2011年与2017年南京市人群归因于代谢危险因素的脑血管病疾病负担

目的  分析2011年与2017年南京市年龄≥ 25岁人群归因于代谢危险因素的脑血管病疾病负担变化。 方法  利用南京市慢性病监测和全球疾病负担资料，根据人群归因分值，分析2011年和2017年高收缩压、高血糖、高总胆固醇、高体重指数和4种代谢因素合并导致脑血管病患者死亡和寿命损失的变化。 结果  2017年，南京市归因于代谢因素合并的脑血管病死亡数为4 978例，导致期望寿命损失1.43岁。高收缩压是导致南京市脑血管病死亡（35.51%）和过早死亡损失寿命年（years of life lost due to premature mortality，YLL）（38.89%）上升的首位代谢因素。与2011年相比，2017年人群归因于高收缩压、高体重指数的脑血管病标化死亡率和标化YLL率均下降，高血糖则相反。男性各代谢因素导致的脑血管病标化YLL率均高于女性。 结论  代谢危险因素尤其高收缩压是导致南京市脑血管病死亡的重要危险因素。有效控制人群体重、血压、血糖和血脂水平，可降低南京市脑血管病疾病负担。

Burden of cerebrovascular diseases attributable to metabolic risks in 2011 and 2017 in Nanjing

  Objective  To analyze the burden of cerebrovascular diseases attributable to metabolic risks in Nanjing population aged 25 years and older in 2011 and 2017.  Methods  The data were extracted from the Nanjing Chronic Disease and Risk Factor Surveillance, the Nanjing Mortality Surveillance and the 2016 Global Burden of Disease Study. Based on population attributable fractions, the deaths and life expectancy losses of cerebrovascular diseases attributable to high systolic blood pressure, high fasting plasma glucose, high total cholesterol, high body mass index and four metabolic risks combination were estimated in 2011 and 2017.  Results  The number of cerebrovascular diseases death attributable to four metabolic risks combination was 4 978, and resulted in a loss of life expectancy of 1.43 years in 2017. High systolic blood pressure appeared as the major cause on cerebrovascular diseases deaths (35.51%) and years of life lost due to premature mortality (YLL) (38.89%). Compared to 2011, the standardized rate of mortality and YLL on cerebrovascular diseases due to high systolic blood pressure and high body mass index in 2017 showed downward trend, while high fasting plasma glucose showed upward trend. Males appeared to have higher standardized rate of YLL on cerebrovascular diseases than females.  Conclusions  Metabolic exposures especially high blood pressure were important risk factors attributable to cerebrovascular diseases deaths in Nanjing. Proper management of hypertension, diabetes, dyslipidemia and obesity could remarkably reduce the pervasive burden of cerebrovascular diseases.