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Abstract：
BACKGROUND: The prevalence of stroke disability associated with high BMI has significantly increased over the past three decades. However, it remains uncertain whether high body-mass index (BMI) exerts a similar impact on the disease burden of different stroke subtypes. The aim of this study is to assess the long-term trends of stroke and subtypes mortality attributable to high BMI in China between 1990 and 2019.
METHODS: Data on stroke and subtypes mortality attributable to high BMI in China was extracted in the Global Burden of Disease (GBD) 2019. The trends of age-standardized mortality rate (ASMR) were calculated using the linear regression and age-period-cohort framework.
RESULTS: The changing trend of ASMR on stroke attributable to high BMI in China differed among subtypes, with an estimated annual percentage change (EAPC) and 95%CI of 2.04 (1.86 to 2.21) for ischemic stroke (IS), 0.36 (-0.03 to 0.75) for intracerebral hemorrhage (ICH), and - 4.62 (-5.44 to -3.78) for subarachnoid hemorrhage (SAH). Net and local drift analyses revealed a gradual increase in the proportion of older people with IS and a gradual increase in the proportion of younger people with hemorrhagic strokes. The cohort and period rate ratios varied by subtype, showing an increasing trend for IS and ICH but a decreasing trend for SAH. The stroke mortality attributable to high BMI increased significantly with age for IS and ICH, peaking between ages 50-70 for SAH. Notably, males had higher ASMR related to stroke but exhibited slighter declines or higher growth compared to females in China. Moreover, the population affected by fatal strokes tended to be older among females but more evenly distributed across a wider age range encompassing both younger and older individuals.
CONCLUSIONS: The research findings indicate a rising trend in the ASMR of stroke and subtypes attributable to high BMI in China from 1990 to 2019, with different patterns of change for different subtypes, genders and ages. Consequently, it is imperative for public health authorities in China to formulate guidelines for specific stroke subtypes, genders and ages to prevent the burden of stroke attributable to high BMI.
METHODS: Data on stroke and subtypes mortality attributable to high BMI in China was extracted in the Global Burden of Disease (GBD) 2019. The trends of age-standardized mortality rate (ASMR) were calculated using the linear regression and age-period-cohort framework.
RESULTS: The changing trend of ASMR on stroke attributable to high BMI in China differed among subtypes, with an estimated annual percentage change (EAPC) and 95%CI of 2.04 (1.86 to 2.21) for ischemic stroke (IS), 0.36 (-0.03 to 0.75) for intracerebral hemorrhage (ICH), and - 4.62 (-5.44 to -3.78) for subarachnoid hemorrhage (SAH). Net and local drift analyses revealed a gradual increase in the proportion of older people with IS and a gradual increase in the proportion of younger people with hemorrhagic strokes. The cohort and period rate ratios varied by subtype, showing an increasing trend for IS and ICH but a decreasing trend for SAH. The stroke mortality attributable to high BMI increased significantly with age for IS and ICH, peaking between ages 50-70 for SAH. Notably, males had higher ASMR related to stroke but exhibited slighter declines or higher growth compared to females in China. Moreover, the population affected by fatal strokes tended to be older among females but more evenly distributed across a wider age range encompassing both younger and older individuals.
CONCLUSIONS: The research findings indicate a rising trend in the ASMR of stroke and subtypes attributable to high BMI in China from 1990 to 2019, with different patterns of change for different subtypes, genders and ages. Consequently, it is imperative for public health authorities in China to formulate guidelines for specific stroke subtypes, genders and ages to prevent the burden of stroke attributable to high BMI.
摘要：
背景：在过去的三十年中，与高BMI相关的卒中残疾患病率显著增加。然而,高体重指数(BMI)对不同卒中亚型的疾病负担是否有相似的影响仍不确定.这项研究的目的是评估1990年至2019年间中国高BMI导致的卒中和亚型死亡率的长期趋势。
方法：在2019年全球疾病负担（GBD）中提取了中国高BMI导致的卒中和亚型死亡率数据。使用线性回归和年龄-时期-队列框架计算年龄标准化死亡率（ASMR）的趋势。
结果：中国高BMI导致的卒中ASMR的变化趋势在不同亚型之间存在差异，缺血性卒中（IS）的估计年度变化百分比（EAPC）和95CI为2.04（1.86至2.21），0.36（-0.03至0.75）用于脑出血（ICH），蛛网膜下腔出血（SAH）为-4.62（-5.44至-3.78）。净和局部漂移分析显示，患有IS的老年人比例逐渐增加，出血性中风的年轻人比例逐渐增加。队列和周期比率因亚型而异，IS和ICH呈增加趋势，而SAH呈下降趋势。由于高BMI导致的卒中死亡率随着IS和ICH年龄的增加而显著增加，SAH的年龄在50-70岁之间。值得注意的是,与中国女性相比，男性与卒中相关的ASMR较高，但表现出较小的下降或更高的增长。此外，受致命性中风影响的人群在女性中往往年龄较大,但在更广泛的年龄范围内分布更均匀,包括年轻人和老年人.
结论：研究结果表明，从1990年到2019年，中国高BMI导致的卒中和亚型的ASMR呈上升趋势，不同亚型的变化方式不同。性别和年龄。因此,中国公共卫生当局必须制定针对特定卒中亚型的指南，性别和年龄，以防止中风的负担归因于高BMI。
方法：在2019年全球疾病负担（GBD）中提取了中国高BMI导致的卒中和亚型死亡率数据。使用线性回归和年龄-时期-队列框架计算年龄标准化死亡率（ASMR）的趋势。
结果：中国高BMI导致的卒中ASMR的变化趋势在不同亚型之间存在差异，缺血性卒中（IS）的估计年度变化百分比（EAPC）和95CI为2.04（1.86至2.21），0.36（-0.03至0.75）用于脑出血（ICH），蛛网膜下腔出血（SAH）为-4.62（-5.44至-3.78）。净和局部漂移分析显示，患有IS的老年人比例逐渐增加，出血性中风的年轻人比例逐渐增加。队列和周期比率因亚型而异，IS和ICH呈增加趋势，而SAH呈下降趋势。由于高BMI导致的卒中死亡率随着IS和ICH年龄的增加而显著增加，SAH的年龄在50-70岁之间。值得注意的是,与中国女性相比，男性与卒中相关的ASMR较高，但表现出较小的下降或更高的增长。此外，受致命性中风影响的人群在女性中往往年龄较大,但在更广泛的年龄范围内分布更均匀,包括年轻人和老年人.
结论：研究结果表明，从1990年到2019年，中国高BMI导致的卒中和亚型的ASMR呈上升趋势，不同亚型的变化方式不同。性别和年龄。因此,中国公共卫生当局必须制定针对特定卒中亚型的指南，性别和年龄，以防止中风的负担归因于高BMI。
