The Global Burden of Osteoporosis, Low Bone Mass, and Its Related Fracture in 204 Countries and Territories, 1990-2019.

Background: Low bone mineral density (LBMD), including osteoporosis and low bone mass, has becoming a serious public health concern. We aimed to estimate the disease burden of LBMD and its related fractures in 204 countries and territories over the past 30 years. Methods: We collected detailed information and performed a secondary analysis for LBMD and its related fractures from the Global Burden of Disease Study 2019. Numbers and age-standardized rates related to LBMD of disability-adjusted life-years (DALYs) and deaths in 204 countries and territories were compared by age, gender, socio-demographic index (SDI), and location. Results: Global deaths and DALYs number attributable to LBMD increased from 207 367 and 8 588 936 in 1990 to 437 884 and 16 647 466 in 2019, with a raise of 111.16% and 93.82%, respectively. DALYs and deaths number of LBMD-related fractures increased 121.07% and 148.65% from 4 436 789 and 121248 in 1990 to 9 808 464 and 301 482 in 2019. In 2019, the five countries with the highest disease burden of DALYs number in LBMD-related fractures were India (2 510 288), China (1 839 375), United States of America (819 445), Japan (323 094), and Germany (297 944), accounting for 25.59%, 18.75%, 8.35%, 3.29%, and 3.04%. There was a quadratic correlation between socio-demographic index (SDI) and burden of LBMD-related fractures: DALYs rate was 179.985-420.435SDI+417.936SDI2(R2 = 0.188, p<0.001); Deaths rate was 7.879-13.416SDI+8.839 SDI2(R2 = 0.101, p<0.001). Conclusions: The global burden of DALYs and deaths associated with LBMD and its related fractures has increased significantly since 1990. There were differences in disease burden between regions and countries. These estimations could be useful in priority setting, policy-making, and resource allocation in osteoporosis prevention and treatment.

Global burden of non-communicable diseases attributable to dietary risks in 1990-2019.

BACKGROUND: Dietary risks have raised attention worldwide during recent decades. The present burden-of-disease study aimed to evaluate the global dietary risks for non-communicable diseases (NCDs) from 1990 to 2019 and quantify their impact on mortality and disability-adjusted life-years (DALYs). Data from the 2019 Global Burden of Disease Study on deaths and DALYs from NCDs attributable to worldwide dietary risks were obtained and underwent deep analysis by year, age, gender, location, leading risks and leading causes, and their associations were examined. The socio-demographic index (SDI) was used as an indicator of national socio-economic status, as well as the relationships between age-standardised rates of deaths or DALYs and socio-economic status. RESULTS: In 2019, 7.9 million deaths and 187.7 million DALYs were attributable to dietary risk factors. High intake of sodium and low intake of whole grains and fruits were leading dietary risks for deaths and DALYs worldwide. However, both indices showed a decreasing trend by year, an increase by age and a higher disease burden in males. The main distribution of dietary-related NCDs was located in highly populated countries. A negative association between the SDI and disease burden and a positive association between the SDI and male preponderance were found. CONCLUSIONS: Dietary risk factors for NCDs increased significantly and varied across regions during 1990-2019. Therefore, greater efforts are needed to raise public awareness of interventions and improve dietary practices aiming to reduce the disease burden caused by suboptimal dietary intake, especially in developing countries and among males.

[Economic evaluation on the health hazards of residents caused by PM_(2.5) in Beijing, Tianjin and Hebei from 2013 to 2018].

OBJECTIVE: To learn the health hazards and health economic losses caused by PM_(2.5) pollution in Beijing, Tianjin and Hebei to the resident population. METHODS: Fine particular matter concentration and the basic demographic data of Beijing, Tianjin and Hebei from 2013 to 2018 were collected. Circulatory system disease hospitalization and other indexes were chosen as the end point of health effects, appropriate exposure-response relationship were selected, and the economic loss of health effect caused by PM_(2.5) was assessed by the combination of the cost of illness approach and human capital method. RESULTS: From 2013 to 2018, the economic loss of Beijing, Tianjin and Hebei caused by fine particular matter pollution showed a decreasing trend year by year. The health economic losses of Beijing from 2013 to 2018 were 3.815, 4.177, 4.090, 3.818, 2.567 and 2.031 billion yuan; The health economic losses of Tianjin were 3.046, 2.625, 1.882, 1.914, 1.448 and 1.000 billion yuan; The health economic losses of Hebei were 13.719, 11.850, 7.423, 7.216, 6.499 and 4.124 billion yuan, Hebei Province had the highest economic loss in 2013, accounting for 13.719 billion yuan, accounting for 0.51% of GDP in that year. Tianjin had the lowest economic loss in 2018, accounting for 10.0 billion yuan, accounting for 0.05% of GDP in that year. CONCLUSION: The health loss caused by PM_(2.5) pollution in Beijing, Tianjin and Hebei region shows a decreasing trend year by year, but the number is still very considerable, and the monitoring and control of PM_(2.5) pollution need to be further strengthened.

Global burden and gender disparity of vision loss associated with diabetes retinopathy.

PURPOSE: To assess the trend patterns and gender disparity in global burden of vision loss due to diabetic retinopathy (DR) by year, age, region and socioeconomic status using prevalence and years lived with disability (YLDs) from Global Burden of Disease (GBD) study 2017. METHODS: Prevalence and YLDs data of vision loss attributable to DR were extracted from GBD Study 2017 in 195 countries and territories. Socio-demographic Index (SDI) in 2017 was cited as indicators of socioeconomic status. Kruskal-Wallis test, Dunn's multiple comparisons and Pearson linear correlation were adopted to evaluate the gender disparity and association with socioeconomic levels. RESULTS: Globally, total age-standardized prevalence and YLDs rates of vision loss due to DR peaked around 2005, with prevalence rate of 58.98 [95% uncertainty interval (UI) 50.95-68.56] and YLDs rate of 5.00 (95% UI 3.51-6.84) per 100 000 population, respectively. The burden were expected to increase to 65.74 (95% UI 60.14-70.86) and 5.68 (95% UI 4.07-7.22) by 2050. The burden would increase according to our projection based on current epidemiological situation. However, gender disparity has existed since 1990 and been enlarging in recent years, with female being more heavily impacted. This pattern remained with ageing among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized prevalence rates was positively related to SDI (r = 0.1661, p = 0.0203). Diabetes has become a more important risk over the past 3 decades among the leading causes of vision loss. CONCLUSIONS: The DR-related vision loss burden tended to increase under ageing population according to our projection with significant gender disparity. Public awareness of DR and gender sensitive health policy should be emphasized.

Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025.

Diabetes mellitus is a leading cause of mortality and reduced life expectancy. We aim to estimate the burden of diabetes by type, year, regions, and socioeconomic status in 195 countries and territories over the past 28 years, which provide information to achieve the goal of World Health Organization Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2025. Data were obtained from the Global Burden of Disease Study 2017. Overall, the global burden of diabetes had increased significantly since 1990. Both the trend and magnitude of diabetes related diseases burden varied substantially across regions and countries. In 2017, global incidence, prevalence, death, and disability-adjusted life-years (DALYs) associated with diabetes were 22.9 million, 476.0 million, 1.37 million, and 67.9 million, with a projection to 26.6 million, 570.9 million, 1.59 million, and 79.3 million in 2025, respectively. The trend of global type 2 diabetes burden was similar to that of total diabetes (including type 1 diabetes and type 2 diabetes), while global age-standardized rate of mortality and DALYs for type 1 diabetes declined. Globally, metabolic risks (high BMI) and behavioral factors (inappropriate diet, smoking, and low physical activity) contributed the most attributable death and DALYs of diabetes. These estimations could be useful in policy-making, priority setting, and resource allocation in diabetes prevention and treatment.

Global burden of noncommunicable disease attributable to high body mass index in 195 countries and territories, 1990-2017.

PURPOSE: The increasing burden of noncommunicable diseases (NCDs) attributable to high body mass index (BMI) represents both a threat and an opportunity for intervention. Estimates of the global latest trend of high BMI-related NCDs and its association with socioeconomic status can facilitate strategic intervention and inform further research. METHODS: This global burden of disease study extracted global, regional, and national data on death and disability-adjusted life years (DALYs) attributable to high BMI-related NCDs from the GBD Study 2017. Secondary analyses were performed by year, age, sex, and specific causes of death and DALYs. The 2017 Socio-demographic Index (SDI) was used as an indicator of national socioeconomic status. The association between age-standardized death or DALYs rate and socioeconomic status were analyzed. RESULTS: Worldwide, 4.7 million deaths and 147.7 million DALYs of NCDs were related to high BMI in 2017, with a projection to 5.5 million deaths and 176.9 million DALYs in 2025. Globally, high BMI-related burden showed an increasing trend with males being more heavily impacted overall. The trend and magnitude of high BMI-related disease burden varied substantially in different geographical and socioeconomic regions. Specifically, the low-middle, middle, and high-middle SDI countries were associated with a higher burden. The leading three causes of DALYs attributable to high BMI in 2017 were ischemic heart diseases, stroke, and diabetes mellitus. CONCLUSIONS: High BMI-related burden of NCDs is worsening, particularly in developing countries. Our findings may enhance public awareness of interventions to reduce the diseases burden caused by high BMI.

Global burden of noncommunicable diseases attributable to high fasting plasma glucose.

BACKGROUND: Hyperglycemia is a major public health concern. An understanding of the latest trends of the global burden of noncommunicable diseases (NCDs) by high fasting plasma glucose (HFPG) is critical for determining research priorities and planning health policy. METHODS: This is a comparative burden-of-disease study. We obtained global, regional, and national data on deaths and disability-adjusted life years (DALYs) of NCDs attributable to HFPG from the Global Burden of Disease Study 2017, performed a secondary analysis of deaths and DALYs by time, age, gender, location, and specific causes, and analyzed their associations. RESULTS: In 2017, 6.39 million deaths and 166.36 million DALYs from NCDs were attributable to HFPG, accounting for 15.6% and 10.7% of all deaths and DALYs, respectively. The burden's rate decreased with time, increased with age and was significantly higher in males. A negative association was found between the sociodemographic index (SDI) and disease burden, and a positive association was found between SDI and male superiority by gender difference and gender ratio. CONCLUSIONS: The burden of NCDs attributable to HFPG has increased significantly since 1990 and varied widely across regions. Greater efforts are needed to prevent and control hyperglycemia, especially in less developed countries and among males.