The Burden and Trends of Ischemic Heart Disease Attributable to Low Physical Activity Globally and in China，1990—2021
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摘要:
目的 系统分析1990—2021年全球及中国归因于低体力活动（low physical activity，LPA）的缺血性心脏病（ischemic heart disease，IHD）负担，并预测2022—2030年的变化趋势。 方法 基于全球疾病负担2021数据库，采用Joinpoint回归、年龄-时期-队列（age-period-cohort，APC）模型、分解分析及贝叶斯年龄-时期-队列（Bayesian age-period-cohort，BAPC）模型进行趋势分析。 结果 2021年，全球归因于LPA的IHD年龄标准化死亡率（age-standardized mortality rates，ASMR）和伤残调整生命年率（age-standardized DALYs rates，ASDR）分别为2.88/10万和46.63/10万，中国分别为3.52/10万和46.05/10万。Joinpoint回归显示全球ASMR和ASDR呈下降趋势，而中国呈M型波动上升，且性别差异显著。APC模型提示中国男性自1997年后负担加重，1971年后出生队列风险上升。分解分析显示人口增长和人口老龄化是疾病负担的主要驱动因素。BAPC模型预测显示，预计2030年中国疾病负担增长将高于全球，年轻男性群体更明显。 结论 全球归因于LPA的IHD负担呈下降趋势，但中国因人口增长和人口老龄化导致疾病负担持续攀升，其中女性群体的绝对负担更重，而年轻男性群体呈现上升趋势。 Abstract:Objective To systematically analyze the burden of ischemic heart disease （IHD） attributable to low physical activity （LPA） globally and in China from 1990 to 2021, and to predict its trends up to 2030, thereby providing evidence for formulating relevant healthcare policies. Methods Based on the global burden of disease （GBD） 2021 data, a comprehensive analysis and projection were conducted using Joinpoint regression, age-period-cohort （APC） modeling, decomposition analysis, and Bayesian age-period-cohort （BAPC） modeling. Results In 2021, the global age-standardized mortality rates （ASMR） and age-standardized DALYs rates （ASDR） for IHD attributable to LPA were 2.88 per 100, 000 and 46.63 per 100, 000, respectively. In China, the corresponding figures were 3.52 per 100, 000 and 46.05 per 100, 000. Joinpoint regression analysis revealed a declining trend in global ASMR and ASDR, whereas in China, these rates showed an M-shaped fluctuating rise with significant gender disparities. The APC model indicated an increasing burden among Chinese males since 1997, with elevated risks for birth cohorts after 1971. Decomposition analysis highlighted population growth and aging as the primary drivers of the disease burden. BAPC model projections suggested that by 2030, China’s disease burden was expected to grow faster than the global average, with the trend being more pronounced among younger male populations. Conclusion The global burden of IHD attributable to LPA is declining. However, in China, due to population growth and aging, the disease burden continues to rise, characterized by a heavier absolute burden among females and a particularly pronounced increasing trend among young males. -
图 1 2021年全球与中国各年龄组死亡及DALYs变化趋势
A：全球变化趋势；B：中国变化趋势。
Figure 1. Trends in deaths and DALYs across age groups globally and in China，2021
图 2 基于Joinpoint回归法分析1990—2021年全球与中国ASMR及ASDR时序演变趋势
A：全球演变趋势；B：中国演变趋势。
Figure 2. Temporal trends in ASMR and ASDR based on Joinpoint regression analysis globally and in China from 1990 to 2021
图 3 全球与中国ASMR及ASDR的年龄-时期-队列分析
A：年龄分析；B：时期分析；C：队列分析。
Figure 3. Age - period - cohort analysis of ASMR and ASDR globally and in China
图 4 1990—2021年全球与中国死亡及DALYs的分解分析
A：死亡数的分解分析；B：DALYs数的分解分析。
Figure 4. Decomposition analysis of deaths and DALYs globally and in China，1990—2021
图 5 全球及中国死亡率与DALYs率2022—2030年的预测趋势
A：死亡率的预测趋势；B：DALYs率的预测趋势。
Figure 5. Projected trends in mortality and DALYs globally and in China from2022 to 2030
表 1 1990年与2021年全球和中国归因于LPA的IHD疾病负担
Table 1. Disease burden of IHD attributable to LPA globally and in China，1990 and 2021
类别 病例数（95%UI） 变化百分比 （100%） ASR（1/100,000人,95%UI） EAPC 1990 2021 1990 2021 死亡 总体 全球 125,730 （55,488～199,339） 232,250 （103,518～371,375） 84.72 4.09 （1.78～6.56） 2.88 （1.28～4.59） -1.19 （-1.23 to -1.15） 中国 12,808 （5,227～22,545） 57,721 （23,735～106,094） 350.66 2.86 （1.12～5.37） 3.52 （1.43～6.58） 1.12 （0.78 to 1.46） 男性 全球 38,023 （16,293～60,944） 79,945 （36,705～129,067） 110.25 2.88 （1.21～4.80） 2.33 （1.07～3.82） -0.71（-0.78 to -0.65） 中国 3,478 （1,308～6,722） 19,968 （6,770～41,355） 474.12 1.99 （0.63～4.32） 3.14 （0.99～6.75） 1.88 （1.53 to 2.24） 女性 全球 87,707 （38,827～139,152） 152,305 （66,250～248,989） 73.65 4.76 （2.11～7.66） 3.24 （1.41～5.29） -1.29 （-1.32 to -1.25） 中国 9,330 （3,700～16,837） 37,753 （14,452～72,337） 304.64 3.41 （1.28～6.30） 3.82 （1.45～7.45） 0.82 （0.48 to 1.16） DALYs 总体 全球 2,248,011 （1,013,161～3,466,301） 3,897,941 （1,767,043～6,116,373） 73.40 64.51 （28.79～101.42） 446.63 （ （21.15～73.38） -1.14 （-1.19 to -1.09） 中国 237,710 （103,506～396,304） 827,789 （365,855～1,470,328） 248.23 40.72 （16.75～71.08） 46.05 （19.74～83.48） 0.80 （0.52 to 1.07） 男性 全球 785,494 （347,068～1,216,683） 1,482,151 （693,907～2,337,776） 89.69 49.36 （21.34～78.43） 39.41 （18.46～62.34） -0.83 （-0.91 to -0.75） 中国 67,960 （26,365～127,958） 298,139 （106,539～569,059） 339.70 27.40 （9.66～55.38） 39.89 （13.55～80.83） 1.54 （1.25 to 1.82） 女性 全球 1,462,516 （657,058～2,257,655） 2,415,790 （1,072,448～3,832,823） 65.18 73.85 （33.00～114.68） 51.88 （23.05～82.18） -1.22 （-1.26 to -1.18） 中国 169,751 （66,965～291,627） 529,650 （206,021～966,577） 212.02 50.65 （19.90～90.15） 51.24 （20.08～94.75） 0.44 （0.16 to 0.73） 
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