Global burden of metabolic diseases, 1990–2021
Zhang H. Zhou X.-D. Shapiro M.D. Lip G.Y.H. Tilg H. Valenti L. Somers V.K. Byrne C.D. Targher G. Yang W. Viveiros O. Opio C.K. Mantzoros C.S. Ryan J.D. Kok K.Y.Y. Jumaev N.A. Perera N. Robertson A.G. Abu-Abeid A. Misra A. Wong Y.J. Ruiz-Úcar E. Ospanov O. Kızılkaya M.C. Luo F. Méndez-Sánchez N. Zuluaga M. Lonardo A. Al Momani H. Toro-Huamanchumo C.J. Adams L. Al-Busafi S.A. Sharara A.I. Chan W.-K. Abbas S.I. Sookoian S. Treeprasertsuk S. Ocama P. Alswat K. Kong A.P.-S. Ataya K. Lim-Loo M.C. Oviedo R.J. Szepietowski O. Fouad Y. Zhang H. Abdelbaki T.N. Katsouras C.S. Prasad A. Thaher O. Ali A. Molina G.A. Sung K.-C. Chen Q.-F. Lesmana C.R.A. Zheng M.-H.
November 2024W.B. Saunders
Metabolism: Clinical and Experimental
2024#160
Background: Common metabolic diseases, such as type 2 diabetes mellitus (T2DM), hypertension, obesity, hypercholesterolemia, and metabolic dysfunction-associated steatotic liver disease (MASLD), have become a global health burden in the last three decades. The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) data enables the first insights into the trends and burdens of these metabolic diseases from 1990 to 2021, highlighting regional, temporal and differences by sex. Methods: Global estimates of disability-adjusted life years (DALYs) and deaths from GBD 2021 were analyzed for common metabolic diseases (T2DM, hypertension, obesity, hypercholesterolemia, and MASLD). Age-standardized DALYs (mortality) per 100,000 population and annual percentage change (APC) between 1990 and 2021 were estimated for trend analyses. Estimates are reported with uncertainty intervals (UI). Results: In 2021, among five common metabolic diseases, hypertension had the greatest burden (226 million [95 % UI: 190–259] DALYs), whilst T2DM (75 million [95 % UI: 63–90] DALYs) conferred much greater disability than MASLD (3.67 million [95 % UI: 2.90–4.61]). The highest absolute burden continues to be found in the most populous countries of the world, particularly India, China, and the United States, whilst the highest relative burden was mostly concentrated in Oceania Island states. The burden of these metabolic diseases has continued to increase over the past three decades but has varied in the rate of increase (1.6-fold to 3-fold increase). The burden of T2DM (0.42 % [95 % UI: 0.34–0.51]) and obesity (0.26 % [95 % UI: 0.17–0.34]) has increased at an accelerated rate, while the rate of increase for the burden of hypertension (−0.30 % [95 % UI: −0.34 to −0.25]) and hypercholesterolemia (−0.33 % [95 % UI: −0.37 to −0.30]) is slowing. There is no significant change in MASLD over time (0.05 % [95 % UI: −0.06 to 0.17]). Conclusion: In the 21st century, common metabolic diseases are presenting a significant global health challenge. There is a concerning surge in DALYs and mortality associated with these conditions, underscoring the necessity for a coordinated global health initiative to stem the tide of these debilitating diseases and improve population health outcomes worldwide.
Global Burden of Disease , Metabolic diseases , Metabolic dysfunction-associated fatty liver disease , Metabolic dysfunction-associated steatotic liver disease , Obesity
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Department of Medical Record, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
Precision Medicine, Biological Resource Center Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, United States
Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
Department of Medicine, University of Verona, Verona, Italy
Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Amadora, Lisbon, Portugal
Department of Medicine, Aga Khan University, Nairobi, Kenya
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
Pengiran Anak Puteri Rashidah Saadatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Brunei-Muara, Bandar Seri Begawan, Brunei Darussalam
Department Surgical Diseases, Tashkent Medical Academy, Tashkent, Almazar, Uzbekistan
Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
Department of Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
Division of Surgery, Tel Aviv Sourasky Medical Center affiliated to Tel Aviv University, Tel Aviv, Israel
Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, New Delhi, India
Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore
Duke-NUS Medical School, Singapore
Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
Surgical Disease and Bariatric Surgery, Astana Medical University, Aqmola, Astana, Kazakhstan
Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Turkey
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
Department of Surgery, Universidad del Valle, Valle del Cauca, Cali, Colombia
Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
Universidad San Ignacio de Loyola, Lima, Peru
OBEMET Center for Obesity and Metabolic Health, Lima, Peru
Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, WA, Australia
Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
Medical School, The University of Western Australia, Perth, Australia
Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical center, Beirut, Lebanon
Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
Faculty of Health Science, Maimónides University, Buenos Aires, Argentina
Clinical and Molecular Hepatology, Translational Health Research Center (CENITRES), Maimónides University, Buenos Aires, Argentina
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
Department of Bariatric Surgery, University of Montreal, Montreal, QC, Canada
Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines
Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, United States
Department of Surgery, Ashford and St Peters Hospital, Surrey, Chertsey, United Kingdom
Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
Department of Surgery, Marien Hospital Herne, University Hospital of the Ruhr-University of Bochum, NRW, Herne, Germany
Metabolic and Bariatric, Fatimah Hospital, Tehran, Iran
Department of Surgery, USFQ (Universidad San Francisco), Pichincha, Quito, Ecuador
Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
Medical Care Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia
Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia
Gastrointestinal Cancer Center, Mochtar Riyadi Comprehensive Cancer Center (MRCCC) Siloam Semanggi Hospital, Jakarta, Indonesia
Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Zhejiang, Wenzhou, China
Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, United States
Department of Medical Record
MAFLD Research Center
Department of Cardiovascular Medicine
Center for Prevention of Cardiovascular Disease
Liverpool Centre for Cardiovascular Science at University of Liverpool
Department of Clinical Medicine
Department of Internal Medicine I
Department of Pathophysiology and Transplantation
Precision Medicine
Department of Cardiovascular Medicine
Southampton National Institute for Health and Care Research Biomedical Research Centre
Department of Medicine
Metabolic Diseases Research Unit
Department of Metabolic and Bariatric Surgery
Department of Metabolic and Bariatric Surgery
Department of Medicine
Department of Medicine
Department of Hepatology
Pengiran Anak Puteri Rashidah Saadatul Bolkiah Institute of Health Sciences
Department Surgical Diseases
Department of Medicine
Department of Upper Gastrointestinal Surgery
Division of Surgery
Fortis-CDOC Center of Excellence for Diabetes
Department of Gastroenterology & Hepatology
Duke-NUS Medical School
Department of Metabolic
Surgical Disease and Bariatric Surgery
Department of Metabolic and Bariatric Surgery
Department of Cardiovascular Medicine
Liver Research Unit
Department of Surgery
Department of Internal Medicine
Weight Management Unit
Universidad San Ignacio de Loyola
OBEMET Center for Obesity and Metabolic Health
Nutrition and Health Innovation Research Institute
Department of Hepatology
Medical School
Department of Medicine
Division of Gastroenterology and Hepatology
Gastroenterology and Hepatology Unit
Department of Metabolic and Bariatric Surgery
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)
Faculty of Health Science
Clinical and Molecular Hepatology
Faculty of Medicine
Department of Medicine
Liver Disease Research Center
Department of Medicine and Therapeutics
Hong Kong Institute of Diabetes and Obesity
Department of Bariatric Surgery
Department of Surgery
Nacogdoches Center for Metabolic & Weight Loss Surgery
Department of Surgery
Department of Gastroenterology
Department of Endocrinology and Metabolism
Department of General Surgery
First Department of Cardiology
Surgical Gastroenterology
Department of Surgery
Metabolic and Bariatric
Department of Surgery
Department of Internal Medicine
Medical Care Center
Hepatobiliary Division
Digestive Disease & GI Oncology Center
Gastrointestinal Cancer Center
Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province
Section of Endocrinology
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