1999-2022 年美国冠状动脉疾病和肥胖相关死亡率的趋势与差异》（Trends and Disparities in Coronary Artery Disease and Obesity-Related Mortality in the United States from 1999-2022）。

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM Endocrinology, Diabetes and Metabolism Pub Date : 2024-10-27 DOI:10.1002/edm2.70010

Mushood Ahmed, Hira Javaid, Aimen Shafiq, Zain Ali Nadeem, Areeba Ahsan, Abdullah Nofal, Raheel Ahmed, Mahboob Alam, Marat Fudim, Gregg C. Fonarow, Mamas A. Mamas

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引用次数: 0

摘要

背景：美国近一半的成年人患有肥胖症，肥胖易导致动脉粥样硬化，并可能导致冠状动脉疾病（CAD）预后不良。我们的目的是按年龄、性别、种族和地理位置分层，确定美国成年人中与冠状动脉疾病和肥胖相关的死亡率趋势：方法：使用 CDC-WONDER 数据库提取年龄≥25 岁成年人的死亡证明数据。计算每 10 万人的粗死亡率（CMR）和年龄调整死亡率（AAMR），并通过 Joinpoint 回归分析法计算死亡率的年百分比变化（APC）和平均 APC（AAPC）来描述时间趋势：结果：从 1999 年到 2022 年，美国共记录了 273,761 例与 CAD 和肥胖相关的死亡。从 1999 年到 2018 年，AAMR 持续上升（APC：4.3，95% 置信区间（CI）：3.4-4.9），此后一直飙升至 2022 年（APC：11.4；95% CI：7.7-19.1）。在 COVID-19 大流行期间（2020-2022 年），AAMR 几乎是研究期间其他时间的两倍。此外，男性的 AAMR 几乎是女性的两倍。非西班牙裔（NH）黑人或非裔美国人的 AAMR 最高，其次是 NH 白人、西班牙裔或拉丁裔以及其他 NH 人口。各人口普查地区的 AAMR 差异很小。农村地区的 AAMR（AAMR：5.9，95% CI：5.8-5.9）高于城市地区（AAMR：4.4，95% CI：4.4-4.5）：我们观察到，在整个研究期间，与 CAD 和肥胖相关的死亡人数呈上升趋势，并在 COVID-19 大流行期间达到高峰。

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Trends and Disparities in Coronary Artery Disease and Obesity-Related Mortality in the United States From 1999–2022

Background

Almost half of the US adult population has obesity, which predisposes to atherosclerosis and can lead to poor prognosis in coronary artery disease (CAD). We aim to identify CAD and obesity-related mortality trends among adults in the United States stratified by age, sex, race and geographical location.

Methods

The CDC-WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change (APC) and the average APC (AAPC) in the rates using Joinpoint regression analysis.

Results

From 1999 to 2022, a total of 273,761 CAD and obesity-related deaths were recorded in the United States. The AAMR increased consistently from 1999 to 2018 (APC: 4.3, 95% confidence interval (CI): 3.4–4.9) and surged thereafter till 2022 (APC: 11.4; 95% CI: 7.7–19.1). During the COVID-19 pandemic (2020–2022), AAMR almost doubled that of the rest of the study period. Additionally, the AAMR for males was nearly twice that of females. Non-Hispanic (NH) Blacks or African Americans displayed the highest AAMR, followed by NH Whites, Hispanic or Latino, and other NH populations. AAMRs showed minimal variation by census regions. Rural areas exhibited a higher AAMR (AAMR: 5.9, 95% CI: 5.8–5.9) than urban areas (AAMR: 4.4, 95% CI: 4.4–4.5).