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Abstract：
BACKGROUND: This study aims to analyze breast cancer burden attributable to high body mass index (BMI) and high fasting plasma glucose (FPG) in China from 1990 to 2019.
METHODS: Data were obtained from the Global Burden of Disease (GBD) study 2019. Deaths and disability-adjusted life years (DALYs) were used for attributable burden, and age-period-cohort (APC) model was used to evaluate the independent effects of age, period and birth cohort.
RESULTS: In 2019, the age-standardized mortality and DALY rates of breast cancer attributable to high BMI were 1.107 (95% UI: 0.311, 2.327) and 29.990 (8.384, 60.713) per 100 000, and mortality and DALY rates attributable to high FPG were 0.519 (0.095, 1.226) and 13.662 (2.482, 32.425) per 100 000. From 1990 to 2019, the age-standardized mortality and DALY rates of breast cancer attributable to high BMI increased by 1.192% and 1.180%, and the trends of high FPG were not statistically significant. The APC results showed that the age effects of high BMI and high FPG-mortality and DALY rates increased, with the highest rates in the age group over 80 years. The birth cohort effects of high BMI showed \"inverted V\" shapes, while high FPG showed downward trends.
CONCLUSIONS: Age was the main reason for the increase of attributable burden, and postmenopausal women were the high-risk groups. Therefore, targeted prevention measures should be developed to improve postmenopausal women\'s awareness and effectively reduce the prevalence of obesity and diabetes, thereby reducing the breast cancer burden caused by metabolic factors in China.
METHODS: Data were obtained from the Global Burden of Disease (GBD) study 2019. Deaths and disability-adjusted life years (DALYs) were used for attributable burden, and age-period-cohort (APC) model was used to evaluate the independent effects of age, period and birth cohort.
RESULTS: In 2019, the age-standardized mortality and DALY rates of breast cancer attributable to high BMI were 1.107 (95% UI: 0.311, 2.327) and 29.990 (8.384, 60.713) per 100 000, and mortality and DALY rates attributable to high FPG were 0.519 (0.095, 1.226) and 13.662 (2.482, 32.425) per 100 000. From 1990 to 2019, the age-standardized mortality and DALY rates of breast cancer attributable to high BMI increased by 1.192% and 1.180%, and the trends of high FPG were not statistically significant. The APC results showed that the age effects of high BMI and high FPG-mortality and DALY rates increased, with the highest rates in the age group over 80 years. The birth cohort effects of high BMI showed \"inverted V\" shapes, while high FPG showed downward trends.
CONCLUSIONS: Age was the main reason for the increase of attributable burden, and postmenopausal women were the high-risk groups. Therefore, targeted prevention measures should be developed to improve postmenopausal women\'s awareness and effectively reduce the prevalence of obesity and diabetes, thereby reducing the breast cancer burden caused by metabolic factors in China.
摘要：
背景：这项研究旨在分析1990年至2019年中国归因于高体重指数（BMI）和高空腹血糖（FPG）的乳腺癌负担。
方法：数据来自2019年全球疾病负担（GBD）研究。死亡和残疾调整寿命年(DALYs)用于归因负担，和年龄周期队列（APC）模型用于评估年龄的独立影响，时期和出生队列。
结果：2019年，归因于高BMI的乳腺癌的年龄标准化死亡率和DALY率为1.107（95％UI：0.311，2.327）和29.990（8.384，60.713）/100000，归因于高FPG的死亡率和DALY率为0.519（0.095，1.226）和13.662（2.48232.425）/100000。从1990年到2019年，高BMI导致的乳腺癌的年龄标准化死亡率和DALY率分别增加了1.192%和1.180%。高FPG趋势无统计学意义。APC结果显示，高BMI和高FPG死亡率和DALY率的年龄效应增加，在80岁以上的年龄组中发病率最高。高BMI的出生队列效应表现为“倒V”形，而高FPG呈下降趋势。
结论：年龄是归因负担增加的主要原因，绝经后妇女是高危人群。因此,制定针对性的预防措施,提高绝经后妇女的认识,有效降低肥胖和糖尿病的患病率,从而减轻我国代谢因素引起的乳腺癌负担。
方法：数据来自2019年全球疾病负担（GBD）研究。死亡和残疾调整寿命年(DALYs)用于归因负担，和年龄周期队列（APC）模型用于评估年龄的独立影响，时期和出生队列。
结果：2019年，归因于高BMI的乳腺癌的年龄标准化死亡率和DALY率为1.107（95％UI：0.311，2.327）和29.990（8.384，60.713）/100000，归因于高FPG的死亡率和DALY率为0.519（0.095，1.226）和13.662（2.48232.425）/100000。从1990年到2019年，高BMI导致的乳腺癌的年龄标准化死亡率和DALY率分别增加了1.192%和1.180%。高FPG趋势无统计学意义。APC结果显示，高BMI和高FPG死亡率和DALY率的年龄效应增加，在80岁以上的年龄组中发病率最高。高BMI的出生队列效应表现为“倒V”形，而高FPG呈下降趋势。
结论：年龄是归因负担增加的主要原因，绝经后妇女是高危人群。因此,制定针对性的预防措施,提高绝经后妇女的认识,有效降低肥胖和糖尿病的患病率,从而减轻我国代谢因素引起的乳腺癌负担。
