Archives of Medical Science最新文献

Introduction: To evaluate global trends and SDI-related inequalities in the burden of ischemic heart disease (IHD) from 1990 to 2021, and project trajectories to 2035. This analysis provides crucial evidence to inform health policy and resource allocation for reducing future disparities.

Material and methods: Using Global Burden of Disease (GBD) 2021 data, we analyzed IHD prevalence, incidence, deaths, and disability-adjusted life years (DALYs) across 204 countries. Analyses included temporal trends, decomposition, inequality assessment, and Bayesian projections.

Results: From 1990 to 2021, global age-standardized death rates declined annually by 1.3% and DALYs by 1.2%, while prevalence showed a slight increase (AAPC = 0.03%). High-SDI regions achieved the largest reductions, whereas low- and middle-SDI regions experienced persistent or rising burdens. Decomposition analysis indicated that population growth (110%) and aging (67%) were the main drivers of increasing DALYs, partially offset by epidemiological improvements (-77%). By 2035, despite continued declines in age-standardized rates, the absolute number of IHD cases is projected to increase by 18.2%.

Conclusions: IHD remains a major global health challenge, with substantial SDI-driven disparities that persist despite overall progress. Strengthening prevention in low- and middle-SDI regions, addressing the growing healthcare demands of aging populations, and fostering sustained international collaboration are critical to reducing inequalities, guiding resource allocation, and ultimately alleviating the global burden.

Introduction: The global prevalence of estrogen-related cancers is often underappreciated, with a significant impact on women's health. Our goal is to explore the patterns and trends in estrogen-related cancers among women, both pre- and post-menopausal, spanning from 1990 to 2021. We conducted secondary analyses to assess the burden of estrogen-related cancers using data from GBD 2021.

Material and methods: We sourced data from the Global Burden of Disease Study (GBD) 2021, focusing on the incidence, mortality, and disability-adjusted life years (DALYs) for two predominant estrogen-related cancers: breast and ovarian cancer. This data encompassed 204 countries and territories, covering a period from 1990 to 2021. We calculated the estimated annual percentage changes (EAPC) across different age groups and socio-demographic indices (SDIs) to assess the evolving trends over time. Spearman's correlation analysis was employed to scrutinize the relationship between age-standardized rates and SDI. Furthermore, we utilized the Bayesian age-period-cohort model to forecast the trajectory of estrogen-related cancers from 2021 to 2035.

Results: From 1990 to 2021, the global age-standardized incidence rate (ASIR) for pre- and post-menopausal breast cancer and premenopausal ovarian cancer increased, while postmenopausal ovarian cancer declined. Meanwhile, the DALY and age-standardized mortality rate (ASMR) for two cancers showed a downward trend worldwide. Breast cancer is prevalent globally, followed by ovarian cancer, highlighting the disparities in the burden of estrogen-related cancers across different regions. Worldwide, the burden patterns of estrogen-related cancers differ significantly between pre- and post-menopausal women. In 2021, a strong positive correlation was found between the ASIR of two cancers and the ASMR of ovarian cancer with SDI (r > 0, p < 0.05), while a negative correlation existed between the ASMR of premenopausal breast cancer concerning SDI (r < 0, p < 0.05). Except for a drop in ASIR for postmenopausal ovarian cancer from 2021 to 2035, the ASIR for pre- and post-menopausal breast and premenopausal ovarian cancer is expected to rise. Predictions indicate an increase in the ASMR and DALYs for premenopausal estrogen-related cancers, while a decrease is expected for postmenopausal ones.

Conclusions: Estrogen-related cancers remain a major global health issue, with increasing burden. It is crucial for policymakers to stay informed about these trends, develop targeted screening strategies based on age and region, and allocate resources effectively.

Introduction: Physical inactivity is a well-established risk factor for ischemic stroke, yet the global burden of ischemic stroke attributable to physical inactivity among older adults remains poorly understood. This study aimed to investigate the global burden of ischemic stroke attributable to physical inactivity among adults aged 55 and above from 1990 to 2021, focusing on socioeconomic status, regional variations, and temporal trends.

Material and methods: We calculated death and disability-adjusted life years (DALYs) on a global scale and across various Socio-demographic Index (SDI) regions. To analyze temporal trends, we employed joinpoint regression analysis. The total changes in disease burden were partitioned into three fundamental drivers: aging demographics, population expansion, and epidemiological trends. Additionally, the Bayesian age-period-cohort model was applied to forecast future trends.

Results: The global age-standardized death rate (ASDR) declined from 12.9 (95% UI: -2.3 to 28.6) in 1990 to 8.8 (95% UI: -2.7 to 21.2) in 2021, with an estimated annual percentage change (EAPC) of -1.53 (95% CI: -1.68 to -1.38). High SDI regions experienced the sharpest declines in both deaths and ASDR, while low and low-middle SDI regions showed slower progress. Joinpoint regression analysis revealed distinct temporal trends, with high SDI regions exhibiting the most substantial declines. Decomposition analysis highlighted the contributions of population growth and aging to increased disease burden, while epidemiological changes played a beneficial role in reducing the burden. Age and sex patterns revealed progressive increases in death and DALY rates with age, along with gender disparities, particularly in older age groups. The Bayesian age-period-cohort (BAPC) model projected a U-shaped trend in global ASDR for males and a consistent decline for females by 2050.

Conclusions: This research offers a thorough evaluation of the global impact of ischemic stroke due to physical inactivity in older adults between 1990 and 2021. The results underscore substantial inequalities in socioeconomic status and regional progress, noting particularly slow advancements in low and middle-income countries. The study highlights the necessity for focused interventions, enhanced healthcare accessibility, and robust stroke prevention initiatives to mitigate the global impact of ischemic stroke linked to physical inactivity. Future investigations should concentrate on examining the socio-economic, cultural, and policy-driven factors shaping these trends, thereby informing evidence-based approaches to alleviate the burden of ischemic stroke.