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中国全科医学 ›› 2025, Vol. 28 ›› Issue (16): 2050-2058.DOI: 10.12114/j.issn.1007-9572.2024.0497

所属专题： 内分泌代谢性疾病最新文章合辑

• 论著 • 上一篇    下一篇

1990—2021年全球与中国老年2型糖尿病的疾病负担调查与未来趋势预测

赵晓晓1,2, 柯立鑫3, 荀杨芹4, 王海博5, 高武霖1, 乔天慈1, 卢笑晖1, 武继彪2,*(), 卢存存6,*()   

  1. 1250014　山东省济南市，山东中医药大学附属医院
    2250399　山东省济南市，山东中医药大学
    39713GZ荷兰格罗宁根，格罗宁根大学医学中心儿科学实验室
    4100730　北京市，中国医学科学院北京协和医学院群医学与公共卫生学院
    5730000　甘肃省兰州市，甘肃中医药大学附属医院重症医学科
    6100700　北京市，中国中医科学院中医临床基础医学研究所
  • 收稿日期:2024-09-09 修回日期:2025-02-27 出版日期:2025-06-05 发布日期:2025-04-22
  • 通讯作者: 武继彪, 卢存存


  • 作者贡献：

    赵晓晓负责数据收集、图表制作和初稿撰写；柯立鑫、荀杨芹负责数据整理、论文修订；王海博、高武霖、乔天慈、卢笑晖负责数据核查和论文修订；武继彪负责研究指导、论文修订和经费支持；卢存存负责研究选题、统计分析、图表制作和论文修订。

  • 基金资助:
    山东省自然科学基金青年项目(NO.ZR2022QH123)

Investigation and Future Trend Prediction of Disease Burden of Elderly Type 2 Diabetes Mellitus Globally and in China from 1990 to 2021

ZHAO Xiaoxiao1,2, KE Lixin3, XUN Yangqin4, WANG Haibo5, GAO Wulin1, QIAO Tianci1, LU Xiaohui1, WU Jibiao2,*(), LU Cuncun6,*()   

  1. 1Affiliated Hospital of Shandong University of TCM, Jinan 250014, China
    2Shandong University of TCM, Jinan 250399, China
    3Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, Netherlands
    4School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    5Department of Critical Care Medicine, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou 730000, China
    6Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
  • Received:2024-09-09 Revised:2025-02-27 Published:2025-06-05 Online:2025-04-22
  • Contact: WU Jibiao, LU Cuncun

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摘要： 背景 老年2型糖尿病（T2DM）已成为全球性及中国国内影响人口健康的重大公共卫生难题，明确与之相关的疾病负担迫在眉睫。 目的 分析1990—2021年全球与中国老年T2DM的疾病负担并预测未来趋势，为公共卫生和医疗决策提供参考。 方法 从全球疾病负担（GBD）数据库2021，提取并整理1990—2021年全球与中国60岁及以上T2DM患者的发病和死亡负担数据。以GBD 2021标准人口为基础，估算60岁及以上T2DM群体的年龄标准化发病率和死亡率。利用Joinpoint回归计算平均年度变化百分比（AAPC）评估疾病负担的趋势变化。基于年龄和性别进行亚组分析，利用分解分析方法探讨老龄化、人口增长和流行病学改变3个因素对疾病负担改变的相对影响。使用贝叶斯模型预测2022—2035年的发病数和死亡数。 结果 2021年全球与中国老年T2DM的发病数分别为6 047 049例和800 764例，与1990年相比，分别增加178.68%和220.28%。1990—2021年全球年龄标准化发病率整体呈上升趋势（AAPC=1.21%，P<0.001），但中国的整体上升趋势却无统计学意义（AAPC=0.29%，P=0.189）。2021年全球与中国老年T2DM的死亡数分别为1 304 150例和149 972例，与1990年相比，分别增加164.68%和197.98%。1990—2021年全球年龄标准化死亡率整体呈上升趋势（AAPC=0.32%，P<0.001），但中国的趋势却相对平稳（AAPC=0.01%，P=0.922）。此外，全球与中国在1990年和2021年的发病数和死亡数均为女性高于男性，且60~64岁组在2021年的发病数中占比最高，70~74岁组在死亡数中占比最高。分解分析发现人口增长是全球和中国老年T2DM发病数和死亡数增加的主要影响因素。预测分析表明2022—2035年全球老年T2DM的发病数和死亡数以及中国的死亡数将继续呈上升趋势。 结论 全球和中国老年T2DM的发病和死亡负担依然沉重，迫切需要进一步加强和制订更加有效的公共卫生政策和临床防控策略，从而为降低老年T2DM的基本负担发挥积极作用。

关键词: 2型糖尿病, 老年人, 疾病负担, 流行病学特征, 预测分析

Abstract:

Background

Type 2 diabetes mellitus (T2DM) among the elderly has become a significant public health problem both globally and in China, affecting population health. It is extremely urgent to clarify the related disease burden.

Objective

To assess the disease burden of T2DM among the elderly population globally and in China from 1990 to 2021, project future trends, and offer insights to inform public health and medical decision-makings.

Methods

Data on incidence and mortality burdens of individuals aged 60 years and above with T2DM in China and around the world were extracted from the global Burden of Disease (GBD) 2021 database. Age-standardized incidence and mortality rates were estimated based on the GBD 2021 standard population. Joinpoint regression was utilized to calculate the average annual percentage change (AAPC) for assessing disease burden trends. Subgroup analyses were performed based on age and sex, and decomposition analysis was performed to examine how aging, population growth, and epidemiological changes impacted disease burden. Bayesian models were employed to forecast prevalence and mortality between 2022 and 2035.

Results

In 2021, the global incidence of T2DM stood at 6 047 049, while in China, it reached 800 764, representing increases of 178.68% and 220.28%, respectively, compared to the incidence in 1990. Over the period from 1990 to 2021, the global age-standardized incidence rate exhibited a significant overall upward trend (AAPC=1.21%, P<0.001), whereas the trend in China was not statistically significant (AAPC=0.29%, P=0.189). The number of deaths among elderly T2DM patients in 2021 in the global and Chinese populations was 1 304 150 and 149 972, respectively, marking increases of 164.68% and 197.98% compared to the number of deaths in 1990. Throughout the same period, the global age-standardized mortality rate displayed a consistent upward trend (AAPC=0.32%, P<0.001), while the trend in China remained relatively stable (AAPC=0.01%, P=0.922). Notably, the number of incidence and mortality for female in 1990 and 2021, globally and in China, exceeded those of males. Meanwhile, the 60-64 age group had the highest proportion of incidences in 2021, while the 70-74 age group had the highest proportion of deaths. Population growth emerged as the primary influencer driving the rise in incidence and mortality in elderly T2DM patients in both global and Chinese populations, as revealed by decomposition analysis. The projection indicates a continued increase in the incidence and mortality of elderly T2DM patients worldwide and in China from 2022 to 2035.

Conclusion

The persistent heavy burden of incidence and mortality among elderly individuals with T2DM in both global and Chinese populations necessitates urgent reinforcement and formulation of more effective public health policies and clinical prevention and control strategies to alleviate the fundamental burden associated with this demographic.

Key words: Type 2 diabetes mellitus, Older adult, Disease burden, Epidemiological feature, Predictive analysis

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