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摘要:
目的 了解1990—2019年内蒙古自治区居民糖尿病死亡特征和疾病负担情况,为自治区卫生行政部门制定糖尿病相关政策提供基础数据支持和理论依据。 方法 利用2019年全球疾病负担研究(GBD 2019)内蒙古数据通过Joinpoint Regression Program软件进行回归分析,计算1990—2019年内蒙古自治区居民糖尿病的粗死亡率、标化死亡率、伤残调整寿命年(DALY)率、早死损失寿命年(YLL)率、伤残损失寿命年(YLD)率,采用年度变化百分比(APC)反映糖尿病疾病负担变化趋势。 结果 1990—2019年内蒙古自治区糖尿病死亡率由3.58/10万增至8.03/10万,APC为2.8%;DALY率由2.90人年/1000人增长至6.59人年/1000人,APC为3.0%;标化死亡率和标化DALY率均呈现先上升后下降的变化趋势(P<0.05),男性的标化死亡率和标化DALY率均呈现上升趋势(P<0.05)。 死亡人数、死亡率、疾病负担指标均随着年龄的增长而上升,在≥70岁年龄组达到最高。 结论 内蒙古自治区糖尿病疾病负担严重,男性人群疾病负担及伤残疾病负担较严重,卫生行政部门应该加强糖尿病防控工作,针对重点人群进行干预工作。 Abstract:Objective To understand the mortality and disease burden of diabetes in Inner Mongolia autonomous region during 1990–2019, and provide basic data support and theoretical basis for the development of diabetes prevention and control related policies. Methods Using data from the global burden of disease study 2019 (GBD 2019), we calculated crude mortality, standardized mortality, disability adjusted life year (DALY) rates, early life loss (YLL) rates, years lived with disability (YLD) rates in adults with diabetes in Inner Mongolia during 1990–2019, the annual percentage change (APC) was used to reflect changing trends of disease burden caused by diabetes. Results The mortality rate of diabetes increased from 3.58/100000 to 8.03/100000 in Inner Mongolia during 1990–2019, with an APC of 2.8%. The DALY rates increased from 2.90 per 1000 person years to 6.59 per 1000 person years with an APC of 3.0%. Whereas both the standardized mortality rate and standardized DALY rate declined first and then increased, but the standardized mortality rate and standardized DALY rate in men showed an increasing trend. And all the above trend changes were statistically significant (P<0.05). The number of deaths, mortality rate, and disease burden all increased with age and reached peaks in age group ≥70 years. Conclusion Inner Mongolia had a serious burden of diabetes, the burden of the disease and disability in men was most serious, and it is necessary to strengthen diabetes prevention and control and conduct targeted intervention in the elderly. -
Key words:
- Diabetes /
- Mortality /
- Disease burden /
- Disability adjusted life years
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表 1 1990-2019年内蒙古自治区糖尿病死亡情况
Table 1. Death of diabetes in Inner Mongolia autonomous region, 1990−2019
年份 粗死亡率(/10万) 标化死亡率(/10万) 男性 女性 合计 男性 女性 合计 1990 3.19 4.00 3.58 6.25 7.77 6.87 1991 3.21 3.99 3.59 6.20 7.61 6.77 1992 3.29 4.06 3.66 6.29 7.59 6.81 1993 3.35 4.22 3.77 6.33 7.73 6.90 1994 3.42 4.35 3.87 6.38 7.72 6.93 1995 3.54 4.48 3.99 6.49 7.74 7.00 1996 3.66 4.72 4.17 6.60 7.95 7.15 1997 3.79 4.72 4.24 6.71 7.77 7.13 1998 4.01 4.86 4.42 6.94 7.77 7.25 1999 4.23 5.05 4.62 7.16 7.86 7.40 2000 4.43 5.30 4.85 7.30 8.01 7.55 2001 4.54 5.42 4.96 7.30 7.99 7.55 2002 4.75 5.76 5.24 7.42 8.23 7.73 2003 4.89 6.01 5.43 7.42 8.31 7.77 2004 5.14 6.25 5.67 7.59 8.38 7.89 2005 5.26 6.46 5.84 7.60 8.36 7.88 2006 5.23 6.35 5.77 7.34 7.92 7.53 2007 5.26 6.21 5.72 7.18 7.47 7.22 2008 5.44 6.17 5.79 7.31 7.22 7.15 2009 5.72 6.34 6.02 7.61 7.23 7.28 2010 6.06 6.59 6.31 7.95 7.29 7.46 2011 6.20 6.73 6.45 8.00 7.19 7.40 2012 6.36 6.74 6.55 8.04 6.93 7.27 2013 6.51 6.89 6.69 8.05 6.83 7.20 2014 6.72 7.05 6.88 8.04 6.73 7.14 2015 6.83 7.12 6.97 7.89 6.48 6.94 2016 7.01 7.35 7.17 7.81 6.43 6.89 2017 7.21 7.63 7.41 7.70 6.40 6.84 2018 7.46 7.96 7.70 7.63 6.38 6.82 2019 7.80 8.28 8.03 7.66 6.35 6.82 1990—2019年 变化率(%) 144.22 106.81 124.19 22.58 −18.22 −0.66 年度变化百分比(%) 3.2 2.5 2.8 0.9 −0.8 P值 <0.01 <0.01 <0.01 <0.01 <0.01 置信区间下限 3.1 2.3 2.7 0.7 −1.0 置信区间上限 3.4 2.6 3 1.0 −0.5 表 2 1990-2019年内蒙古自治区糖尿病死亡率年龄分布
Table 2. Mortality rates of diabetes in different age groups in Inner Mongolia autonomous region, 1990−2019
年份 粗死亡率(/10万) < 5岁 5~14岁 15~49岁 50~69岁 70~岁 1990 0.50 0.14 0.91 15.02 55.89 1991 0.49 0.13 0.90 14.81 55.41 1992 0.49 0.13 0.91 14.86 56.12 1993 0.48 0.13 0.94 15.04 57.13 1994 0.47 0.14 1.02 14.99 57.43 1995 0.46 0.14 1.11 14.97 58.26 1996 0.45 0.14 1.16 15.24 59.99 1997 0.43 0.13 1.15 15.07 60.69 1998 0.41 0.13 1.22 15.23 61.99 1999 0.39 0.12 1.24 15.34 64.14 2000 0.36 0.11 1.26 15.36 66.04 2001 0.33 0.11 1.23 14.93 66.87 2002 0.29 0.10 1.21 15.38 68.22 2003 0.26 0.08 1.16 15.44 68.65 2004 0.24 0.08 1.17 15.22 69.91 2005 0.22 0.08 1.17 14.64 70.53 2006 0.20 0.07 1.14 13.73 67.24 2007 0.18 0.07 1.11 12.84 64.59 2008 0.17 0.06 1.09 12.15 64.48 2009 0.16 0.07 1.08 11.76 66.81 2010 0.15 0.06 1.07 11.56 69.95 2011 0.14 0.06 1.02 11.30 70.60 2012 0.13 0.06 0.97 11.02 70.41 2013 0.13 0.06 0.94 10.66 71.50 2014 0.12 0.05 0.94 10.42 72.65 2015 0.12 0.05 0.92 10.23 71.83 2016 0.12 0.05 0.93 10.17 71.96 2017 0.11 0.05 0.95 10.19 72.08 2018 0.10 0.04 0.96 10.29 72.15 2019 0.09 0.04 0.98 10.45 71.89 1990—2019年 变化率(%) −81.3 −69.4 7.3 −30.4 28.6 表 3 1990-2019年内蒙古自治区糖尿病伤残调整寿命年情况
Table 3. Disability adjusted life year of diabetes in Inner Mongolia autonomous region, 1990−2019
年份 伤残调整寿命年(万人年) 伤残调整寿命年率(人年/1000人) 标化伤残调整寿命年率(人年/1000人) 男性 女性 合计 男性 女性 合计 男性 女性 合计 1990 3.55 2.95 6.50 3.05 2.75 2.90 4.37 4.30 4.32 1991 3.72 3.03 6.75 3.16 2.80 2.99 4.48 4.29 4.37 1992 3.90 3.14 7.04 3.28 2.87 3.08 4.59 4.30 4.44 1993 4.05 3.28 7.33 3.37 2.96 3.17 4.66 4.34 4.50 1994 4.20 3.41 7.61 3.46 3.05 3.27 4.71 4.36 4.53 1995 4.35 3.55 7.90 3.55 3.14 3.36 4.75 4.36 4.55 1996 4.45 3.68 8.13 3.61 3.23 3.43 4.73 4.37 4.55 1997 4.51 3.70 8.21 3.63 3.22 3.43 4.67 4.25 4.46 1998 4.59 3.77 8.35 3.67 3.25 3.47 4.63 4.18 4.40 1999 4.68 3.84 8.52 3.73 3.29 3.52 4.59 4.12 4.35 2000 4.82 3.97 8.79 3.82 3.38 3.61 4.59 4.12 4.35 2001 5.02 4.14 9.16 3.96 3.50 3.74 4.64 4.15 4.39 2002 5.38 4.48 9.85 4.21 3.78 4.00 4.80 4.36 4.57 2003 5.76 4.83 10.59 4.49 4.06 4.29 4.96 4.56 4.76 2004 6.18 5.20 11.38 4.80 4.35 4.58 5.14 4.74 4.94 2005 6.49 5.48 11.98 5.03 4.57 4.81 5.23 4.81 5.02 2006 6.73 5.62 12.34 5.19 4.67 4.94 5.23 4.74 4.98 2007 6.97 5.74 12.71 5.35 4.76 5.07 5.23 4.67 4.95 2008 7.23 5.87 13.10 5.54 4.86 5.21 5.26 4.61 4.93 2009 7.51 6.05 13.56 5.73 5.00 5.38 5.30 4.60 4.95 2010 7.78 6.25 14.03 5.92 5.15 5.55 5.35 4.59 4.97 2011 7.99 6.40 14.39 6.07 5.27 5.68 5.34 4.53 4.94 2012 8.19 6.48 14.67 6.21 5.32 5.78 5.33 4.43 4.87 2013 8.37 6.56 14.92 6.32 5.38 5.87 5.29 4.33 4.81 2014 8.56 6.62 15.18 6.46 5.42 5.96 5.27 4.23 4.75 2015 8.70 6.67 15.37 6.55 5.45 6.02 5.20 4.12 4.66 2016 8.65 6.61 15.26 6.49 5.39 5.96 5.05 3.95 4.50 2017 8.60 6.55 15.15 6.44 5.32 5.91 4.91 3.79 4.35 2018 8.97 6.78 15.75 6.71 5.50 6.13 4.97 3.80 4.38 2019 9.70 7.24 16.93 7.25 5.87 6.59 5.19 3.89 4.54 1990—2019年变化率(%) 173.15 145.50 160.61 138.15 113.58 126.98 18.76 −9.47 5.16 年度变化百分比(%) 3.1 2.9 3.0 0.6 −0.2 P值 <0.01 <0.01 <0.01 <0.01 >0.05 置信区间下限 2.9 2.6 2.8 0.4 −0.5 置信区间上限 3.3 3.1 3.2 0.7 0.1 表 4 1990-2019年内蒙古自治区糖尿病伤残调整寿命年率年龄分布
Table 4. Disability adjusted life year rates of diabetes in different age groups in Inner Mongolia autonomous region, 1990−2019
年份 伤残调整寿命年率(人年/1000人) < 5岁 5~14岁 15~49岁 50~69岁 70~岁 1990 0.44 0.13 1.65 12.27 21.24 1991 0.43 0.12 1.68 12.50 21.68 1992 0.43 0.12 1.72 12.74 22.22 1993 0.42 0.12 1.77 12.97 22.73 1994 0.41 0.13 1.84 13.06 23.04 1995 0.41 0.13 1.93 13.09 23.28 1996 0.39 0.13 1.97 13.06 23.49 1997 0.38 0.12 1.96 12.77 23.44 1998 0.36 0.12 1.99 12.50 23.45 1999 0.34 0.11 1.99 12.27 23.63 2000 0.32 0.11 2.00 12.12 23.89 2001 0.29 0.10 2.03 12.15 24.32 2002 0.26 0.09 2.10 12.70 25.25 2003 0.23 0.08 2.19 13.20 26.17 2004 0.21 0.08 2.31 13.56 27.07 2005 0.19 0.08 2.41 13.59 27.48 2006 0.18 0.07 2.49 13.35 26.92 2007 0.16 0.07 2.57 13.10 26.34 2008 0.15 0.07 2.67 12.89 26.04 2009 0.14 0.07 2.77 12.76 26.08 2010 0.13 0.07 2.86 12.72 26.26 2011 0.12 0.07 2.92 12.62 25.99 2012 0.12 0.07 2.97 12.46 25.47 2013 0.11 0.06 3.03 12.22 25.05 2014 0.11 0.06 3.08 11.99 24.63 2015 0.10 0.06 3.11 11.79 23.98 2016 0.10 0.06 3.13 11.25 22.96 2017 0.10 0.06 3.13 10.78 22.06 2018 0.09 0.06 3.14 11.08 22.31 2019 0.08 0.06 3.14 11.97 23.31 1990—2019年 变化率(%) −80.9 −54.3 90.5 −2.4 9.7 表 5 1990-2019年内蒙古自治区糖尿病早死损失寿命年、伤残损失寿命年情况
Table 5. Years of life lost, years lived with disability of diabetes in Inner Mongolia autonomous region, 1990−2019
年份 早死损失寿命年
(万人年)标化早死损失寿命年率
(人年/1000人)伤残损失寿命年
(万人年)标化伤残损失寿命年率
(人年/1000人)男性 女性 合计 男性 女性 合计 男性 女性 合计 男性 女性 合计 1990 1.07 1.24 2.31 1.38 1.83 1.57 2.48 1.70 4.19 2.99 2.47 2.74 1991 1.08 1.24 2.32 1.36 1.78 1.55 2.64 1.79 4.43 3.11 2.51 2.83 1992 1.11 1.27 2.38 1.37 1.77 1.55 2.79 1.87 4.66 3.21 2.54 2.89 1993 1.14 1.32 2.46 1.37 1.79 1.56 2.92 1.95 4.87 3.29 2.55 2.94 1994 1.17 1.39 2.55 1.38 1.80 1.57 3.03 2.03 5.06 3.33 2.56 2.97 1995 1.21 1.45 2.66 1.39 1.81 1.58 3.14 2.10 5.24 3.35 2.56 2.97 1996 1.25 1.53 2.78 1.41 1.85 1.61 3.20 2.15 5.35 3.32 2.52 2.94 1997 1.29 1.52 2.80 1.42 1.78 1.58 3.22 2.18 5.40 3.25 2.47 2.87 1998 1.36 1.57 2.93 1.46 1.78 1.60 3.23 2.20 5.42 3.16 2.40 2.80 1999 1.43 1.61 3.04 1.50 1.78 1.62 3.25 2.23 5.47 3.10 2.35 2.73 2000 1.50 1.68 3.18 1.52 1.79 1.64 3.32 2.29 5.61 3.07 2.33 2.71 2001 1.53 1.69 3.22 1.51 1.76 1.62 3.49 2.45 5.94 3.13 2.40 2.77 2002 1.60 1.77 3.37 1.53 1.79 1.65 3.78 2.71 6.48 3.27 2.56 2.92 2003 1.65 1.81 3.46 1.52 1.79 1.65 4.11 3.02 7.13 3.44 2.77 3.11 2004 1.73 1.87 3.60 1.55 1.79 1.66 4.45 3.33 7.78 3.60 2.95 3.28 2005 1.76 1.92 3.68 1.54 1.77 1.64 4.73 3.57 8.30 3.69 3.04 3.38 2006 1.77 1.87 3.64 1.49 1.67 1.57 4.96 3.74 8.70 3.74 3.08 3.42 2007 1.78 1.81 3.59 1.45 1.56 1.50 5.19 3.92 9.12 3.78 3.10 3.45 2008 1.82 1.77 3.59 1.45 1.48 1.46 5.42 4.10 9.52 3.81 3.13 3.47 2009 1.88 1.78 3.66 1.48 1.46 1.46 5.63 4.28 9.90 3.83 3.14 3.49 2010 1.96 1.80 3.76 1.51 1.44 1.46 5.83 4.45 10.27 3.84 3.15 3.51 2011 1.98 1.81 3.79 1.50 1.40 1.43 6.01 4.59 10.60 3.84 3.14 3.50 2012 2.01 1.79 3.80 1.49 1.33 1.40 6.18 4.69 10.87 3.84 3.10 3.48 2013 2.04 1.80 3.84 1.47 1.29 1.37 6.33 4.76 11.09 3.82 3.04 3.44 2014 2.10 1.81 3.91 1.47 1.26 1.35 6.46 4.81 11.27 3.80 2.98 3.40 2015 2.12 1.81 3.94 1.44 1.21 1.31 6.57 4.86 11.44 3.77 2.91 3.35 2016 2.18 1.86 4.03 1.42 1.19 1.29 6.47 4.75 11.22 3.63 2.76 3.20 2017 2.24 1.92 4.16 1.42 1.18 1.29 6.37 4.63 11.00 3.49 2.62 3.06 2018 2.31 1.99 4.30 1.41 1.18 1.28 6.66 4.79 11.45 3.56 2.62 3.10 2019 2.40 2.06 4.46 1.42 1.17 1.29 7.30 5.17 12.47 3.77 2.72 3.26 1990—2019年 变化率(%) 124.64 66.01 93.1 2.96 −35.9 −18.39 194.01 203.45 197.85 26.03 10.07 18.69 年度变化百分比(%) 0.1 −1.7 −0.8 0.8 0.7 0.7 P值 0.09 <0.01 <0.01 <0.01 <0.01 <0.01 置信区间下限 0.0 −2.0 −1.0 0.5 0.3 0.4 置信区间上限 0.3 −1.4 −0.4 1.0 1.1 1.0 -
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