2013年中国居民高盐饮食对死亡和期望寿命的影响

目的 定量估计中国居民高盐饮食相关的死亡和期望寿命损失，并分析在不同的控制场景下相关死亡和期望寿命损失的变化。方法 利用全国死因监测系统2013年死因监测数据，以及全球疾病负担对中国居民24 h尿钠的估计值，按照比较风险评估理论，采用人群归因分值计算2013年中国居民高盐饮食归因死亡和期望寿命损失。应用相同的方法预测在达到不同的控制目标下，归因死亡和期望寿命损失的变化情况。结果 2013年中国居民归因于高盐饮食的死亡约143万人，占全部死亡的15.6%，其中男性94万（17.4%），女性49万（13.0%），造成中国居民期望寿命损失达2.17岁（男性2.49岁，女性1.71岁）。高盐饮食导致心脑血管病、慢性肾病和胃癌死亡分别约120万人、5万人和18万人，占该疾病死亡的31.5%、30.8%和64.8%。如果实现到2020年食盐摄入量下降10%，到2025年下降15%的慢性病防治规划目标，以及2025年下降30%的WHO自愿性目标，将分别避免死亡约22万人、34万人和73万人，人均期望寿命损失将分别减少0.30岁、0.45岁和0.95岁。结论 高盐饮食给中国居民带来了沉重的疾病负担，是导致心脑血管病、慢性肾病和胃癌死亡的重要危险因素。积极开展有效的综合减盐干预，将带来很好的成本效果。

Deaths and life expectancy losses attributable to diet high in sodium in China

Objective To quantitatively estimate the deaths and life expectancy losses attributable to diet high in sodium in China, and examine the gains and shifts under different control scenarios of sodium consumption. Methods Based on data from the cause-of-death through the National Mortality Surveillance System, and 24 hours urinary sodium values from Global Burden of Disease study on Chinese''s estimates, population attributable fractions with the framework of comparative risk assessment were used to analyze the deaths and life expectancy losses due to diet high in sodium. The same methods were followed to examine the gains and shifts under different control scenarios of sodium consumption. Results In 2013, 1 430 (940 for men and 490 for women) thousand deaths were attributable to diet high in sodium, accounting for 15.6% (17.4% for men and 13.0% for women) of all-cause deaths in China, which causing 2.17 (2.49 for men and 1.71 for women) years of life expectancy loss. Diet with high sodium in 2013 caused 1 200, 50 and 180 thousand deaths from cardiovascular disease, chronic kidney disease and stomach cancer respectively, accounting for 31.5%, 30.8% and 64.8% of those specific causes. Comparing to the baseline in 2013, if the targets of 10% decrease of sodium consumption by 2020 and 15% by 2030 for Chinese chronic disease prevention and treatment planning, and 30% decrease by 2030 for WHO non-communicable disease monitoring framework are achieved, 220, 340 and 730 thousand deaths will be averted, which may gain 0.30, 0.45 and 0.95 years of life expectancy, respectively. Conclusions As one of the leading risk factors, diet high in sodium had caused heavy burden of disease from cardiovascular disease, chronic kidney disease and stomach cancer on Chinese residents. Intervention programs on sodium-reduction are urgently needed in China and related cost-effectiveness is highly expected.