Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021.
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ABSTRACT:
SUBMITTER: GBD 2021 Diabetes Collaborators
PROVIDER: S-EPMC10364581 | biostudies-literature | 2023 Jul
REPOSITORIES: biostudies-literature
Publications
Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021.
Lancet (London, England) 20230622 10397
<h4>Background</h4>Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diab ...[more]
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Project description:Summary Background Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021–30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. Methods In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. Findings Globally, 595 million (95% uncertainty interval 535–656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8–8·4) of the global population, and an increase of 132·2% (130·3–134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4–89·9) for knee, 48·6% (35·9–67·1) for hand, 78·6% (57·7–105·3) for hip, and 95·1% (68·1–135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7–557·2) per 100 000 in 2020, a 9·5% (8·6–10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3–510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8–6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0–9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI –1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. Interpretation Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage. Funding Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
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Project description:BackgroundGout is an inflammatory arthritis manifesting as acute episodes of severe joint pain and swelling, which can progress to chronic tophaceous or chronic erosive gout, or both. Here, we present the most up-to-date global, regional, and national estimates for prevalence and years lived with disability (YLDs) due to gout by sex, age, and location from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, as well as forecasted prevalence to 2050.MethodsGout prevalence and YLDs from 1990 to 2020 were estimated by drawing on population-based data from 35 countries and claims data from the USA and Taiwan (province of China). Nested Bayesian meta-regression models were used to estimate prevalence and YLDs due to gout by age, sex, and location. Prevalence was forecast to 2050 with a mixed-effects model.FindingsIn 2020, 55·8 million (95% uncertainty interval 44·4-69·8) people globally had gout, with an age-standardised prevalence of 659·3 (525·4-822·3) per 100 000, an increase of 22·5% (20·9-24·2) since 1990. Globally, the prevalence of gout in 2020 was 3·26 (3·11-3·39) times higher in males than in females and increased with age. The total number of prevalent cases of gout is estimated to reach 95·8 million (81·1-116) in 2050, with population growth being the largest contributor to this increase and only a very small contribution from the forecasted change in gout prevalence. Age-standardised gout prevalence in 2050 is forecast to be 667 (531-830) per 100 000 population. The global age-standardised YLD rate of gout was 20·5 (14·4-28·2) per 100 000 population in 2020. High BMI accounted for 34·3% (27·7-40·6) of YLDs due to gout and kidney dysfunction accounted for 11·8% (9·3-14·2).InterpretationOur forecasting model estimates that the number of individuals with gout will increase by more than 70% from 2020 to 2050, primarily due to population growth and ageing. With the association between gout disability and high BMI, dietary and lifestyle modifications focusing on bodyweight reduction are needed at the population level to reduce the burden of gout along with access to interventions to prevent and control flares. Despite the rigour of the standardised GBD methodology and modelling, in many countries, particularly low-income and middle-income countries, estimates are based on modelled rather than primary data and are also lacking severity and disability estimates. We strongly encourage the collection of these data to be included in future GBD iterations.FundingBill & Melinda Gates Foundation and the Global Alliance for Musculoskeletal Health.
| S-EPMC11263476 | biostudies-literature
Project description:AimsThis study examines global trends in cardiovascular disease (CVD) associated with kidney dysfunction (KD) from 1990 to 2021 and projects future trends through 2050.MethodsThis study analyzed the 2021 Global Burden of Disease (GBD) database, focusing on age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years rate (ASDR), absolute numbers, estimated annual percentage change, and average annual percent change. A Bayesian age-period-cohort model was employed to project global trends from 2022 to 2050. Variables included age, gender, national levels, and Socio-demographic Index (SDI) regions.ResultsFrom 1990 to 2021, the CVD burden from KD increased, with deaths rising from 1,312,393 to 2,095,800 and DALYs from 27,382,767 to 41,589,861. However, the ASMR decreased from 40.58 per 100,000 in 1990 to 25.55 in 2021, while ASDR fell from 742.17 to 489.81 during the same period. The burden was higher in men, peaking at ages 70-74 and in women at ages 85-89. Regions with lower-middle and low SDI recorded the highest CVD burden, inversely related to SDI levels. Geographically, Central Asia and Eastern Europe recorded the highest rates, while high-income Asia Pacific and Southern Latin America had the lowest. Projections suggest a sustained decline in global CVD burden due to KD from 2022 to 2050, although disparities between sexes are expected to persist, with men bearing a heavier burden.ConclusionCVD attributable to KD remains a major global public health challenge, especially for men, the elderly, and low SDI regions. These spatial and temporal variations highlight the need for region-specific healthcare strategies.
| S-EPMC11869346 | biostudies-literature
Project description:BackgroundRheumatoid arthritis is a chronic autoimmune inflammatory disease associated with disability and premature death. Up-to-date estimates of the burden of rheumatoid arthritis are required for health-care planning, resource allocation, and prevention. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we provide updated estimates of the prevalence of rheumatoid arthritis and its associated deaths and disability-adjusted life-years (DALYs) by age, sex, year, and location, with forecasted prevalence to 2050.MethodsRheumatoid arthritis prevalence was estimated in 204 countries and territories from 1990 to 2020 using Bayesian meta-regression models and data from population-based studies and medical claims data (98 prevalence and 25 incidence studies). Mortality was estimated from vital registration data with the Cause of Death Ensemble model (CODEm). Years of life lost (YLL) were calculated with use of standard GBD lifetables, and years lived with disability (YLDs) were estimated from prevalence, a meta-analysed distribution of rheumatoid arthritis severity, and disability weights. DALYs were calculated by summing YLLs and YLDs. Smoking was the only risk factor analysed. Rheumatoid arthritis prevalence was forecast to 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates.FindingsIn 2020, an estimated 17·6 million (95% uncertainty interval 15·8-20·3) people had rheumatoid arthritis worldwide. The age-standardised global prevalence rate was 208·8 cases (186·8-241·1) per 100 000 population, representing a 14·1% (12·7-15·4) increase since 1990. Prevalence was higher in females (age-standardised female-to-male prevalence ratio 2·45 [2·40-2·47]). The age-standardised death rate was 0·47 (0·41-0·54) per 100 000 population (38 300 global deaths [33 500-44 000]), a 23·8% (17·5-29·3) decrease from 1990 to 2020. The 2020 DALY count was 3 060 000 (2 320 000-3 860 000), with an age-standardised DALY rate of 36·4 (27·6-45·9) per 100 000 population. YLDs accounted for 76·4% (68·3-81·0) of DALYs. Smoking risk attribution for rheumatoid arthritis DALYs was 7·1% (3·6-10·3). We forecast that 31·7 million (25·8-39·0) individuals will be living with rheumatoid arthritis worldwide by 2050.InterpretationRheumatoid arthritis mortality has decreased globally over the past three decades. Global age-standardised prevalence rate and YLDs have increased over the same period, and the number of cases is projected to continue to increase to the year 2050. Improved access to early diagnosis and treatment of rheumatoid arthritis globally is required to reduce the future burden of the disease.FundingBill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
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Project description:BackgroundNeck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050.MethodsSystematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2·5th and 97·5th percentiles of 100 draws of the posterior distribution.FindingsGlobally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32·5% (23·9-42·3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing.InterpretationAlthough age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain.FundingBill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.
| S-EPMC10897950 | biostudies-literature
Project description:IntroductionChronic kidney disease (CKD) is a serious complication of diabetes, and the global burden of the disease is gradually increasing.MethodsThis study systematically analyzed the trends and future projections of the worldwide burden of chronic kidney disease caused by type 1 and type 2 diabetes mellitus based on the Global Burden of Disease Study (GBD) using data from 1990 to 2021. Number of deaths, Age-standardized mortality rates, disability-adjusted life years (DALYs), and age-standardized DALYs rate were used to estimate the disease burden. The study used Estimated Annual Percentage Changes (EAPCs) to calculate trends in the burden of each disease subtype and different regions and assessed the impact of various age groups and metabolic factors on chronic kidney disease due to diabetes. The ARIMA model was further used to predict the burden of Diabetic nephropathy from 2022 to 2050.ResultsThe results of the study showed that the burden of Diabetic nephropathy and its EAPCs varied significantly in distribution across different Sociodemographic Index subgroups of countries as well as among 204 countries and regions worldwide. In addition, the influence of different age groups and metabolic factors on the burden of Diabetic nephropathy also showed significant variability. The effects of metabolic factors on the number of deaths and mortality were positively correlated with age. Different metabolic factors have different effects on the mortality of CKD due to type 1 diabetes and CKD due to type 2 diabetes. The ARIMA model predicts that the global burden of Diabetic nephropathy will continue to increase in the absence of interventions.ConclusionsTo effectively manage CKD caused by diabetes, more accurate and cost-effective diagnostic tools and interventions are needed in the future, especially in low - and middle-income countries with poor healthcare resources.
| S-EPMC11885120 | biostudies-literature
Project description:BackgroundMusculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050.MethodsPrevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts.FindingsGlobally, 494 million (95% uncertainty interval 431-564) people had other musculoskeletal disorders in 2020, an increase of 123·4% (116·9-129·3) in total cases from 221 million (192-253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107-124) from 2020 to 2050, to an estimated 1060 million (95% UI 964-1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47·4% (44·9-49·4) higher in females than in males and increased with age to a peak at 65-69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42·7 million [29·4-60·0]) and was associated with 83 100 deaths (73 600-91 600).InterpretationOther musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data.FundingBill & Melinda Gates Foundation.
| S-EPMC10620749 | biostudies-literature
Project description:BackgroundGastric cancer (GC) is a common malignancy of the digestive system, with significant geographical variation in its disease burden.MethodsThis study used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to analyze three key indicators: incidence, mortality, and disability-adjusted life years (DALYs). Initially, a detailed analysis of the GC burden was conducted from global, regional, national, gender, and age perspectives. Subsequently, the percentage change and average annual percent change (AAPC) of GC were calculated to understand the trends in disease burden. Decomposition analysis and frontier analysis were then performed. Finally, the Bayesian age-period-cohort model was used to predict the trends in age-standardized rates (ASRs) of GC up to 2040.ResultsIn 2021, there were 1.23 million (95% UI: 1.05-1.41 million) new cases of GC globally, with 0.95 million (95% UI: 0.82-1.10million) deaths and 22.79 million (95% UI: 19.58-26.12 million) DALYs. Compared to 1990, the global ASRs of GC has declined, but new cases and deaths have increased. For females, age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALYs rate were 8.6, 7.1, and 165.6 per 100,000, with AAPCs of -2.1, -2.4, and -2.6. For males, they were 20.9, 16.0, and 371.2 per 100,000, with AAPCs of -1.6, -2.1, and -2.3. ASRs fluctuated with increasing Socio-demographic Index (SDI), being higher in middle and high-middle SDI regions. Decomposition analysis indicated negative effects from epidemiological trends on GC burden, while population growth and aging had positive effects. Frontier analysis showed that middle and high-middle SDI regions had more potential for reducing ASRs. Predictions indicate a continued decline in ASRs for both genders by 2040.ConclusionDespite progress in controlling GC, the number of new cases and deaths globally is rising due to population growth and aging. This highlights the need for effective prevention and control strategies.
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Project description:BackgroundThe incidence and mortality rates of pancreatic cancer are rising globally. This study examines global and regional trends in pancreatic cancer incidence, Disability Adjusted Life Years (DALYs), and mortality from 1990 to 2021, utilizing data from the most recent Global Burden of Disease (GBD) 2021 database.MethodsData were sourced from the GBD database over the period from 1990 to 2021. Age-standardized rates for incidence, DALYs, and mortality were calculated per 100,000 population. We also calculated the proportion of DALYs and mortality attributable to risk factors. The Bayesian age-period-cohort model was applied to project future trends until 2050.ResultsBetween 1990 and 2021, the global incidence of pancreatic cancer increased significantly, with the number of cases rising from approximately 207,905 to 508,533 and the age-standardized incidence rate (ASIR) increasing from 5.47 to 5.96 per 100,000 population. The global burden of pancreatic cancer, measured in DALYs, rose from 5.21 million to 11.32 million. Mortality rates showed a similar upward trend, with the number of deaths increasing from around 211,613 to 505,752, and the age-standardized mortality rate (ASMR) rising from 5.655 to 5.948 per 100,000 population. Notable increases in ASIR and ASMR were observed in low-middle and low sociodemographic index regions with males experienced higher rates compared to females. Age-standardized DALYs rate (ASDR) and ASMR worldwide were attributable to tobacco smoking, high BMI, and high fasting plasma glucose. Furthermore, our projection model estimates that the ASIR and ASMR of pancreatic cancer will significantly decline, while the ASDR is anticipated to maintain a steady downward trend by 2050.ConclusionThis study offers a comprehensive analysis of pancreatic cancer trends, providing crucial insights for public health planning and policy-making. Addressing identified risk factors and targeting high-risk populations are essential for effective strategies to reduce the global burden of pancreatic cancer.
| S-EPMC11789343 | biostudies-literature
Project description:Study designThis was an observational study.ObjectiveAssessing the global burden of disease for low back pain (LBP) using the 2021 GBD (Global Burden of Disease) database.Summary of background dataLBP is a leading cause of workforce loss and disability. With societal aging and changes in lifestyle and work habits, the incidence of LBP is expected to rise. This study comprehensively analyzes the epidemiological trends of global LBP from 1990 to 2021.MethodsData publicly available from the 2021 GBD study were utilized, and a systematic analysis was conducted to assess the global burden and epidemiological trends of LBP.ResultsFrom 1990 to 2021, the age-standardized prevalence, incidence, and Years Lived with Disability (YLD) rates of LBP have slightly declined globally. However, the number of affected individuals, new cases, and YLD numbers have significantly increased, making LBP a leading cause of YLD in 2021. The number of affected individuals increases with age, peaking in both men and women between the ages of 50 and 54. Worldwide, women have a higher prevalence of LBP than men, and this increases with age, with both sexes reaching peak prevalence between 80 and 84 years in 2021. Overall, over the past 3 decades, age-standardized YLD rates have shown a positive correlation with the Socio-demographic Index (SDI). In terms of region and nation, Tropical Latin America and Kingdom of Sweden have seen the greatest increase in age-standardized prevalence rates from 1990 to 2021.ConclusionGlobally, LBP remains a notable public health concern, carrying a consistently high burden. To alleviate the future impact of this disease, it is imperative to increase public awareness regarding its risk factors and to implement preventive measures.
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