DataSheet_2_Global, regional and national burden of endocrine, metabolic, blood and immune disorders 1990-2019: a systematic analysis of the Global Burden of Disease study 2019.pdf

BackgroundEndocrine, metabolic, blood and immune disorders (EMBID) is a vital public health problem globally, but the study on its burden and global trends was scarce. We aimed to evaluate the global burden of disease and trends in EMBID from 1990 to 2019.
MethodsWe extracted the data of EMBID-related on death cases, Age-standardized death rates (ASDRs), disability-adjusted life-years (DALYs), Age-standardized DALY rates, years of life lost (YLLs), Age-standardized YLL rates, years lived with disability (YLDs) and Age-standardized YLD rates between 1990 and 2019 from the Global Burden of Disease 2019, by sex, age, and year at the global and geographical region levels. The Annual rate of change was directly extracted from Global Health Data Exchange (GHDx) and we also calculated the age-related age-standardized rate (ASR) to quantify trends in EMBID-related deaths, DALYs, YLLs and YLDs.
ResultGlobally, the EMBID-related ASDRs showed an increasing trend, whereas the DALYs ASR, YLLs ASR and YLDs ASR were decreased between 1990 to 2019. Furthermore, High-income North America and Southern Sub-Saharan Africa had the highest both ASDRs and DALYs ASR, and Southern Sub-Saharan Africa and Caribbean had the highest both YLDs ASR and YLLs ASR in 2019. Males had a higher EMBID-related ASDRs than females, but the DALYs ASR in females were higher than males. The burden of EMBID was higher in older-aged compared to other age groups, especially in developed regions.
ConclusionAlthough EMBID-related ASRs for DALYs-, YLLs- and YLDs declined at the global level from 1990 to 2019, but the ASDRs was increasing. This implied high healthcare costs and more burden of ASDRs due to EMBID in the future. Therefore, there was an urgent need to adopt geographic targets, age-specific targets, prevention strategies and treatments for EMBID to reduce negative health outcomes globally.

背景
内分泌、代谢、血液与免疫疾病（Endocrine, metabolic, blood and immune disorders, EMBID）是全球重大公共卫生问题，但针对其疾病负担与全球流行趋势的研究仍较为匮乏。本研究旨在评估1990年至2019年全球EMBID的疾病负担与流行趋势。

方法
我们从2019年全球疾病负担（Global Burden of Disease 2019）数据库中，提取了1990年至2019年间与EMBID相关的死亡病例、年龄标准化死亡率（Age-standardized death rates, ASDRs）、伤残调整寿命年（disability-adjusted life-years, DALYs）、年龄标准化DALY率、寿命损失年（years of life lost, YLLs）、年龄标准化YLL率、伤残生存年（years lived with disability, YLDs）以及年龄标准化YLD率的数据，覆盖全球及各地理区域层面，按性别、年龄组与年份进行分层统计。我们直接从全球健康数据交换平台（Global Health Data Exchange, GHDx）获取年度变化率数据，并通过计算年龄相关年龄标准化率（age-related age-standardized rate, ASR），以量化EMBID相关死亡、DALYs、YLLs及YLDs的流行趋势。

结果
1990年至2019年，全球范围内EMBID相关的年龄标准化死亡率呈上升趋势，而DALYs年龄标准化率、YLLs年龄标准化率及YLDs年龄标准化率均呈下降趋势。进一步分析显示，2019年，北美高收入地区与撒哈拉以南非洲南部地区的年龄标准化死亡率与DALYs年龄标准化率均处于最高水平；而撒哈拉以南非洲南部地区与加勒比地区的YLDs年龄标准化率及YLLs年龄标准化率最高。男性的EMBID相关年龄标准化死亡率高于女性，但女性的DALYs年龄标准化率高于男性。与其他年龄组相比，老年人群的EMBID疾病负担更高，这一特征在发达地区尤为显著。

结论
尽管1990年至2019年全球范围内，与EMBID相关的DALYs、YLLs及YLDs年龄标准化率均有所下降，但年龄标准化死亡率呈上升态势。这提示未来EMBID相关的医疗成本将居高不下，且相关疾病负担将进一步加重。因此，全球亟需针对不同地理区域、特定年龄组制定针对性的预防策略与治疗方案，以降低EMBID带来的不良健康结局。