The burden of diabetes and hyperglycemia in Brazil-past and present: findings from the Global Burden of Disease Study 2015.
The burden of diabetes and hyperglycemia in Brazil-past and present: findings from the Global Burden of Disease Study 2015.
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DOI：
10.1186/s13098-017-0216-2
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发表时间：
2017
影响因子：
4.8
通讯作者：
Mokdad AH
中科院分区：
文献类型：
--
作者：
Duncan BB;Schmidt MI;Ewerton Cousin;Moradi-Lakeh M;Passos VMA;França EB;Marinho F;Mokdad AH
糖尿病、高血糖症及其并发症在巴西是一个日益严重的问题。然而，迄今为止，尚未全面介绍这一疾病负担的情况。我们使用2015年全球疾病负担数据来描述巴西1990年至2015年的糖尿病患病率、发病率和风险因素。此外，我们还提供了死亡率、过早损失的生命年（YLL）、残疾生存年（YLD）和因糖尿病而损失的残疾调整生命年（DALLS），以及糖尿病所致慢性肾脏疾病（CKD）的类似数据，并作为总体汇总指标，提供了高血糖的类似数据，后者表示为高空腹血糖（HFPG）。从1990年到2015年，糖尿病患病率从3.6%左右上升到6.1%，糖尿病导致的YLL、YLD和DALLS稳步增加。糖尿病的粗死亡率增加了90%，而糖尿病导致的CKD死亡率增加了一倍多。2015年，HFPG成为巴西残疾的第四大原因，占CKD的65%，占所有残疾的7.0%，每年损失4，049，510迪拉姆。在此期间，糖尿病患者增加了118.6%，其中42%是由于巴西人口的增长，72.1%是由于人口老龄化，4.6%是由于糖尿病导致的潜在的年龄标准化DALY率的变化。糖尿病的主要危险因素是高体重指数;一系列饮食因素，最明显的是全谷物、坚果和种子摄入量低，加工肉类摄入量高;体力活动少和吸烟，按此顺序排列。我们的研究表明，糖尿病、糖尿病引起的CKD和高血糖症在巴西造成了巨大且不断增加的负担。这些发现呼吁重新努力控制肥胖和糖尿病的共同流行，并制定战略来应对这些疾病造成的日益增加的负担。本文的在线版本（doi：10.1186/s13098-017-0216-2）包含补充材料，可供授权用户使用。
Diabetes, hyperglycemia, and their complications are a growing problem in Brazil. However, no comprehensive picture of this disease burden has yet been presented to date. We used Global Burden of Disease 2015 data to characterize diabetes prevalence, incidence and risk factors from 1990 to 2015 in Brazil. Additionally, we provide mortality, years of life lost prematurely (YLL), years of life lived with disability (YLD) and disability-adjusted life years (DALYs) lost due to diabetes, as well as similar data for chronic kidney disease (CKD) due to diabetes and, as an overall summary measure, for hyperglycemia, the latter expressed as high fasting plasma glucose (HFPG). From 1990 to 2015 diabetes prevalence rose from around 3.6 to 6.1%, and YLLs, YLDs, and DALYs attributable to diabetes increased steadily. The crude diabetes death rate increased 90% while that of CKD due to diabetes more than doubled. In 2015, HFPG became Brazil’s 4th leading cause of disability, responsible for 65% of CKD, for 7.0% of all disability and for the staggering annual loss of 4,049,510 DALYs. Diabetes DALYs increased by 118.6% during the period, increasing 42% due to growth in Brazil´s population, 72.1% due to population ageing, and 4.6% due to the change in the underlying, age-standardized rate of DALY due to diabetes. Main risk factors for diabetes were high body mass index; a series of dietary factors, most notably low intake of whole grains and of nuts and seeds, and high intake of processed meats; low physical activity and tobacco use, in that order. Our study demonstrates that diabetes, CKD due to diabetes, and hyperglycemia produce a large and increasing burden in Brazil. These findings call for renewed efforts to control the joint epidemics of obesity and diabetes, and to develop strategies to deal with the ever-increasing burden resulting from these diseases. The online version of this article (doi:10.1186/s13098-017-0216-2) contains supplementary material, which is available to authorized users.