Highlights
- •In 2019, the highest age-standardised DALYs were observed in obesity.
- •The highest age-standardised death rates in 2019 were observed for hypertension.
- •Eastern Mediterranean and low SDI countries had highest metabolic-related deaths.
- •Obesity surpasses hypertension as main driver of metabolic-related deaths by 2050.
- •Males will likely continue to bear the largest burden of metabolic diseases in 2050.
Abstract
Background
A significant proportion of premature deaths globally are related to metabolic diseases
in young adults. We examined the global trends and mortality of metabolic diseases
in individuals aged below 40 years using data from the Global Burden of Diseases,
Injuries and Risk Factors Study (GBD) 2019.
Methods
From 2000 to 2019, global estimates of deaths and disability-adjusted life years (DALYs)
were described for metabolic diseases (type 2 diabetes mellitus [T2DM], hyperlipidemia,
hypertension, obesity, non-alcoholic fatty liver disease [NAFLD]). Subgroup analyses
were performed based on sex, geographical regions and Socio-Demographic Index (SDI).
Age-standardised death and DALYs were presented per 100,000 population with 95 % uncertainty
intervals (UI). Projections of mortality and DALYs were estimated using regression
models based on the GBD 2019 data and combining them with Institute for Health Metrics
and Evaluation projection counts for years up to 2050.
Results
In 2019, the highest age-standardised death rates were observed in hypertension (133·88
[121·25–155·73]), followed by obesity (62·59 [39·92–89·13]), hyperlipidemia (56·51
[41·83–73·62]), T2DM (18·49 [17·18–19·66]) and NAFLD (2·09 [1·61–2·60]). Similarly,
obesity (1932·54 [1276·61–2639·74]) had the highest age-standardised DALYs, followed
by hypertension (2885·57 [2580·75–3201·05]), hyperlipidemia (1207·15 [975·07–1461·11]),
T2DM (801·55 [670·58–954·43]) and NAFLD (53·33 [40·73–68·29]). Mortality rates decreased
over time in hyperlipidemia (−0·6 %), hypertension (−0·47 %), NAFLD (−0·31 %) and
T2DM (−0·20 %), but not in obesity (1·07 % increase). The highest metabolic-related
mortality was observed in Eastern Mediterranean and low SDI countries. By 2050, obesity
is projected to contribute to the largest number of deaths (102·8 % increase from
2019), followed by hypertension (61·4 % increase), hyperlipidemia (60·8 % increase),
T2DM (158·6 % increase) and NAFLD (158·4 % increase), with males continuing to bear
the greatest burden across all metabolic diseases.
Conclusion
The growing burden of metabolic diseases, increasing obesity-related mortality trends,
and the sex-regional-socioeconomic disparities evident in young adulthood, underlie
the concerning growing global burden of metabolic diseases now and in future.
Graphical abstract
Graphical Abstract
Keywords
Abbreviation:
APC (annual percentage change), DALYs (disability-adjusted life years), GBD (global burden of diseases), HLD (hyperlipidemia), HTN (hypertension), ICD-10 (International Classification of Diseases-10), NAFLD (non-alcoholic fatty liver disease), NCDs (non-communicable diseases), SDI (Socio-Demographic Index), T2DM (type 2 diabetes mellitus), WHO (World Health Organisation), YLDs (years lived with disability)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 27, 2023
Accepted:
January 17,
2023
Received:
December 3,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
