. Four indices were developed as a proxy for the quality of care using the above-mentioned rates. Thereafter, a Principal Components Analysis (PCA) was applied to construct the Quality of Care Index (QCI) as a summary measure of the developed indices. RESULTS: The incidence of cervical cancer decreased from 1990 to 2019, whereas the incidence of ovarian cancer increased between these years. However, the mortality rate of both cancers decreased in this interval. The global age-standardized QCI for cervical cancer and ovarian cancer were 43.1 and 48.5 in 1990 and increased to 58.5 and 58.4 in 2019, respectively. QCI for cervical cancer and ovarian cancer generally decreased with aging, and different age groups had inequitable QCIs. Higher-income countries generally had higher QCIs for both cancers, but exceptions were also observed. CONCLUSIONS: Uncovering disparities in cervical and ovarian cancer care across locations, Socio-Demographic Index levels, and age groups necessitate urgent improvements in healthcare systems for equitable care. These findings underscore the need for targeted interventions and prompt future research to explore root causes and effective strategies for narrowing these gaps.

Global, regional, and national trends in osteoarthritis disability-adjusted life years (DALYs) from 1990 to 2019: a comprehensive analysis of the global burden of disease study.

OBJECTIVES: This study aimed to investigate global, regional, and national trends in osteoarthritis disability-adjusted life years (DALYs) from 1990 to 2019, identify the burden of osteoarthritis in different age groups, and assess age, period, and cohort effects on osteoarthritis DALYs. STUDY DESIGN: A comprehensive analysis of the Global Burden of Disease Study 2019 data, covering 204 countries and territories. METHODS: We conducted a comprehensive analysis using data from the Global Burden of Disease Study 2019, encompassing 204 countries and territories. Age-standardized DALY rates were calculated, and the age-period-cohort model was employed to examine the age, period, and cohort effects on osteoarthritis DALYs. The annual percentage change (APC) and average annual percentage change (AAPC) were estimated to evaluate trends in DALYs. RESULTS: Globally, osteoarthritis DALYs increased by 114.48 % between 1990 and 2019, with an age-standardized DALY rate growth of 3.3 %. The largest relative growth in DALYs occurred in Middle and Low-middle Socio-Demographic Index (SDI) regions. DALYs increased significantly in almost all age-specific groups, particularly among 45-74 years old age groups. Age, period, and cohort effects analysis revealed a general increase in osteoarthritis DALYs risk over time, with some variations by SDI quintiles and sex. The steepest increase in DALYs occurred in the 30-34 years age group, and the trend attenuated with increasing age. Males showed significantly slower DALYs growth than females in age groups with non-overlapping 95 % confidence intervals. Age effects were consistently higher in females, especially in high-SDI countries. Period and cohort effects generally demonstrated a climbing risk of osteoarthritis DALYs across different SDI quintiles, with more pronounced increases in lower-SDI regions. CONCLUSIONS: Our findings highlight the substantial and increasing burden of osteoarthritis at global, regional, and national levels from 1990 to 2019, with significant variations by age, period, and cohort. These results underscore the importance of developing targeted public health strategies and interventions to address the growing impact of osteoarthritis, particularly in lower-SDI regions and among older populations.

Global, regional, and national burden and trends of migraine among youths and young adults aged 15-39 years from 1990 to 2021: findings from the global burden of disease study 2021.

BACKGROUND: Migraine, a widespread neurological condition, substantially affects the quality of life, particularly for adolescents and young adults. While its impact is significant, there remains a paucity of comprehensive global research on the burden of migraine in younger demographics. Our study sought to elucidate the global prevalence, incidence, and disability-adjusted life-years (DALYs) associated with migraine in the 15-39 age group from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) 2021 study. METHODS: Our comprehensive study analyzed migraine data from the GBD 2021 report, examining the prevalence, incidence, and DALYs across 204 countries and territories over a 32-year span. We stratified the information by age, sex, year, geographical region, and Socio-demographic Index (SDI). To evaluate temporal trends in these metrics, we employed the estimated annual percentage change (EAPC) calculation. RESULTS: Between 1990 and 2021, the worldwide prevalence of migraine among 15-39 year-olds increased substantially. By 2021, an estimated 593.8 million cases were reported, representing a 39.52% rise from 425.6 million cases in 1990. Global trends showed increases in age-standardized prevalence rate, incidence rate, and DALY rate for migraine during this period. The EAPC were positive for all three metrics: 0.09 for ASPR, 0.03 for ASIR, and 0.09 for DALY rate. Regions with medium SDI reported the highest absolute numbers of prevalent cases, incident cases, and DALYs in 2021. However, high SDI regions demonstrated the most elevated rates overall. Across the globe, migraine prevalence peaked in the 35-39 age group. Notably, female rates consistently exceeded male rates across all age categories. CONCLUSION: The global impact of migraine on youths and young adults has grown considerably from 1990 to 2021, revealing notable variations across SDI regions, countries, age groups, and sexes. This escalating burden necessitates targeted interventions and public health initiatives, especially in areas and populations disproportionately affected by migraine.

Global, regional and national burden of male infertility in 204 countries and territories between 1990 and 2019: an analysis of global burden of disease study.

BACKGROUND: Many countries and regions have experienced male fertility problems due to various influencing factors, especially in less developed countries. Unlike female infertility, male infertility receives insufficient attention. Understanding the changing patterns of male infertility in the world, different regions and different countries is crucial for assessing the global male fertility and reproductive health. METHODS: We obtained data on prevalence, years of life lived with disability (YLD), age-standardized rates of prevalence (ASPR) and age-standardized YLD rate (ASYR) from the Global Burden of Disease Study 2019. We analyzed the burden of male infertility at all levels, including global, regional, national, age stratification and Socio-demographic Index (SDI). RESULTS: In 2019, the global prevalence of male infertility was estimated to be 56,530.4 thousand (95% UI: 31,861.5-90,211.7), reflecting a substantial 76.9% increase since 1990. Furthermore, the global ASPR stood at 1,402.98 (95% UI: 792.24-2,242.45) per 100,000 population in 2019, representing a 19% increase compared to 1990. The regions with the highest ASPR and ASYR for male infertility in 2019 were Western Sub-Saharan Africa, Eastern Europe, and East Asia. Notably, the prevalence and YLD related to male infertility peaked in the 30-34 year age group worldwide. Additionally, the burden of male infertility in the High-middle SDI and Middle SDI regions exceeded the global average in terms of both ASPR and ASYR. CONCLUSION: The global burden of male infertility has exhibited a steady increase from 1990 to 2019, as evidenced by the rising trends in ASPR and ASYR, particularly in the High-middle and Middle SDI regions. Notably, the burden of male infertility in these regions far exceeds the global average. Additionally, since 2010, there has been a notable upward trend in the burden of male infertility in Low and Middle-low SDI regions. Given these findings, it is imperative to prioritize efforts aimed at improving male fertility and reproductive health.

Trends and projections of inflammatory bowel disease at the global, regional and national levels, 1990-2050: a bayesian age-period-cohort modeling study.

BACKGROUND: Inflammatory bowel disease (IBD) is a global health concern with varying levels and trends across countries and regions. Understanding these differences is crucial for effective prevention and treatment strategies. METHODS: Using data from the 2019 Global Burden of Disease study, we examine IBD incidence, mortality, and disability-adjusted life years (DALYs) rates in 198 countries from 1990 to 2019. To assess changes in the burden of IBD, estimated annual percentage changes (EAPC) were calculated, and a Bayesian age-period-cohort model was used to predict the future 30-year trends of IBD. RESULTS: In 2019, there were 405,000 new IBD cases globally (95% uncertainty interval (UI) 361,000 to 457,000), with 41,000 deaths (95% UI 35,000 to 45,000) and 1.62million DALYs (95% UI 1.36-1.92million). The global age-standardized incidence rate in 2019 was 4.97 per 100,000 person-years (95% UI 4.43 to 5.59), with a mortality rate of 0.54 (95% UI 0.46 to 0.59) and DALYs rate of 20.15 (95% UI 16.86 to 23.71). From 1990 to 2019, EAPC values for incidence, mortality, and DALYs rates were - 0.60 (95% UI - 0.73 to - 0.48), - 0.69 (95% UI - 0.81 to - 0.57), and - 1.04 (95% UI - 1.06 to - 1.01), respectively. Overall, the burden of IBD has shown a slow decline in recent years. In SDI stratification, regions with higher initial SDI (high-income North America and Central Europe) witnessed decreasing incidence and mortality rates with increasing SDI, while regions with lower initial SDI (South Asia, Oceania, and Latin America) experienced a rapid rise in incidence but a decrease in mortality with increasing SDI. Predictions using a Bayesian model showed lower new cases and deaths from 2020 to 2050 than reference values, while the slope of the predicted incidence-time curve closely paralleled that of the 2019 data. CONCLUSION: Increasing cases, deaths, and DALYs highlight the sustained burden of IBD on public health. Developed countries have stabilized or declining incidence rates but face high prevalence and societal burden. Emerging and developing countries experience rising incidence. Understanding these changes aids policymakers in effectively addressing IBD challenges in different regions and economic contexts.

Socioeconomic indices guided linear mixed-effects and meta-regression modelling of the temporal, global and regional prevalence of Helicobacter pylori in environmental waters: A class I carcinogen.

Environmental waters (EW) substantially lend to the transmission of Helicobacter pylori (Hp). But the increase in Hp infections and antimicrobial resistance is often attributed to socioeconomic status. The connection between socioeconomic status and Hp prevalence in EW is however yet to be investigated. This study aimed to assess the impacts of socioeconomic indices (SI: continent, world bank region (WBR), world bank income (WBI), WHO region, Socio-demographic Index (SDI quintile), Sustainable Development Index (SuDI), and Human Development Index (HDI)) on the prevalence of Hp in EW. Hp-EW data were fitted to a generalized linear mixed-effects model and SI-guided meta-regression models with a 1000-resampling test. The worldwide prevalence of Hp in EW was 21.76% [95% confidence interval [CI]: 10.29-40.29], which declined significantly from 59.52% [43.28-74.37] in 1990-99 to 19.36% [3.99-58.09] in 2010-19 and with increasing trend in 2020-22 (33.33%, 22.66-45.43). Hp prevalence in EW was highest in North America (45.12%, 17.07-76.66), then Europe (22.38%, 5.96-56.74), South America (22.09%, 13.76-33.49), Asia (2.98%, 0.02-85.17), and Africa (2.56%, 0.00-99.99). It was negligibly different among sampling settings, WBI, and WHO regions demonstrating highest prevalence in rural location [42.62%, 3.07-94.56], HIEs [32.82%, 13.19-61.10], and AMR [39.43%, 19.92-63.01], respectively. However, HDI, sample size, and microbiological method robustly predict Hp prevalence in EW justifying 26.08%, 21.15%, and 16.44% of the true difference, respectively. In conclusion, Hp is highly prevalence in EW across regional/socioeconomic strata and thus challenged the uses of socioeconomic status as surrogate for hygienic/sanitary practices in estimating Hp infection prevalence.

Spatial and temporal patterns of prostate cancer burden and their association with Socio-Demographic Index in Asia, 1990-2019.

BACKGROUND: Prostate cancer is the second most frequently diagnosed cancer for males worldwide, but the spatial and temporal trends of prostate cancer burden remain unknown in Asia. This study aimed to investigate the changing spatial and temporal trends of incidence, prevalence, mortality, disability-adjusted life year (DALY), and mortality-to-incidence ratio (MIR) of prostate cancer, and their association with the Socio-Demographic Index (SDI) in 48 Asian countries from 1990 to 2019. METHODS: Data were extracted from the Global Health Data Exchange query tool, covering 48 Asian countries from 1990 to 2019. The average annual percent change was calculated to evaluate temporal trends. Spatial autocorrelation analysis was used to obtain spatial patterns, and the association between SDI and prostate cancer burden was estimated using a spatial panel model. RESULTS: In Asia, the age-standardized incidence and prevalence of prostate cancer increased in almost all countries, and its mortality and DALY also increased in over half of the countries. Significantly regional disparities were found in Asia, and the hot spots for incidence, prevalence, mortality, and DALY were all located in Western Asia, the hot spots of percent change also occurred in Western Asia for incidence and DALY. Furthermore, SDI had a positive association with mortality (coef = 2.51, 95% confidence interval [CI]: 2.13-2.90) and negative association with DALY (coef = -14.99, 95% CI: -20.37 to -9.60) and MIR (coef = -0.95, 95%CI: -0.99 to -0.92). CONCLUSIONS: Prostate cancer burden increased rapidly throughout Asia and substantial disparities had persisted between countries. Geographically targeted interventions are needed to reduce the prostate cancer burden throughout Asia and in specific countries.

Prevalence, incidence and years lived with disability due to polycystic ovary syndrome in 204 countries and territories, 1990-2019.

STUDY QUESTION: What is the global, regional and national burden of polycystic ovary syndrome (PCOS), by age and socio-demographic index (SDI), over the period 1990-2019? SUMMARY ANSWER: In 2019, the global age-standardized point prevalence, incidence and years lived with disability (YLD) of PCOS were 30.4, 29.5 and 29.9 per 100 000 population, respectively. WHAT IS KNOWN ALREADY: Data from the Global Burden of Disease (GBD) study 2017 showed that the global age-standardized PCOS incidence rate increased 1.45% over the period 1990-2017. STUDY DESIGN, SIZE, DURATION: A systematic analysis of the PCOS prevalence, incidence and YLDs across 204 countries and territories was performed. PARTICIPANTS/MATERIALS, SETTING, METHODS: Data on the point prevalence, annual incidence and YLDs due to PCOS were retrieved from the GBD study 2019 for 204 countries and territories from 1990 to 2019. The counts and age-standardized rates (per 100 000) are presented, along with their corresponding 95% uncertainty intervals (UIs). MAIN RESULTS AND THE ROLE OF CHANCE: In 2019, the global age-standardized point prevalence and annual incidence rates for PCOS were 1677.8 (95% UI: 1166.0 to 2192.4) and 59.8 (95% UI: 41.7 to 78.9) per 100 000, which represents a 30.4% and 29.5% increase since 1990, respectively. Moreover, the global age-standardized YLD rate in 2019 was 14.7 (6.3-29.5), an increase of 29.9% since 1990. In 2019, Italy (7897.0), Japan (6298.7) and New Zealand (5419.1) had the highest estimated age-standardized point prevalences of PCOS. Globally, the number of prevalent cases and the point prevalence of PCOS peaked in the 25-29 years and 40-44 years age groups, respectively. Positive associations were found between the burden of PCOS and the SDI at the regional and national levels. LIMITATIONS, REASONS FOR CAUTION: Variations in how PCOS was defined is a major limitation that prevents valid comparisons between different regions. WIDER IMPLICATIONS OF THE FINDINGS: Globally, the burden of PCOS has increased at an alarming rate, making it a major public health concern. Increasing public awareness about this common condition, improving management options and increasing support to reduce factors which lead to further complications, need to be public health priorities. STUDY FUNDING/COMPETING INTEREST(S): The Bill and Melinda Gates Foundation, who were not involved in any way in the preparation of this manuscript, funded the GBD study. The Shahid Beheshti University of Medical Sciences, Tehran, Iran (Grant No. 28709) also supported the present report. The authors declare no competing interests. TRIAL REGISTRATION NUMBER: N/A.

The burden of chronic obstructive pulmonary disease and its attributable risk factors in the Middle East and North Africa region, 1990-2019.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. The present study reported the burden of COPD, and its attributable risk factors, in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex and socio-demographic index (SDI). METHODS: Data from the Global Burden of Disease (GBD) 2019 study were used to report the burden of COPD in the MENA countries. The prevalence, deaths, and disability-adjusted life-years (DALYs) were presented as counts and age-standardised rates per 100,000 population, with their associated 95% uncertainty intervals (UIs). RESULTS: In 2019, the regional age-standardised point prevalence and rates of death due to COPD were 2333.9 (2230.1, 2443.6) and 26.1 (22.2, 29.5) per 100,000, which represent a 30.6% (28.2%, 33.0%) increase and an 18.0% (2.8%, 30.9%) decrease, respectively, since 1990. The regional age-standardised DALY rate in 2019 was 649.1 (574.6, 717.7) per 100,000, which had decreased by 11.8% (0.9%, 21.1%) since 1990. Turkey had the highest age-standardised point prevalence in 2019 [3287.1 (3187.4, 3380.3)], while Afghanistan had the highest age-standardised death [40.4 (24.2, 52.6)] and DALY [964.5 (681.8, 1203.2)] rates. The regional age-standardised point prevalence, death and DALY rates in 2019 increased with advancing age and were higher in males in almost all age groups. There was a U-shaped association between SDI and the burden of COPD over the period 1990 to 2019. Moreover, in 2019 smoking (43.7%), ambient particulate matter pollution (22.8%) and occupational particulate matter (11.4%) had the largest proportion of attributable DALYs for both sexes. CONCLUSIONS: COPD is one of the leading causes of death and disability in the MENA region, although the age-standardised burden has decreased over the last 30 years. Nevertheless, COPD accounted for a substantial number of deaths and DALYs, especially among the elderly. Programs targeting risk factors, like smoking, should be taken into consideration.

Trends in Prevalence Cases and Disability-Adjusted Life-Years of Parkinson's Disease: Findings from the Global Burden of Disease Study 2019.

BACKGROUND: Parkinson's disease is a common, age-related progressive neurodegenerative disorder with considerable socioeconomic burdens, although the studies in incremental burdens to the disease's rapid growth are incomplete and lag behind. We aim to assess global burdens of Parkinson's disease based on a public database online. METHODS: Based on the Global Burden of Disease, Injuries, and Risk Factors Study, we screened a range of indicators including prevalence cases, disability-adjusted life-years (DALYs), age-standardized prevalence rates (ASPRs), and age-standardized DALY rate (ASDR). The join point regression was used to assess the indicators, wherein the ASPR and the ASDR were referred to temporal trends for burdens of Parkinson's disease. RESULTS: Prevalence cases of global Parkinson's disease were on the rise for 30 years, with an increase of 155.51% during 1990-2019. Temporal trend of ASDRs was on the rise during 1990-2002 but in decline during 2002-2019. The ASPRs had a turning point in 2017 and a decline during 2017-2019 (annual percentage change = -0.51%, p > 0.05). China, India, the USA, Japan, and Germany shared the five highest prevalence cases and DALYs in 2019. The Socio-Demographic Index (SDI) was in relation to a significantly positive ASPR (R = 0.61, p < 0.001) but not a significantly negative ASDR (R = -0.044, p = 0.53), respectively. CONCLUSIONS: In this study, a range of indicators for global burdens of Parkinson's disease were on the rise during 1990-2019. Tremendous efforts should be in place to prevent Parkinson's disease, especially among the populations of males, with advanced ages, in East Asia, and in regions with high SDI.

Measuring the global disease burden of polycystic ovary syndrome in 194 countries: Global Burden of Disease Study 2017.

STUDY QUESTION: What is the current burden of polycystic ovary syndrome (PCOS) at the global, regional, and country-specific levels in 194 countries and territories according to age and socio-demographic index (SDI)? SUMMARY ANSWER: Slight increases in age-standardized incidence of PCOS and associated disability-adjusted life-years (DALYs) were evidenced among women of reproductive age (15-49 years) from 2007 to 2017 at the global level, and in most regions and countries. WHAT IS KNOWN ALREADY: No detailed quantitative estimates of the PCOS incidence and DALYs by age and SDI in these 194 countries and territories have been published previously. STUDY DESIGN, SIZE, DURATION: An age- and SDI-stratified systematic analysis of the PCOS incidence and DALYs across 194 countries and territories has been performed. PARTICIPANTS/MATERIALS, SETTING, METHODS: We used data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2017 to estimate the total and age-standard PCOS incidence rates and DALYs rates among women of reproductive age in both 2007 and 2017, and the trends in these parameters from 2007 to 2017. MAIN RESULTS AND THE ROLE OF CHANCE: Globally, women of reproductive age accounted for 1.55 million (95% uncertainty intervals (UIs): 1.19-2.08) incident cases of PCOS and 0.43 million (0.19-0.82) associated DALYs. The global age-standardized PCOS incidence rate among women of reproductive age increased to 82.44 (64.65-100.24) per 100 000 population in 2017, representing an increase of 1.45% (1.43-1.47%) from 2007 to 2017. The rate of age-standardized DALYs increased to 21.96 (12.78-31.15) per 100 000 population in 2017, representing an increase of 1.91% (1.89-1.93%) from 2007 to 2017. Over the study period, the greatest increase in the age-standardized PCOS incidence and DALYs rates were observed in the middle-SDI and high-middle SDI regions, respectively. At the GBD regional level, the highest age-standardized incidence and DALY rates in 2017 were observed in Andean Latin America, whereas the largest percentage increases in both rates from 2007 to 2017 were observed in Tropical Latin America. At the national level, Ecuador, Peru, Bolivia, Japan, and Bermuda had the highest age-standardized incidence rates and DALYs rates in both 2007 and 2017. The highest increases in both the age-standardized incidence rates and DALYs rates from 2007 to 2017 were observed in Ethiopia, Brazil, and China. LIMITATIONS, REASONS FOR CAUTION: Although the GBD (2017) study aimed to gather all published and unpublished data, the limited availability of data in some regions might have led to the estimation of wide UIs. Additionally, the PCOS phenotype is complicated and the diagnostic criteria are constantly changing. Consequently, the incidence of PCOS might have been underestimated. WIDER IMPLICATIONS OF THE FINDINGS: Knowledge about the differences in the PCOS burden across various locations will be valuable for the allocation of resources and formulation of effective preventive strategies. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by grants from the Innovative Talent Support Plan of the Medical and Health Technology Project in Zhejiang Province (2021422878), Ningbo Science and Technology Project (202002N3152), Ningbo Health Branding Subject Fund (PPXK2018-02), Sanming Project of Medicine in Shen-zhen (SZSM201803080), and National Social Science Foundation (19AZD013). No potential conflicts of interest relevant to this article were reported. TRIAL REGISTRATION NUMBER: N/A.

Global, Regional, and National Change Patterns in the Incidence of Low Back Pain From 1990 to 2019 and Its Predicted Level in the Next Decade.

Objectives: To analyze and describe the spatiotemporal trends of Low back pain (LBP) burdens from 1990 to 2019 and anticipate the following decade's incidence. Methods: Using data from the Global Burden of Disease (GBD) 2019 Study, we described net drifts, local drifts, age effects, and period cohort effects in incidence and forecasted incidence rates and cases by sex from 2020 to 2029 using the Nordpred R package. Results: LBP remained the leading cause of the musculoskeletal disease burden globally and across all socio-demographic index (SDI) regions. China is the top country. For recent periods, high-SDI countries faced unfavorable or worsening risks. The relative risk of incidence showed improving trends over time and in successively younger birth cohorts amongst low-middle-, middle- and high-middle-SDI countries. Additionally, the age-standardized incidence rates (ASIR) of LBP in both sexes globally showed a decreasing trend, but the incident cases would increase from 223 to 253 million overall in the next decade. Conclusion: As the population ages, incident cases will rise but ASIR will fall. To minimise LBP, public awareness and disease prevention and control are needed.

Distributions and Trends of the Global Burden of DKD Attributable to Lead Exposure: A Systematic Analysis of GBD from 1990 to 2019.

Long-term exposure to lead is associated with an increased risk of diabetic kidney disease (DKD). However, limited data exist on global trends in DKD burden attributable to lead exposure, especially across diverse regions categorized by socioeconomic level. We aimed to assess the spatiotemporal changes in DKD burden attributable to lead exposure from 1990 to 2019 across 204 countries and regions with varying socio-demographic index (SDI) metrics. This retrospective analysis utilized data from the Global Burden of Disease Study 2019 (GBD2019) database. We estimated the burden of DKD attributable to lead exposure using the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR), accounting for sex, age, nationality, and SDI. The annual percentage change (APC) and average annual percentage change (AAPC) were calculated using the Joinpoint model to evaluate trends in the ASMR and ASDR attributable to lead exposure from 1990 to 2019. Gaussian process regression was used to model the relationship between the SDI and ASMR/ASDR. Globally, the burden of DKD attributable to lead exposure has significantly increased since 1990, especially among elderly men and in regions such as Asia, Central Latin America, North Africa, the Middle East, and low-SDI regions. In 2019, the ASMR and ASDR of DKD attributable to lead exposure were 0.68 (95% CI: 0.40, 0.98) per 100,000 people and 15.02 (95% CI: 8.68, 22.26) per 100,000 people, respectively. From 1990 to 2019, the global ASMR and ASDR attributable to lead-associated DKD changed by 15.45% and -1.78%, respectively. The global AAPCs of the ASMR and ASDR were 0.55 (95% CI: 0.45, 0.65) and -0.01 (95% CI: -0.12, 0.1), respectively. Significant declining trends were observed in the high-income Asia Pacific region, eastern sub-Saharan Africa, North Africa, the Middle East, and other regions with high SDIs. Over this 30-year study period, the global burden of DKD attributable to lead exposure has increased, particularly in regions with low SDI. Lead exposure remains a significant concern in the global burden of diabetic kidney disease.

Global Burden of Ischemic Heart Disease from 2022 to 2050: Projections of Incidence, Prevalence, Deaths, and Disability-Adjusted Life Years.

AIMS: Ischemic heart disease (IHD) has been a significant public health issue worldwide. This study aims to predict the global burden of IHD in a timely and comprehensive manner. METHODS AND RESULTS: Incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for IHD from 1990 to 2021 were derived from the Global Burden of Disease 2021 database and three models (linear, exponential, and Poisson regression) were used to estimate their trends over time at the global, regional, and national levels by age, sex, and country groups, with the gross domestic product per capita was applied to adjust the model. The model results revealed that the global burden of IHD is expected to increase continuously by 2050. By 2050, global IHD incidence, prevalence, deaths, and DALYs are projected to reach 67.3 million, 510 million, 16 million, and 302 million, respectively, which represents an increase of 116%, 106%, 80%, and 62% from 2021. Moreover, the results showed that regions with lower socio-demographic index (SDI) bore a greater burden of IHD than those with higher SDI, with men having a higher burden of IHD than women. People over 70 years old account for a major part of the burden of IHD, and premature death of IHD is also becoming more serious. CONCLUSION: The global burden of IHD will increase further by 2050, potentially due to population aging and economic disparities. Hence, it is necessary to strengthen the prevention of IHD and formulate targeted strategies according to different SDI regions and special populations.

Global burden of burns and its association with socio-economic development status, 1990-2019.

BACKGROUND: Burns represent important global health problems. Whereas many studies are limited by the difficulties in estimating the burden of burns and instead focus on the causes of burns, such as fire, heat, and hot substances. Therefore, a complete assessment of the burden of all injuries leading to burns is essential to developing reasonable global intervention strategies. METHODS: Data on three classes of burns, including "< 20 % total burned surface area without lower airway burns" (Moderate injury), "> =20 % total burned surface area or > = 10 % burned surface area if head/neck or hands/wrist involved w/o lower airway burns" (Major injury), "Lower airway burns" (Inhalation injury) were collected from the Global Burden of Disease 2019 database. Age-standardized incidence rates (ASR-I) and Years Lived with Disability (ASR-YLDs) for burns has been standardized by removing the influence of population size and age structure. They were extracted and stratified by cause, year, sex, age, socio-demographic index, country, and territory. RESULTS: In terms of ASR-I and ASR-YLDs, burns showed a significant decrease from 1990 to 2019, especially for moderate and major injury. In 2019, the burden of moderate injury was positively correlated with socio-demographic index while major injury was negatively correlated (P < 0.05). We found no correlation between socio-demographic index and the burden for inhalation injury (P > 0.05). Fire, heat, and hot substances were the most important cause of burns except for inhalation injury. The most common association with inhalation injury was falls, which were also a major cause of moderate and major injury. CONCLUSIONS: The Global Burden of Disease 2019 database data can be used to guide the allocation of resources to reduce ASR-I and ASR-YLDs of different burn classes.

Global Epidemiology and Geographic Variations of Pediatric-Onset Inflammatory Bowel Disease: A Comprehensive Analysis of the Global Burden of Disease Study 1990 to 2019.

BACKGROUND: An increasing incidence of pediatric-onset inflammatory bowel disease (PIBD) has been reported in many countries. However, the global burden and distribution of this disease remain less understood. We aimed to examine the global epidemiology and trends of PIBD from 1990 to 2019. METHODS: Data from the 2019 Global Burden of Disease Study, covering 204 countries, were analyzed. We assessed key measures like incidence, prevalence, mortality, and disability-adjusted life years (DALYs) using linear regression to calculate annual percentage changes and assess trends. RESULTS: Between 1990 and 2019, the PIBD incidence rate increased and the DALY rate and mortality rate declined. The incidence rate was notably elevated in the high Socio-demographic Index (SDI) quintile, reaching 6.3 per 100 000 person-years, corresponding to 13 914 new cases in 2019. Incidence and prevalence of PIBD positively correlated with the SDI, while higher death and DALY burdens were observed in lower-SDI countries. In 2019, the top 5 countries with the highest PIBD incidence rates were Canada (19.9 per 100 000 population), Denmark (12.4 per 100 000 population), Hungary (8.5 per 100 000 population), Austria (8.1 per 100 000 population), and the United States (7.4 per 100 000 population). Several countries experienced significant increases in incidence rates from 1990 to 2019, led by Taiwan (annual percent change 4.2%), followed by China (2.8%), Japan (2.1%), Australia (1.8%), and Hungary (1.6%). DISCUSSION: PIBD incidence has significantly increased since 1990. High-SDI countries face higher incidence, while lower-SDI countries experience higher mortality and DALY burdens. The study underscores the need for ongoing monitoring and research to address this emerging public health issue.

This study analyzed global pediatric-onset inflammatory bowel disease trends from 1990 to 2019. Findings show an increased incidence, especially in high Socio-demographic Index countries, highlighting a growing public health concern and the need for continued monitoring and investigation.

Type 2 diabetes attributable to ambient particulate matter pollution: a global burden study from 1990 to 2019.

Background: This study assesses the changes over time and geographical locations in the disease burden of type 2 diabetes (T2D) attributed to ambient particulate matter pollution (APMP) from 1990 to 2019 in 204 countries and regions with different socio-demographic indexes (SDI). Methods: The Global Burden of Diseases Study 2019 (GBD2019) database was used to analyze the global burden of T2D attributed to APMP. This study evaluated both the age-standardized death rate (ASDR) and disability-adjusted life years (DALYs) related to T2D, comparing data from 1990 to 2019. Estimated Annual Percentage Changes (EAPCs) were also utilized to investigate the trends over the 30-year study period. Results: The global age-standardized DALY rate and ASDR exhibited an increasing trend, with an EAPC of 2.21 (95% CI: 2.15 to 2.27) and 1.50 (95% CI: 1.43 to 1.58), respectively. This rise was most notable among older adult populations, men, regions in Africa and Asia, as well as low-middle SDI regions. In 2019, the ASDR for T2D caused by APMP was recorded at 2.47 per 100,000 population, while the DALY rate stood at 108.98 per 100,000 population. Males and countries with middle SDI levels displayed significantly high age-standardized death and DALY rates, particularly noticeable in Southern Sub-Saharan Africa. Conversely, regions with high SDI levels like High-income North America demonstrated decreasing trends. Conclusion: This study reveals a significant increase in T2D worldwide as a result of APMP from 1990 to 2019, with a particular emphasis on its impact on men, the older adult, and regions with low to middle SDI levels. These results underscore the urgent necessity for implementing policies aimed at addressing air pollution in order to reduce the prevalence of T2D, especially in the areas most heavily affected.

Epidemiological patterns of chronic kidney disease attributed to type 2 diabetes from 1990-2019.

Background: This study investigates the burden of chronic kidney disease attributed to type 2 diabetes (CKD-T2D) across different geographical locations and time periods from 1990 to 2019. A total of 204 countries and regions are included in the analysis, with consideration given to their socio-demographic indexes (SDI). The aim is to examine both spatial and temporal variations in CKD-T2D burden. Methods: This research utilized data from the 2019 Global Burden of Diseases Study to evaluate the age-standardized incidence rates (ASIR), Disability-Adjusted Life Years (DALYs), and Estimated Annual Percentage Change (EAPC) associated with CKD-T2D. Results: Since 1990, there has been a noticeable increase of CKD age-standardized rates due to T2D, with an EAPCs of 0.65 (95% confidence interval [CI]: 0.63 to 0.66) for ASIR and an EAPC of 0.92 (95% CI: 0.8 to 1.05) for age-standardized DALYs rate. Among these regions, Andean Latin America showed a significant increase in CKD-T2D incidence [EAPC: 2.23 (95% CI: 2.11 to 2.34) and North America showed a significant increase in CKD-T2D DALYs [EAPC: 2.73 (95% CI: 2.39 to 3.07)]. The burden was higher in male and increased across all age groups, peaking at 60-79 years. Furthermore, there was a clear correlation between SDI and age-standardized rates, with regions categorized as middle SDI and High SDI experiencing a significant rise in burden. Conclusion: The global burden of CKD-T2D has significantly risen since 1990, especially among males aged 60-79 years and in regions with middle SDI. It is imperative to implement strategic interventions to effectively address this escalating health challenge.