Global burden of disease attributable to metabolic risk factors in adolescents and young adults aged 15–39, 1990–2021
Zhou X.-D. Chen Q.-F. Targher G. Byrne C.D. Mantzoros C.S. Zhang H. Lonardo A. Lip G.Y.H. Porta G. Misra A. Robertson A.G. Luo F. Alisi A. Yang W. El-Shabrawi M. Al Momani H. Somers V.K. Katsouras C.S. Méndez-Sánchez N. Lefere S. Szepietowski O. Sung K.-C. Hui Ng N.B. Valenti L. Lee W.S. Pik-Shan Kong A. Kızılkaya M.C. Ocama P. Ali A. Viveiros O. Ryan J.D. Toro-Huamanchumo C.J. Perera N. Ataya K. Yen Kok K.Y. Gracia-Sancho J. Sharara A.I. Prasad A. Oviedo R.J. Ospanov O. Ruiz-Úcar E. Alswat K. Abbas S.I. Abdelbaki T.N. Wong Y.J. Fouad Y. Shapiro M.D. Bacopoulou F. Sookoian S. Kehar M. Chan W.-K. Treeprasertsuk S. Adams L. Turan S. Zuluaga M. Pirola C.J. Thaher O. Molina G.A. Jumaev N.A. Al-Busafi S.A. Opio C.K. Lim-Loo M.C. Adithya Lesmana C.R. Kamani L. Zheng M.-H.
December 2024Churchill Livingstone
Clinical Nutrition
2024#43Issue 12391 - 404 pp.
Background: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally. Aims: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15–39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database. Methods: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults. The estimated annual percentage changes (EAPC) of DALYs were utilized to depict the trends from 1990 to 2021. Results: From 1990 to 2021, the DALY rates attributable to all metabolic risk factors showed a globally significant upward trend, with EAPC reaching 33.0 % (27.4–38.7). Compared to females, males had a heavier burden and a more significant increase in deaths and DALYs attributable to metabolic risk factors. High BMI and high FPG have become the top two metabolic risk factors in 2021, with summary exposure variables (SEV) rising by 84.2 % and 53.6 %, respectively. Low-middle socio-demographic index (SDI), middle SDI, and high SDI regions experienced upward regional trends in DALY rates, while low SDI regions remained stable. Among 204 countries and territories, 101 (49.5 %) showed a significant increase in DALY rates, as indicated by the EAPC. Conclusions: There is a substantial global burden attributable to metabolic risk factors in adolescents and young adults in 2021, especially high BMI and high FPG. This calls for further investigation and intervention to address this emerging trend.
Adolescents and young adults , Global disease burden , Metabolic risk factors
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Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Department of Medicine, University of Verona, Verona, Italy
Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, United Kingdom
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, United States
Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
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
Pediatric Hepatology, Transplant Unit, Hospital Infantil Menino Jesus and Hospital Sirio Libanes, San Paulo, Brazil
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 Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Childrens Hospital, IRCCS, Rome, Italy
Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
Department of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt
Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, United States
First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
Hepatology Research Unit, Department Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
Liver Research Center Ghent, Ghent University, Ghent, Belgium
Department of Surgery, Ashford and St Peters Hospital, Chertsey, Surrey, United Kingdom
Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
Department of Paediatrics, Khoo Teck Puat-National University Childrens Medical Institute, National University Hospital, Singapore
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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 Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong
Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong
Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Turkey
Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
Metabolic and Bariatric, Fatimah Hospital, Tehran, Iran
Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Lisbon, Amadora, Portugal
Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
Universidad San Ignacio de Loyola, Lima, Peru
Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
Department of Bariatric Surgery, University of Montreal, Montreal, QC, Canada
Pengiran Anak Puteri Rashidah Saadatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Brunei-Muara, Bandar Seri Begawan, Brunei Darussalam
Liver Vascular Biology Laboratory, IDIBAPS Biomedical Research Institute - Hospital Clínic de Barcelona & CIBEREHD, Barcelona, Spain
Department of Visceral Surgery and Medicine, Inselspital - University of Bern, Bern, Switzerland
Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India
Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, United States
Surgical Disease and Bariatric Surgery, Astana Medical University, Aqmola, Astana, Kazakhstan
Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates
Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore
Duke-NUS Medical School, Singapore
Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston–Salem, NC, United States
Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, Aghia Sophia Childrens Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
University Research Institute of Maternal and Child Health & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Childrens Hospital of Eastern Ontario, Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
Medical School, The University of Western Australia, Perth, Australia
Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
Departament of Surgery, Universidad del Valle, Cali, Valle del Cauca, Colombia, United States
Systems Biology of Complex Diseases, Centro de Investigación Traslacional en Salud, Universidad Maimónides, Buenos Aires, Argentina
Department of Surgery, Marien Hospital Herne, University Hospital of the Ruhr-University of Bochum, NRW, Herne, Germany
Department of Surgery, USFQ (Universidad San Francisco), Pichincha, Quito, Ecuador
Department Surgical Diseases, Tashkent Medical Academy, Almazar, Tashkent, Uzbekistan
Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
Department of Medicine, Aga Khan University, Nairobi, Kenya
Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines
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
Department of Gastroenterology, Liaquat National Hospital, Karachi, Pakistan
MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China
Department of Cardiovascular Medicine
Medical Care Center
Department of Medicine
Metabolic Diseases Research Unit
Southampton National Institute for Health and Care Research Biomedical Research Centre
Department of Medicine
Section of Endocrinology
Department of Endocrinology and Metabolism
Department of Internal Medicine
Liverpool Centre for Cardiovascular Science at University of Liverpool
Department of Clinical Medicine
Pediatric Hepatology
Fortis-CDOC Center of Excellence for Diabetes
Department of Upper Gastrointestinal Surgery
Department of Cardiovascular Medicine
Research Unit of Molecular Genetics of Complex Phenotypes
Department of Metabolic and Bariatric Surgery
Department of Pediatrics and Pediatric Hepatology
Weight Management Unit
Department of Cardiovascular Medicine
First Department of Cardiology
Liver Research Unit
Hepatology Research Unit
Liver Research Center Ghent
Department of Surgery
Department of Internal Medicine
Department of Paediatrics
Department of Paediatrics
Department of Pathophysiology and Transplantation
Precision Medicine
Department of Paediatrics
Department of Medicine and Therapeutics
Hong Kong Institute of Diabetes and Obesity
Department of Metabolic and Bariatric Surgery
Department of Medicine
Metabolic and Bariatric
Department of Metabolic and Bariatric Surgery
Department of Hepatology
Universidad San Ignacio de Loyola
Department of Medicine
Department of Bariatric Surgery
Pengiran Anak Puteri Rashidah Saadatul Bolkiah Institute of Health Sciences
Liver Vascular Biology Laboratory
Department of Visceral Surgery and Medicine
Division of Gastroenterology and Hepatology
Surgical Gastroenterology
Nacogdoches Center for Metabolic & Weight Loss Surgery
Surgical Disease and Bariatric Surgery
Department of Metabolic
Liver Disease Research Center
Department of Metabolic and Bariatric Surgery
Department of General Surgery
Department of Gastroenterology & Hepatology
Duke-NUS Medical School
Department of Gastroenterology
Center for Prevention of Cardiovascular Disease
Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care
University Research Institute of Maternal and Child Health & Precision Medicine
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)
Faculty of Health Science
Clinical and Molecular Hepatology
Division of Pediatric Gastroenterology
Gastroenterology and Hepatology Unit
Faculty of Medicine
Department of Hepatology
Medical School
Pediatric Endocrinology and Diabetes
Departament of Surgery
Systems Biology of Complex Diseases
Department of Surgery
Department of Surgery
Department Surgical Diseases
Department of Medicine
Department of Medicine
Department of Surgery
Hepatobiliary Division
Digestive Disease & GI Oncology Center
Gastrointestinal Cancer Center
Department of Gastroenterology
MAFLD Research Center
Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province
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