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Abstract：
Due to the essential role of calcium in vital biological functions, diet low in calcium (DLC) is associated with various diseases. However, there is a lack of study about the current prevalence and health burden due to DLC using reliable data sources.
We used data from the Global Burden of Disease study 2019 (GBD 2019) to estimate the prevalence and health burden of DLC in 204 countries from 1990 to 2019, by age, sex, and sociodemographic index (SDI). The estimates were produced in DisMod-MR 2.1, a Bayesian meta-regression tool. Summary exposure value (SEV) was used to show the prevalence of DLC, while diseases adjusted life year (DALY) was used to represent the disease burden. The disease burden was estimated for DLC-induced colorectal cancer. Spearman Rank Order correlation was used for correlation analysis, and estimated annual percentage (EAPC) was used to reflect the temporal trends.
From 1990 to 2019, the global prevalence of DLC decreased (EAPC of SEV, -0.47; 95% CI, -0.5 to -0.43), but have increased in Oceania region and in many countries, such as United Arab Emirates, New Zealand, Japan, and France. The global DALYs associated with low in calcium were estimated to be 3.14 million (95% uncertainty interval (UI), 2.25-4.26 million) in 2019, with an age standardized rate of 38.2 (95% UI, 27.2-51.8) per 100,000. Unlike the prevalence, the global age standardized DALY rates has remained unchanged (EAPC, -0.03; 95% CI, -0.12 to 0.07), but has increased in over 80 of the 204 countries, located mainly in Asia, Africa, and South America. In all years and regions, the age standardized SEV and DALY rates were higher in male people than that in female people. The prevalence (rho = -0.823; P < 0.001) and disease burden (rho = -0.433; P < 0.001) associated with diet in low calcium were strongly correlated to SDI. The prevalence decreased with age, but the DALY rates increased with age and peaked at about 90 years. The prevalence of DLC has decreased worldwide and in most countries, but the disease burden of DLC induced colorectal cancer has increased in over 40% of countries worldwide.
Countries with low sociodemographic level and male people are more likely to experience the risk of DLC and related disease burden. Related measures in improve dietary calcium intake are in need to address diet in low calcium related health problems.
We used data from the Global Burden of Disease study 2019 (GBD 2019) to estimate the prevalence and health burden of DLC in 204 countries from 1990 to 2019, by age, sex, and sociodemographic index (SDI). The estimates were produced in DisMod-MR 2.1, a Bayesian meta-regression tool. Summary exposure value (SEV) was used to show the prevalence of DLC, while diseases adjusted life year (DALY) was used to represent the disease burden. The disease burden was estimated for DLC-induced colorectal cancer. Spearman Rank Order correlation was used for correlation analysis, and estimated annual percentage (EAPC) was used to reflect the temporal trends.
From 1990 to 2019, the global prevalence of DLC decreased (EAPC of SEV, -0.47; 95% CI, -0.5 to -0.43), but have increased in Oceania region and in many countries, such as United Arab Emirates, New Zealand, Japan, and France. The global DALYs associated with low in calcium were estimated to be 3.14 million (95% uncertainty interval (UI), 2.25-4.26 million) in 2019, with an age standardized rate of 38.2 (95% UI, 27.2-51.8) per 100,000. Unlike the prevalence, the global age standardized DALY rates has remained unchanged (EAPC, -0.03; 95% CI, -0.12 to 0.07), but has increased in over 80 of the 204 countries, located mainly in Asia, Africa, and South America. In all years and regions, the age standardized SEV and DALY rates were higher in male people than that in female people. The prevalence (rho = -0.823; P < 0.001) and disease burden (rho = -0.433; P < 0.001) associated with diet in low calcium were strongly correlated to SDI. The prevalence decreased with age, but the DALY rates increased with age and peaked at about 90 years. The prevalence of DLC has decreased worldwide and in most countries, but the disease burden of DLC induced colorectal cancer has increased in over 40% of countries worldwide.
Countries with low sociodemographic level and male people are more likely to experience the risk of DLC and related disease burden. Related measures in improve dietary calcium intake are in need to address diet in low calcium related health problems.
摘要：
背景：由于钙在重要的生物学功能中具有必不可少的作用，低钙饮食（DLC）与各种疾病有关。然而,缺乏使用可靠数据源对DLC造成的当前患病率和健康负担的研究.
方法：我们使用了2019年全球疾病负担研究（GBD2019）的数据，按年龄估算了1990年至2019年204个国家DLC的患病率和健康负担，性别,和社会人口统计学指数(SDI)。这些估计是在DisMod-MR2.1中产生的，这是一个贝叶斯元回归工具。摘要暴露值（SEV）用于显示DLC的患病率，而疾病调整生命年(DALY)用于代表疾病负担。估计DLC诱导的结直肠癌的疾病负担。采用Spearman秩相关进行相关分析，估计的年度百分比(EAPC)用于反映时间趋势。
结果：从1990年到2019年，DLC的全球患病率下降（SEV的EAPC，-0.47；95%CI，-0.5至-0.43），但在大洋洲地区和许多国家有所增加，如阿拉伯联合酋长国，新西兰,Japan,和法国。与低钙相关的全球DALYs估计为314万(95%不确定区间(UI)，2019年2.25-426万），年龄标准化率为38.2（95%UI，27.2-51.8）每100,000。与流行程度不同，全球年龄标准化DALY率保持不变(EAPC，-0.03；95%CI，-0.12至0.07），但是在204个国家中的80多个国家中，主要位于亚洲，非洲,和南美洲。在所有年份和地区，男性的年龄标准化SEV和DALY率高于女性。与低钙饮食相关的患病率（rho=-0.823;P<0.001）和疾病负担（rho=-0.433;P<0.001）与SDI密切相关。患病率随着年龄的增长而下降，但是DALY率随着年龄的增长而增加，并在90岁左右达到峰值。DLC的患病率在世界范围内下降，在大多数国家，但DLC诱导的结直肠癌的疾病负担在全球超过40%的国家增加。
结论：社会人口统计学水平较低的国家和男性人群更有可能经历DLC和相关疾病负担的风险。改善膳食钙摄入的相关措施需要解决饮食中与低钙相关的健康问题。
方法：我们使用了2019年全球疾病负担研究（GBD2019）的数据，按年龄估算了1990年至2019年204个国家DLC的患病率和健康负担，性别,和社会人口统计学指数(SDI)。这些估计是在DisMod-MR2.1中产生的，这是一个贝叶斯元回归工具。摘要暴露值（SEV）用于显示DLC的患病率，而疾病调整生命年(DALY)用于代表疾病负担。估计DLC诱导的结直肠癌的疾病负担。采用Spearman秩相关进行相关分析，估计的年度百分比(EAPC)用于反映时间趋势。
结果：从1990年到2019年，DLC的全球患病率下降（SEV的EAPC，-0.47；95%CI，-0.5至-0.43），但在大洋洲地区和许多国家有所增加，如阿拉伯联合酋长国，新西兰,Japan,和法国。与低钙相关的全球DALYs估计为314万(95%不确定区间(UI)，2019年2.25-426万），年龄标准化率为38.2（95%UI，27.2-51.8）每100,000。与流行程度不同，全球年龄标准化DALY率保持不变(EAPC，-0.03；95%CI，-0.12至0.07），但是在204个国家中的80多个国家中，主要位于亚洲，非洲,和南美洲。在所有年份和地区，男性的年龄标准化SEV和DALY率高于女性。与低钙饮食相关的患病率（rho=-0.823;P<0.001）和疾病负担（rho=-0.433;P<0.001）与SDI密切相关。患病率随着年龄的增长而下降，但是DALY率随着年龄的增长而增加，并在90岁左右达到峰值。DLC的患病率在世界范围内下降，在大多数国家，但DLC诱导的结直肠癌的疾病负担在全球超过40%的国家增加。
结论：社会人口统计学水平较低的国家和男性人群更有可能经历DLC和相关疾病负担的风险。改善膳食钙摄入的相关措施需要解决饮食中与低钙相关的健康问题。
