1990-2019年中国归因于高BMI的肾癌疾病负担

目的:描述和分析1990-2019年中国人群归因于高体质量指数（body mass index,BMI）的肾癌疾病负担变化趋势。方法:基于2019年全球疾病负担研究(GBD2019)部分数据，按照性别、年龄、年份对近三十年归因于高BMI的肾癌人群死亡数、伤残调整寿命年(disability adjusted life year,DALY)、过早死亡损失寿命年（years of life lost,YLL）和伤残损失寿命年（years lived with disability,YLD）及其年龄标化率等指标分类记录。并采用Joinpoint回归模型计算平均年度变化百分比（AAPC）反映中国与全球以及不同社会人口学指数（socio-demographic index,SDI）地区归因于高BMI的肾癌疾病负担及其变化趋势。结果:从1990到2019年，中国归因于高BMI的肾癌疾病的标化死亡率由0.03/10万上升至0.13/10万，标化DALY率从0.86/10万增加到3.45/10万，增长率分别为333%和301%。伴随年龄增加，死亡率、DALY率、YLL率和YLD率均明显上升，在DALY率的占比中，YLD率值虽低于YLL率，但增速较YLL率快。中国归因标化死亡率和标化DALY率的增长趋势显著高于全球及不同SDI地区，AAPC分别高达4.8%和4.9%（P均＜0.05)，且男性的增长速率较女性更显著。结论:1990-2019年我国归因于高BMI的肾癌负担进行性加重并呈持续上升状态，早死导致疾病负担比重大，伤残疾病负担增速快，尤其是在男性和老年人群中更为显著。对此，积极控制肥胖/超重、加强肾癌早期筛查、注重康复指导和健康干预成为减轻疾病负担的重要措施。

Disease burden of renal cancer attributable to high BMI in China from 1990 to 2019

Objective:To describe and analyze the variation tendency of renal cancer burden attributed to high body mass index（BMI） in China from 1990 to 2019.Methods:Partial data were obtained from the Global Burden of Disease Study 2019(GBD2019),the indicators such as mortality,disability adjusted life year(DALY),years of life lost(YLL),years lived with disability(YLD) and their age-standardized rates attributed to high BMI in the renal cancer population in the past thirty years were recorded by gender,age and year.The Joinpoint regression model was used to calculate the average annual percentage change(AAPC) reflecting the burden of renel cancer disease attributable to high BMI and its changing trend in China versus the global and different socio-demographic index(SDI) regions.Results:From 1990 to 2019,the standardized mortality rate of renal cancer due to high BMI in China increased from 0.03/100 000 to 0.13/100 000,and the standardized DALY rate increased from 0.86/100 000 to 3.45/100 000,with growth rates of 333% and 301% respectively.With the increase of age,the mortality rate,DALY rate,YLL rate and YLD rate all increased obviously.In the proportion of DALY rate,the YLD rate value was lower than the YLL rate,but its growth rate was faster than YLL rate.The increasing trends of attributed standardized mortality and DALY rates were significantly higher in China than globally and different SDI regions,with AAPC reaching 4.8% and 4.9%,respectively(both P<0.05),and the growth rate of male was more significant than that of female in China.Conclusion:From 1990 to 2019,the burden of renal cancer due to high BMI in China increased progressively and kept on rising,with the premature death led to a larger disease burden，and the burden of disability increased rapidly,especially in male and the elderly.Therefore,actively controlling obesity/overweight,strengthening early screening of renal cancer,focusing on rehabilitation guidance and health intervention have become important measures to reduce the disease burden.